Skip to main content

Pinpoint the Positive, People!

Pillow talk, anyone?

Date: July 17, 2017 | Time: 7:14am | Posted By: Christopher Renne

Hey Jacksonville, time for a little pillow talk!

Sorry for the pun, but I couldn't resist. But here is a serious question for you: when was the last time you thought about the pillow you lay your head on at night? You should, because it can impact you more than you might think!

First of all, a comfortable pillow can make it that much easier to get a good night's sleep. But even more importantly, it can help protect pain in your head, you neck, your shoulders, your hips and other problem areas. If you suffer from chronic pain in your joints, I recommend that you take a good hard look at that soft pillow!

Generally speaking, a good pillow should provide support to your muscles with support and keep your upper body in alignment. Your head should be aligned with the spine and curved forward slightly, just as it would be in a healthy resting position if you were awake. If your pillow is too high or too flat it keeps your neck out of alignment while you are sleeping. This causes muscle strain through your shoulders and cervical spine. Studies show that good pillows support the head at about 4-6" off the bed (this means you'll want to change your pillow regularly, as pillows flatten out over time).

There isn't one perfect pillow. Everybody will find different pillows that work best for them. Choosing the right pillow depends on a lot of factors. Your personal comfort level is the first! But another big factor is what position you sleep in.

Side sleepers

When you are lying on your side, your pillow should support your head so that your spinal column is a straight horizontal line. Because your head is heavy, you will want a firm pillow that gives it lots of support. Studies show that you should probably avoid feather pillows, since they compress the most. Use a soft pillow and you will feel it in your cervical spine the next day!

I want to note that if you are a side-sleeper, it's important that you also put a pillow between your legs. This will keep your hips from rotating while you sleep, pulling your spine out of alignment.

Back sleepers

The spine is naturally curved, so if you sleep in this position it is key to support your head and neck! When you're standing with a correct, neutral posture, your neck has a curve and your head is slightly forward. You want a pillow that maintains this same posture when you are sleeping. Back sleepers don't need as firm pillows as side sleepers do.

You may find that putting a second pillow under your knees helps alleviate back pain while you are sleeping in this position.

Front sleepers

As a chiropractor, I really wish that no one slept on their front side! Unfortunately, some of us are accustomed to it. When you sleep like this, you have to turn your face to the side in order to breathe. This means your head and neck are twisted wayout of alignment the whole night through, forcing your muscles to compensate.

If you are going to sleep like this, you want a very flat pillow under your head. You might even just sleep flat on the mattress. Placing a pillow underneath your pelvis can help your lower back. But to be honest, if it is even remotely possible, I recommend trying to switch to a side or back sleeping position. Sure, you'll have a few sleepless nights. But you might just save yourself some major back and neck pain down the road!

Can't decide

Do you switch it up during the night? Don't worry, there are pillows for you too! You can find pillows that have higher areas for side sleeping and lower areas for back sleeping. Give it a shot!

Types of pillows

There are so many pillows out there these days! Orthopedic pillows offer extra head support and are contoured to fit the curve of your neck. If you have cervical neck problems and are a back sleeper, this is a great solution. Some side-sleepers enjoy using body pillows, as one pillow can support their head and fit between their legs.

Your standard pillow is still an excellent choice, too. Standard pillows come with a number of different fillings to choose from including:

. Down or down-alternative

. Latex

. Memory foam

. Water

. Buckwheat hulls

The last option, Buckwheat hulls, is becoming popular among those with degenerative disc diseases and other severe spine problems.

But only you can decide what pillow feels truly comfortable and supportive. I'd recommend trying a few different types of pillows. You never know, you may come across something that gives that old pillow you've been using for years a run for its money! Wouldn't it be worth it for a good night's sleep?

At Active Medical and Chiropractic we have a selection of specialized pillows that you might find helpful if your current pillow isn't giving you the support you need. Ask us about it on your next visit!

