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Center for Integrative Medicine, Spring 2012

Chiropractic Care: Safe for Sprains, Strains and Pains

Chiropractors are moving into the medical mainstream, but wellness chiropractors offer something extra. Wellness chiropractors “consider the whole patient, not just the area that hurts,” says Anthony J. Wyrwas, DC, DACRB, DAAPM, CCSP, CSCS, who joined the Center for Integrative Medicine in April.

Primary care with a twist

Chiropractic physicians provide primary care but focus on muscles, ligaments, joints, nerves and surrounding tissues. They work with primary care doctors and specialists to relieve pain from new and old injuries and from chronic and acute conditions.

Chiropractors are especially skilled at treating:

  • Back and neck pain
  • Pelvic pain
  • Shoulder, elbow and wrist pain
  • Hip, knee and ankle pain

However, they do not prescribe medications. Dr. Wyrwas — a wellness chiropractor, sports chiropractor and certified strength and conditioning specialist — relies instead on corrective exercises, home exercise prescriptions and soft-tissue work. He also can advise patients on how to lose weight to relieve joint pressure and correct posture.

The chiropractor’s tools of the trade include:

  • Exercise prescriptions to increase muscular endurance, improve overall function and reduce stresses on the body
  • Soft-tissue therapy, including active release therapy, myofascial release therapy or cross-tissue friction massage
  • Joint bracing and taping with KinesioTape or Leukotape
  • Mobilization and manipulation of the spine and joints

Spinal manipulation, or adjustments, date back to ancient Egypt and were once the chiropractor’s stock-in-trade. But that is longer the case. “I only adjust 30 to 50 percent of my patients now,” says Dr. Wyrwas.

Gain without pain

“Treatments generally do not hurt,” he says. “Everyone has a full exam and workup first. The treatment prescription is based on what is best for the patient and what the patient is most comfortable with.”

Experienced chiropractic physicians easily make adjustments for patients with complex conditions including high blood pressure and diabetes. For example, patients on certain blood thinners should steer clear of manipulation. “No problem,” says Dr. Wyrwas. “We work around that in conjunction with the patient’s medical doctor or primary care physician.”

Some patients with chronic pain respond to manipulation under anesthesia, a treatment that Dr. Wyrwas administers in the hospital.

Chiropractic visits can be short-term or long-term. The great majority of chiropractic services are covered by insurance companies, which consider chiropractic care to be cost-effective.

For an appointment with Dr. Wyrwas, please call 216.986.HEAL (4325).

No Need to Greet Spring With a Sneeze — Help Is Available

As the spring landscape unfolds, budding brings misery along with beauty if you’re allergic to pollen.

Pollen can travel for miles. Inhaling it when you have seasonal allergies, or hay fever, can trigger an immune reaction. Your cells release a chemical called histamine. You sneeze. Your nose runs. Your eyes water and itch.

Symptoms can last for weeks or months. But with changing weather patterns, pollen seasons overlap, and symptoms last longer.

The good news is that you don’t have to rely on antihistamines or suffer their side effects to feel better.

Homeopathic and herbal remedies

“Daily nasal rinsing with a neti pot can also help allergy sufferers. Be sure to use sterile water,” says Center for Integrative Medicine physician Brenda Powell, MD. “Allergy sufferers may also wish to try the herb butterbur. It comes in standard pill form and can be taken up to three times a day for symptoms of hay fever such as sneezing and congestion.”

Double-blind studies have found that butterbur was more effective than placebo and as effective as the popular drug Allegra® in reducing seasonal allergy symptoms.

Acupuncture also effective

In addition, the world health organization endorses acupuncture to treat allergic rhinitis, including hay fever. Researchers are trying to understand how acupuncture — an ancient Chinese therapy using hair-thin needles placed in the body for therapeutic effect — helps relieve conditions like allergies.

“One study looking at a group of 45 participants with hay fever demonstrated that acupuncture worked just as well as an antihistamine, and the effects lasted longer,” notes Jamie Starkey, LAc, Lead Acupuncturist for the Center for Integrative Medicine.

“Another study published in Pediatrics in 2008 found acupuncture to be effective in decreasing allergy symptoms in children, with no serious side effects reported.”

Get a head start

The effects of acupuncture are cumulative, so visits once a week for five to 10 weeks are recommended. “The sooner you begin acupuncture before your allergy season begins, the better,” says Ms. Starkey.

Once you’ve completed a course of acupuncture, you’ll be evaluated to see how well your symptoms have diminished. Once the peak effect is achieved, acupuncture visits are tapered. You may continue them every two to three weeks, every few months, or on an as-needed basis.

Acupuncture treatments are provided in the Center for Integrative Medicine at our Lyndhurst campus, Avon Family Health, Strongsville, Broadview Heights, Main Campus and Sports Health Facility.

To make an appointment for acupuncture or to see Dr. Powell, call 216.444.HEAL (4325).

Wellness Store Products Can Help You Manage Hay Fever

The Cleveland Clinic Wellness Store offers products that can help you manage seasonal allergies, or hay fever:

  • Himalayan Institute Neti Pot™, Sinus Spray and Aromatherapy Inhaler. This line of products removes excess mucous, and washes away pollen, dust and nasal/sinus irritants
  • Sprayology® Allergease Homeopathic Oral Spray. This FDA-regulated spray temporarily relieves allergy and hay fever symptoms such as runny nose, itchy eyes, rash, headache and sneezing
  • La Roche-Posay™ Toleriane Facial Cream and Thermal Spring Water. This line of facial cleansers and moisturizers are fragrance-free for people with sensitive skin
  • 21 Drops Decongest Essential Oil. This blend of Ravintsara, eucalyptus, black pepper and myrrh oils can release congestion, reduce fever and stimulate the immune system
  • CleanRest® Allergen-Barrier Pillows, and Mattress and Pillow Encasements. These pillows and cases block dust mites and other allergens, as well as bed bugs. They are also water-resistant.

