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Center for Integrative Medicine, Summer 2013

Don’t Let ‘Text Neck’ Get the Best of You

Five years ago, Center for Integrative Medicine chiropractor Andrew Bang, DC, saw an increase in teens with neck pain. Not surprising, he sees patients of all ages today for what he calls “text neck” — and hopes that spreading the word will make the problem disappear.

Dr. Bang first noticed it in his waiting room. “Patients complaining of neck pain were sitting with their chins on their chests, looking at their smartphones,” he says.

Trouble with the curve

The neck normally has a “banana-like curve” that helps distribute the weight of the head onto the discs between the neck vertebrae, he explains. Constantly looking down at a smartphone, tablet or laptop causes the neck to straighten, losing this curve.

Loss of this curve causes an uneven distribution of the weight of the head on the neck. This leads to overstretched extensor muscles on the back of the neck and overstrengthened flexor muscles on the front of the neck. This constant imbalance leads to problems like poor posture, neck pain, numbness, headaches, migraines and more.

How chiropractors can help

As a chiropractor, Dr. Bang has advanced training in muscle work and extremity manipulation and treats every type of joint pain. When he sees patients with “text neck,” he prescribes massage therapy and uses exercises to strengthen the extensor muscles and stretch the flexor muscles.

“I will massage and adjust patients but that doesn’t fix the problem,” he says. “Patients have to change their behavior or they will undo the treatment they are receiving.”

Hold the phone: Here’s how to do it

He gives patients these neck-friendly tips for viewing smartphones, tablets and computers:

  • Smartphones: Rest your right elbow on your side, and hold the phone with your right hand. Use your left arm to support the right so you can hold the phone comfortably.
  • Tablets: Sit with your back against a couch, chair or wall. Bring your knees up and rest your elbows on them as you hold the tablet.
  • Computers: When using a desktop, adjust your computer screen so that it’s eye-level and an arm’s length away.
Keep up the good habits

These good habits will reduce aggravating neck problems and keep “text neck” from recurring.

In contrast, continuing to constantly look down at smartphones, tablets and computers can wear out the discs in the neck, eventually leading to herniated discs or arthritis.

“Awareness is the best solution. Computers are never going away, so we have to try to adapt and become ergonomically sound,” says Dr. Bang. “If you can correct a few of these habits and spend more time with good posture rather than poor posture, you will aggravate your neck less often.”

To see Dr. Bang for any type of joint pain or for migraines, please call Cleveland Clinic’s Center for Integrative Medicine, please call 216. 986.HEAL (4325).

Acupuncture Beneficial for Lingering Concussion Symptoms

By Jamie Starkey, LAc

If you think you may have suffered a concussion, it’s crucial to seek medical attention immediately. When concussion symptoms linger (called post-concussion syndrome), care from different medical specialties — including integrative medicine — may help.

The initial symptoms of concussion are dizziness, lightheadedness, wobbling or stumbling, lack of concentration and focus, glazed eyes and slow responsiveness. Sometimes symptoms can linger for days, weeks, months and even years, leading to post-concussion syndrome.

A team approach to concussions

Athletes are most susceptible to concussions. Physicians in the Cleveland Clinic Concussion Center (from Cleveland Clinic Sports Health, the Neurological Institute, the Orthopaedics & Rheumatologic Institute and the Pediatric Institute) are establishing expert guidelines for concussion diagnosis, prevention, care and recovery.

The Center for Integrative Medicine has a unique relationship with Cleveland Clinic Sports Health physicians. Sports health physicians may prescribe traditional treatments for post-concussion syndrome, such as medication and physical therapy, or refer patients for psychotherapy.

Adding acupuncture to the mix

They also encourage some patients to try an integrative treatment option: acupuncture. Patients looking to expedite their recovery or who have not seen much progress with conventional treatment may find the relief they are looking for through acupuncture. Skilled acupuncturists in our Center for Integrative Medicine can address these post-concussion syndrome symptoms:

  • Lingering headache
  • Persistent dizziness
  • Insomnia
  • Unrelieved neck pain
  • Anxiety/depression
  • Fatigue

Acupuncture involves gently inserting very fine needles to stimulate or calm certain areas of the body, promoting a healing effect. During the first acupuncture appointment, the Center for Integrative Medicine acupuncturist performs a detailed assessment and suggests a treatment plan based on those findings.

Shared visits reduce costs

The plan may involve regular acupuncture visits to decrease overall symptoms, including pain scores if pain persists. Shared acupuncture medical appointments are an economical option, allowing you to experience the proven benefits of acupuncture at reduced cost. Individual appointments are $100, and insurance coverage for them varies. Shared appointments are $40.

To see an acupuncturist for ongoing concussion symptoms in an individual or shared appointment, please call the Center for Integrative Medicine at 216.986.HEAL (4325).