Yours in health,


Christopher B. Renne, D.C.

4111 Atlantic Boulevard

Jacksonville, FL 32207

<view entire article>

Hey, Doc, What kind of mattress do you recommend?

Date: July 6, 2017 | Time: 8:24am | Posted By: Christopher Renne

Hi, friends. Dr. Chris here to share with you some helpful tips to help you make the best possible decision when purchasing a new mattress. As a chiropractor, I am asked to provide input on this on a daily basis, often multiple times a day. And here's what I have found: There is no correct answer to the question. Rather, the question itself prompts many more queries to get to a possible right answer ro a very loaded question.

My friends at have created a comprehensive approach to finding a sleep solution that will likely work best for you. Below, you will find educational material provided by Tuck that may help you find the perfect answer to your sleep needs.

What is the best mattress for back pain?

A healthy spine serves three main functions:
  • It protects the spinal cord, considered the body's communication system, the nerve roots, and the internal organs of the body.
  • It provides structural support for an upright posture.
  • It facilitates flexible movement.
An unhealthy spine means an unhealthy body and mind. The spinal column needs proper support at night. A well-chosen mattress can help in the maintenance of proper posture.
The Mayo Clinic advises that "there doesn't doesn't appear to be one type of mattress that's best for people with back pain." Instead, a helpful mattress is "a matter of what feels most comfortable to you." According to a report by the National Institutes of Health, "having a comfortable mattress and pillow can help promote a good night's sleep."
In the 2015 Sleep in America poll by the National Sleep Foundation, people with acute and chronic pain reported that environmental factors often disturbed their sleep. The environmental factors that affect quality of sleep included noise, light, temperature, and, indeed, an uncomfortable mattress.
While no one type of mattress is a fix for all, in general, a firmer mattress-one that supports the spine at all points throughout its natural curve-is preferred by back sufferers. According to, an independent, peer-reviewed website whose contributors are medical doctors and doctoral degree holders, a firm mattress can work, but it some mattresses can be too hard. In those cases, "it can cause aches and pains in pressure points such as the hips."
The caution about a mattress that's too firm was confirmed by a peer-reviewed study published by the medical journal The Lancet. Researchers tested 313 adults with chronic, nonspecific low-back pain and who complained about back ache when sleeping and upon rising found that after 90 days. Some of them were randomly assigned firm mattresses and others medium-firm mattresses. Mattresses of medium firmness improved pain and disability among patients with chronic nonspecific lower back pain. Doctors and manufacturers agree that if a mattress helps you sleep well and wake up rested, regardless of its firmness and composition, it's a good mattress for your specific back pain.

What to look for when buying a mattress?