The Cleveland Clinic Wellness Store is located on our main campus on the first floor of Building H. Some of these products are available online at

How You Can Manage Your Gluten Intolerance

By Christine Spiroch, PhD, PA-C

Research shows that approximately 70 percent of the U.S. population has an adverse reaction to gluten. Gluten is found in wheat, barley, rye and other grains such as kamut and spelt. Reactions include:

  • Constipation
  • Diarrhea
  • Gas and bloating
  • Abdominal pain
  • Joint pain
  • Migraines
  • Fatigue
  • Asthma and eczema
  • Anemia
  • Failure to thrive
  • Sinusitis

Reactions to gluten are described in three ways:

  1. Gluten intolerance: Intolerance suggests vague symptoms such as abdominal pain and that no testing has been done.
  2. Gluten allergy: Allergy suggests that testing has been done and reveals a positive reaction to gluten.
  3. Celiac disease: Celiac disease describes the autoimmune form of gluten intolerance. This means that the body’s immune defenses see gluten as a foreign substance. Celiac disease is confirmed by blood tests or biopsy (a sampling of tissue in the large intestine). A diagnosis calls for lifelong avoidance of gluten.

Gluten reactions are usually delayed from several hours to several days after ingestion. In contrast, the allergic response to peanuts, strawberries or shellfish is generally more immediate, occurring seconds to hours after ingestion. Delayed allergic responses affect quality of life, while immediate allergic responses can be life-threatening (causing a severe reaction called anaphylaxis).

Several types of blood tests are available to identify gluten intolerance, gluten allergy and celiac disease.

Trial of diet may improve symptoms

Treatment for gluten intolerance, gluten allergy and celiac disease begins with trial of a gluten-free diet. Patients may not recognize that gluten is responsible for their symptoms because they have learned to live with them and regard them as normal.

Patients start following a gluten-free diet for five to seven days to see if they notice a difference in symptoms. For many patients, trial of a gluten-free diet yields a positive response in symptom management.

If symptoms do not improve and tests results do not support maintaining a gluten-free diet, then patients may reintroduce gluten into their diets and watch for previous symptoms to return. Other potential causes for their symptoms are then pursued, such as intestinal bacteria overgrowth, Candida or other food allergies.

Diet benefits others too

Gluten-free foods have become much more palatable and available over the past 10 years as word of their benefits has spread. A gluten-free diet may benefit those who are unaware of or have not been diagnosed with gluten allergy.

For example, joint pain is often considered a normal part of aging, but nowhere does it say that joint pain automatically develops after a certain age. Anyone with joint pain who doesn’t want to take medication may be pleasantly surprised by a trial of a gluten-free diet. Eliminating gluten may relieve their symptoms.

Similarly, patients with a family history of stomach disorders may believe that constipation, diarrhea gas and/or bloating simply "run in the family.” Eliminating gluten in the diet may relieve abdominal symptoms in people who never considered them abnormal.

Gluten-Free Products Available

Cleveland Clinic’s Wellness Store offers many gluten-free products, including:

  • Popcorn Indiana®
  • Popcorners® Popped Corn Chips
  • Larabar® Food Bars
  • Think Thin® Protein Bars
  • Blue Diamond® Baked Nut Chips
  • Eat Your Vegetables™ Chips
  • Rhythm™ Kale Chips
  • Pure Organic™ Bars

The Cleveland Clinic Wellness Store is located on our main campus on the first floor of Building H.

Lifestyle 180 Chia Muffins

"Chia is a great-tasting whole grain that makes foods moist by absorbing 10 times its weight in water and with its own healthy omega-3 fat."

Michael Roizen, MD, Chair, Wellness Institute, and Chief Wellness Officer, Cleveland Clinic


1 tablespoon ground chia seeds
1-1/2 cups whole wheat flour
2 teaspoons ground cinnamon
½ teaspoon ground nutmeg
2 teaspoons baking soda
½ teaspoon salt
15 ounces canned pumpkin
¼ cup canola oil
2 tablespoons agave nectar
1 tablespoon vanilla extract
¾ cup chopped walnuts
¼ cup water or no-sugar-added apple juice
1 cup fresh apple, peeled and grated (5-1/2 ounces by weight)
(grate apple on large-hole side of the grater)

  1. Preheat oven to 350°F.
  2. Combine the chia seeds, flour, cinnamon, nutmeg, baking soda, and salt. Mix with a wire whisk.
  3. In a separate bowl combine pumpkin, canola oil, agave nectar, vanilla, walnuts, and water or juice. Mix, and then fold into dry ingredients.
  4. Fold in the grated apple.
  5. Scoop into paper cups in muffin tins and bake for 33 minutes, or until inserted toothpick comes out clean.
  6. Remove from muffin tin and cool on wire rack.

Makes 12-14 muffins; 150 calories per muffin.

What’s in it for you?

Total fat 9 g
Saturated fat 1 g
Healthy fats 8 g
Fiber 3 g
Carbohydrates 16 g
Sugar 4 g
Protein 3 g
Sodium 270 mg
Calcium 29 mg
Magnesium 36 mg
Selenium 10 mcg
Potassium 152 mg

From the book: YOU on a Diet, by Michael F. Roizen, MD and Mehmet C. Oz, MD