Treating Acid Reflux Without Medication

Discover 4 things that spell relief

If you suffer with frequent heartburn or acid indigestion, you may be one of millions of Americans with gastroesophageal reflux disease (GERD). Antacids and prescription acid blockers can help soothe symptoms, but long-term use can cause other health problems, according to Tanya Edwards, MD, of the Center for Integrative Medicine.

Your body needs stomach acid because:

Acid begins digesting food in your stomach. “If stomach acid doesn’t do its function, larger material can get into the small intestine and make digestion there more difficult,” says Dr. Edwards.

Acid helps sterilize the food you eat. Otherwise, “bad” bacteria and yeast on food can quickly overwhelm the “good” bacteria in your gut. That can lead to things like irritable bowel and leaky gut syndrome.

Certain nutrients, like calcium and B12, require acid for absorption. “People on long-term acid blockers have a higher incidence of bone fractures and B12 deficiency, which has been linked to anemia, neurological problems and depression,” says Dr. Edwards.

The real cause of GERD

For people with GERD, stomach acid isn’t the real problem. So taking acid-blocking drugs isn’t the real solution.

The problem is that the muscle (called the lower esophageal sphincter) between your esophagus and stomach doesn’t close adequately. This allows stomach acid to back up into the esophagus. It could be because the muscle is weak. Or it could be because there’s too much pressure on the muscle — due to extra weight around your middle or a buildup of food in your stomach.

Four ways to find relief without drugs

Dr. Edwards recommends alternative treatments, in this order:

  1. Cut out high-fat foods, smoking, caffeine and peppermint. These things relax the lower esophageal sphincter. Peppermint’s calming and numbing effect may be good for indigestion, nausea and other stomach ailments. But it’s not good for GERD, when you need to tighten your lower esophageal muscle.
  2. Work on losing weight, if needed. Obesity causes increased abdominal pressure that can push whatever is in your stomach up toward your esophagus. Reducing this pressure is an important long-term goal.
  3. Speed up digestion with enzymes. “After age 40, your pancreas produces less enzymes that help digestion in your small intestine,” says Dr. Edwards. “That slows down your entire digestive process, which can mean your stomach doesn’t empty as quickly.” Digestive enzymes, available at any health food store, can keep things moving.
  4. Counter bad bacteria with probiotics. Some studies have linked GERD to certain bacteria in the stomach and esophagus. Getting a dose of “good” bacteria in probiotics can help offset these “bad” bacteria.

“Usually, I’ll recommend a combination of probiotics and digestive enzymes,” says Dr. Edwards. “This alone has taken care of GERD symptoms in 75 percent of my patients and has allowed them to begin weaning off of acid-blocking drugs.”

For some patients, GERD is caused by food intolerance. Cutting out wheat, dairy, nuts or eggs may resolve it. Acupuncture also can be effective, adds Dr. Edwards.

“In integrative medicine, our goal is to treat the underlying problem,” she notes. “These treatments address the root cause of GERD instead of masking its symptoms with medications that may cause future complications.”

To talk to one of our physicians about alternative treatments for acid reflux or GERD, call the Center for Integrative Medicine at 216.986.HEAL (4325).

Recipe: Black Bean Hummus


30 ounces canned black beans, unsalted and fat-free
1 tablespoon tahini sesame butter
4 teaspoons fresh lemon juice
1 tablespoon ground cumin seeds
½ teaspoon table salt
1 teaspoon garlic powder
1 teaspoon light soy sauce

  1. Combine ingredients Vitamix or food processor and blend.
  2. Serve with fresh veggies and gluten-free crackers.
Nutrition Information

Serving size: 2 tablespoons

Calories: 25
Total fat: 0 g
Saturated fat: 0 g
Trans fat: 0 g
Cholesterol: 0 mg
Sodium: 50 mg
Total carbohydrate: 4 g
Dietary fiber: 1 g
Sugars: 0 g
Protein: 2 g

New Integrative Medicine Physician Joins Our Staff

The Center for Integrative Medicine is pleased to welcome integrative medicine physician Lyla Blake-Gumbs, MD, MPH, who sees patients at our Lyndhurst campus.

Dr. Blake-Gumbs is an integrative medicine specialist with an interest in energy balance and chronic illness. She is Assistant Professor of Family Medicine at Case Western Reserve University (CWRU) School of Medicine.

After graduating from Hahnemann University School of Medicine in Philadelphia, Dr. Blake-Gumbs trained in family medicine at the University of Texas Southwestern Medical Center at Dallas. She came to Cleveland as a training fellow at the Case Comprehensive Cancer Center and earned a Master of Public Health in Epidemiology and Biostatistics at CWRU.

Dr. Blake-Gumbs has done medical missionary work in the Amazon basin in Brazil. She is fluent in English, Spanish and Portuguese.

For a consultation with Dr. Blake-Gumbs, please call the Center for Integrative Medicine at 216.986.HEAL (4325).