Buying a mattress is a significant and consequential expense, so it is best to try out a mattress before committing to it. Does this mean that a mattress from a box is out of the question? Not at all, if the manufacturer offers the standard 100-day money-back guarantee. A hundred days is a much more thorough inspection period than whatever customers can find out during the time they spend trying out mattresses at a store.
There are four key factors to consider when buying a mattress:
  • Spinal alignment
    • Maintaining the natural curve of the back helps promote restful sleep. This means that the back ought not to be excessively arched, but not flat either. Some of this can be accomplished with an appropriate sleeping position.
    • For back sleepers, placing a small pillow under the knees and a flatter pillow under the lower back will reduce pressure on the spine.
    • Sleeping on the stomach is not recommended for back pain sufferers because it does not preserve the curvature of the spine. But for those who cannot help but sleep that way, using a flat pillow or no pillow at all for the head is recommended. Some doctors also advise placing a small flat pillow under the stomach, hips, pelvis.
    • For side sleepers, placing a pillow between the knees in a way that promotes the alignment of the hip bones can bring relief. The American Academy of Family Physicians points to this position as the healthiest for low back pain. It advises sleeping with knees bent and a pillow under the head and neck and a pillow between the knees.
    • Mayo Clinic offers a helpful slide show showing positions that promote pain-free backs.
    • In addition to smartly situating our bodies during sleep, mattresses can play a role in promoting the proper alignment, too.
    • In 2015, Consumer Reports found that medium-firm to firm mattresses tend to promote the natural curvature of the spine. For back sleepers, mattresses that best accomplished this goal ranged from an innerspring mattress (not the best choice for those back sleepers who tend to roll over to their sides), memory foam beds dubbed by the manufacturers as "ultra firm," which CR found to be medium firm, to adjustable air mattresses (which are also good for those who occasionally roll over to their sides).
    • The American Academy of Family Physicians recommends using a firm mattress to promote the proper alignment. This recommendation is, however, is challenged by some data, including the already mentioned Lancet study.
    • Medium-firm to firm mattress can work well for those who end up sleeping on their stomachs or for larger people (those weighing 230 pounds and above) who need more resistance to hold up their weight. But some softness-provided by a pillow top, for example-is often needed to cushion the shoulder and hip bones of side sleepers. A mattress that is too firm can "push on [the] main pressure points and take you out of alignment," according to Arya Nick Shamie, associate professor of orthopedic surgery and neurosurgery at Santa Monica UCLA Medical Center. "If it's too soft, those pressure points won't be properly supported, so your whole body flops back."
  • Comfort
    • Comfort is the most subjective of criteria. How comfortable a mattress is amounts, ultimately, to one consideration: who sleeps on it.
    • One size doesn't fit all. Yes, some universal basic considerations apply-the mattress should support the natural curve of the spine and, as a result, most doctors and sleep experts recommend medium-firm mattresses. But if a softer mattress offers the kind of cushioning and buoyancy that consistently relieve the back pain of some sufferers, it would make little sense for them to switch to a firm mattress. Smaller people (under 120 pounds) often find softer mattresses enough to provide an appropriate support to their frames.
  • Pressure point relief
    • The areas of the body that are particularly sensitive to pressure are known as pressure points. They can often be felt in bony areas. People suffering from fibromyalgia are particularly prone to developing areas of tenderness.
    • Any mattress that distributes the sleeper's weight evenly throughout works to relieve the pressure points.
  • Temperature
    • Does the comfort layer of the mattress have a cooling effect? Or does it hold your body heat and leave you sweaty and uncomfortable? These questions have become increasingly important to mattress shoppers. The National Institutes of Health counsels cooler temperatures for sleep. Cooling increases blood flow, and that, in turn, leads to oxygenation.
    • Memory foam, especially in its earliest forms, had the problem of enveloping the body with too much heat and was particularly bad for the sleepers prone to hot flashes or night sweats or who lived in warmer climates. Mattress technology has advanced to address this issue through techniques like body temperature-absorbing materials (phase change materials or PCMs), and through the use of cooling gels, copper, or other materials in the top layer. Cooling mattress toppers, bought separately, too, purport to offer the same remedy.
    • When Consumer Reports tested mattresses, it found that gel does not provide a cooler sleep. The mattresses with "a layer of gel-infused foam that's supposed to provide a cooling effect" do not have that effect because "that layer is buried beneath other layers," the testers reported. "While our tests have shown that innerspring mattresses containing gel did tend to sleep slightly cooler, the reverse was true with gel-infused foam beds."

How do various mattress types relate to back pain?

Memory foam mattresses conform to the body in response to weight and heat.

  • Pros:
    • Even distribution of the body weight and in turn relieve pressure points.
    • Motion isolation
  • Cons:
    • Offgassing
    • Little support for stomach sleepers
    • Too much firmness can aggravate pressure points

Innerspring or coil mattresses rely on springs or coils to provide support.

  • Pros:
    • Firmer support
    • Good for heavier people and stomach sleepers
  • Cons:
    • Motion transfer

Hybrid mattresses can offer the best of all worlds, combining coils with a top layer of foam or latex, or both foam and latex.

  • Pros:
    • Deliver the medium firmness preferred by back pain sufferers
    • Better at cradling the body than the innerspring mattresses
    • Provide more buoyancy than memory foam mattresses
  • Cons:
    • Hybrid mattresses tend to be quite expensive
    • Salespeople sometimes falsely claim that the more coils the better the mattress.

Latex mattresses are made from either synthetic or natural rubber.

  • Pros:
    • Tends to be firmer than foam
    • Does not heat up as easily as other materials
    • High point elasticity means more comfort and pressure point relief
  • Cons:
    • Some sleepers are allergic to latex
    • Motion transfer is sometimes an issue
    • Some latex gives off an odor similar to that of a wet band-aid

Airbed mattresses that use adjustable air-filled chambers instead of coils and are topped with foam.

  • Pros:
    • Pressure can be adjusted throughout the mattress
    • Bed-sharing partners can have the kind of firmness they each want
  • Cons:
    • In cheaper airbeds, with fewer air chambers, a big air "bubble" can pop up when someone sits or lays down on the other side of the bed
    • Can be expensive
In addition to mattress type, another factor to which back pain sufferers need to pay attention is the frequency of replacing the mattress. Watch for signs of age such as sagging and how long, it takes for the mattress to recover from body impressions. The conventional advice is to replace the mattress every eight years. However, chronic back pain sufferers might need to replace their mattresses more frequently.
I hope you find this information of value when you start your search for the ideal sleeping solution. Thank you to the folks at and to Kellen Smith for sharing this information.
Until next time, be well, friends in Jacksonville and beyond!
All the best,

Dr. Christopher Renne
A Jacksonville, Florida based Board Certified Chiropractic Physician specializing in the treatment of spinal and extraspinal pain syndromes. Dr. Renne can be reached via email at

<view entire article>

Easy to Implement Tips for Better Sleep

Date: June 19, 2017 | Time: 9:34am | Posted By: Christopher Renne

From the Desk of Christopher B. Renne, DC

Hey there, Jacksonville! Let's talk about sleep. Are you getting enough? Too many people are not!

And that's a problem, because lack of sleep has been linked to everything from mood swings to pimple breakouts to weight gain to poor memory to a weakened immune system, and even to vision problems. The fact is, our bodies need sleep to function in a normal, healthful manner.

But sometimes you might have trouble sleeping. It could be due to stress, or chronic pain, or some other issue. Maybe you toss and turn but just can't fall asleep. Maybe you wake up at 4 AM and find yourself just lying there until the alarm goes off. Maybe you sleep through the night but you're still waking up exhausted.

Whatever the case may be, here are some tips to help you get those forty winks.

1. Give yourself a chance to wind down before bed

What are you doing right before you switch off the lights? Checking work emails? Watching TV? Playing video games?

These are all fine activities on their own, but they stimulate your brain rather than sedate it. If you are doing these kinds of things right before bedtime, experts strongly recommend that you take a break. Give yourself an hour before bed to start winding down - and you should probably make sure that hour is electronics free.

Many people find that establishing a relaxing bedtime ritual also promotes sleep. See what works for you. Bedtime is an excellent chance to spend time with a good book!

2. Don't stay in bed if you aren't sleeping

This one is as simple as it sounds: if you can't sleep after lying there for 20-30 minutes, get out of bed.

Lying there worrying that you can't get to sleep will probably not help you get to sleep! Get up and engage in some calm activity that won't overstimulate you (don't turn on that TV!). Have a cup of non-caffeinated tea or a glass of warm milk. Read some more of that book. When you feel gravity dragging your head toward your pillow it's time to fall back into bed, hopefully this time to sleep.

3. Keep a regular sleep schedule

If you're like many people, you stay very busy on weekdays and so on the weekends you sleep in as much as possible. Or perhaps you simply find yourself going to bed at different times every night. Both of these patterns can lead to poor sleep. Going to bed at roughly the same time every night and waking up at a normal hour, even on weekends, can help you get more consistent restful sleep.

That doesn't mean you have to get up at 7 AM on Saturday. But sleeping half the day away can wreak havoc on your sleep schedule and leave you feeling tired and drained come Monday morning.

4. Exercise daily

If you've been sitting in an office all day, your body may still have pent-up energy to burn come bedtime. That could make getting to sleep difficult. A vigorous workout - not too close to bedtime - can exhaust your body and your mind and help you get those badly needed Z's.

5. Consider your sleep environment

There may be simple changes you can make in your bedroom that will help you get a good night's sleep. Here are some ideas to consider:

. Blackout curtains on the window can block out external light sources which keep you awake.

. A white noise machine helps lull some people to sleep.

. Make sure your bedroom is nice and cool. Too warm and you may have trouble staying asleep.

. Is your pet waking you up at 2 AM every night? Your little fluff ball may need to sleep somewhere other than your bedroom.

. Make sure your pillows are comfortable. Replace them regularly.

. Make sure your mattress is doing the job. Most mattresses need to be replaced once every ten years or so.

Believe it or not, Active Chiropractic and Medical has a number of ways to help people with pain sleep at night. Perhaps there is a special pillow or mattress that might make you more comfortable. Or maybe you just need help with pain. If aches and pains are keeping you awake, come in and see us!

Here is wishing you a good night's sleep, Jacksonville!

renne 199x300

Yours in health,

Christopher B. Renne, D.C.

4111 Atlantic Boulevard

Jacksonville, FL 32207

904-398-4860 <view entire article>

What do I do if I'm in an accident?

Date: June 12, 2017 | Time: 10:27am | Posted By: Christopher Renne

Hello, friends and patients,

Here is something to think about: When was the last time you were in a car accident?

Car industry studies show that on average a driver is in an auto collision once every 17.9 years. So if you've had a clean driving record for a couple of decades, watch out - you're overdue!

Almost everyone who gets behind the wheel of an automobile will, sooner or later, be in an accident. Even if you are a terrific driver! When it does happen, you may be shaken up and not sure what to do next. So it really pays to plan ahead! Here are a few steps to take after you've been in an accident:

1. Pull over and call 911

This is always a good idea and should really be the first thing you do. Sometimes the other driver in the accident may try to talk you out of calling the authorities. Don't let them! 911 can dispatch medical help if required. They will also send a police officer to the scene. That officer can assess the whether everyone is safe, what was damaged, and make a determination of who was at fault.

2. Exchange information

If you are able to, try to collect critical information from everyone that was involved in the accident. That means names, driver's licenses, insurance information, and license plates. Don't forget that if you carry a smart phone, like most people do these days, you can use the camera on it to snap pictures of license plates other documents.

3. Document the scene

Still have that smartphone handy? Great, because it's a good idea to snap some pictures of the scene itself. Then, when the police arrive, make sure to ask if they will be filing a report. After that, it is time to call your insurance company and let them know you have been in a fender bender. Your pictures, phone call, and the police report help establish what happened for your auto insurance and any personal injury claims. Without it, it is your word against the other driver.

4. Consult a medical professional

Obviously if you are hurt you need immediate transportation to the hospital. If the collision was severe, you may even want to wait to move until paramedics arrive and evaluate you for spinal injuries. But even if you walk away from the accident feeling fine, you should consult a medical professional as soon as possible. Some injuries can take days to show up. This is especially true of back and neck injuries resulting from auto collisions. Don't assume that you're fine! The sooner you get checked out, the better.

So many of the folks that come through my door have pain and injuries resulting from a car accident. If you have been in an accident, I highly recommend you don't wait or take any chances. Call and make an appointment to see us today!

Yours in health,


Christopher B. Renne, D.C.

4111 Atlantic Blvd

Jacksonville, FL 32207

<view entire article>

Connect With Us