Dr. Craig Chappell DO, CAQSM, RMSK, IROM-C
Find out from Dr. Chappell himself what board certifications he has and what it means to have them.
Dr. Craig Chappell DO, CAQSM, RMSK, IROM-C
Find out from Dr. Chappell himself what board certifications he has and what it means to have them.
If you had artificial disc replacement surgery you were probably hoping that your back pain would go away. So you may be surprised when you have new post-surgery. In this video Dr. Chappell of In2It Medical shares why pain is common and what can be done to alleviate it.
We grabbed Dr. Chappell to ask him one of our top Frequently Asked Questions. In this video, Dr. Chappell shares the two different type of medical school paths. A DO can also specialize. In this segment he shares his educational background and experience. He also shares why he's passionate about Osteopathic Manipulation and how he uses this certifications in his practice.
If you’ve ever injured yourself or had an infection, you know that acute inflammation, with swelling, redness, and warmth, is part of the body’s healing process. It not only alerts you that something is wrong, but it helps deliver white blood cells to the affected area and restricts movement. This same process, however, can have negative effects when it becomes a chronic condition.
Chronic inflammation is usually caused by an immune response to some sort of “threat” to the body (such as a resistant infection or gluten), although it can still be triggered when there is no real threat. It may linger after a threat is resolved or continue because a threat isn’t resolving. Regardless of what causes it, chronic inflammation is hazardous to the body because the white blood cells begin attacking healthy tissue as well. It has even been linked to serious or life-threatening diseases such as cardiovascular disease, cancer, diabetes, rheumatoid arthritis, chronic kidney disease (CKD), and chronic obstructive pulmonary disease (COPD). Symptoms of chronic inflammation include fatigue, body and joint pain, gastrointestinal complaints, skin problems, regular infections and increased mucus production.
Although this sounds scary, the good news is that chronic inflammation can be reduced through three simple lifestyle changes:
1. Improve Your Diet
· Eat more anti-inflammatory foods
Foods that naturally reduce inflammation include tomatoes, olive oil, fruits (especially apples and blueberries) leafy greens, nuts, fatty fish and some spices such as ginger and turmeric.
· Eat fewer inflammatory foods
Foods that trigger inflammation include refined carbohydrates such as white rice and white bread, lard and shortening, red or processed meats, fried foods or any other foods with trans fats and sodas or other sugary drinks.
· Avoid processed sugar
Processed sugar, especially high-fructose corn syrup, is linked with increased inflammation as well as contributing to obesity, another inflammation trigger. Natural sugars, like those found in fruit, do not have the same inflammatory effect.
In general, Americans are at a higher risk for nutrition-related inflammation because our diet in often includes a lot of processed foods. By contrast, the Mediterranean diet is naturally anti-inflammatory.
2. Increase Your Activity
Multiple studies have shown links to reduced inflammation and regular exercise. For best results, be sure to get 30-45 minutes of exercise—both cardio and weight or resistance training—at least 4 times a week.
3. Reduce Your Stress
There are different kinds of stress: “good” stress, for example, can be a catalyst for progression, while “bad” stress prompts the release of excess levels of cortisol. Cortisol regulates the inflammatory and immune response, and elevated levels of cortisol can reduce its effectiveness, allowing inflammation to continue. Habits such as meditation, visualization, and purposeful breathing are all effective at reducing stress. Taking time to relax, re-center, be active, and talk with loved ones can also improve stress levels.
Stress can also affect our ability to sleep or sleep well, and improper amounts of sleep also trigger inflammation. Making even small changes in your lifestyle to promote better sleep will help improve the level of chronic inflammation in your body and will help you cope better with stress.
Although the concept of “eat better, move more and stress less” is not a new one, the ramifications of living this lifestyle (or not living it) go far beyond just being healthy—making these changes could save your life.
If you are suffering from chronic pain, come see us at In2it Medical. We can help you understand the source of your pain and find the right pain management options for you.
Carpal Tunnel Syndrome can be diagnosed using ultrasound. We can see the common symptoms but without ultrasound we can not be sure something else isn’t going on with the nerve prior to going forward with a surgery. Dr. Chappell shows us in this video exactly what to look for in the ultrasound when looking at the nerves.
Bassinet or crib? Jungle or forest animal décor? Eagerly awaiting baby’s arrival or struggling to cope with back pain?
Expectant moms have a lot of decisions to make when preparing for a new baby but choosing to live with debilitating pain doesn’t have to be one of them. It’s common knowledge that pregnant women can expect some degree of pain and discomfort during pregnancy. For the safety of the growing baby, these moms are also limited in what home remedies they can use to treat their symptoms, which can make it even more frustrating. If you are dealing with this, you are not alone: nearly 70% of pregnant women will experience significant lower back and pelvic pain.
However, there are therapeutic treatment options available that can provide relief for your lower back and pelvic pain more effectively than a not-too-warm bath and time with your favorite body pillow. Osteopathic manipulation treatment (OMT)—which is safe for mom and baby—is offered at In2it Medical, and it can help reduce your pain and improve your body’s function during pregnancy and may even improve post-delivery recovery so you can focus on your new bundle of joy.
What is causing your pain during pregnancy?
During pregnancy, the mother’s body undergoes a number of structural and physiological changes to accommodate a growing baby. These include:
· The hormone relaxin is produced, which (among other things) allows your ligaments to stretch, placing more pressure on your muscles and joints.
· The position of the pelvis changes, causing extra stretching of related muscles and the sacroiliac joints, leading to lower back and pelvic pain.
· Your stomach grows with the baby, changing your center of gravity and adding weight to your frame, which adds stress to your joints and muscles.
· Blood production increases, along with water and sodium retention, and blood pressure can decrease.
· Sciatic pain can also develop as the baby moves lower into the pelvis and adds pressure to the surrounding structures and nerves.
Although these changes are a normal part of pregnancy, they can also seriously limit your daily activities, especially when paired with the fatigue, gastrointestinal complaints, and reduced mobility that often accompany pregnancy as well.
How can OMT help?
This is where OMT comes in. According to an article published in The Journal of the America Osteopathic Association, “The application of osteopathic manipulative treatment (OMT) may improve and optimize physiologic function, which can alleviate somatic dysfunctions and improve quality of life for pregnant women. If OMT is applied from the beginning of pregnancy through delivery, these hemodynamic changes can be controlled so that they may continue to provide benefits to the fetus but also be cultivated to avoid harm to the pregnant patient.”1 In short, OMT can help make all the pregnancy-related changes manageable rather than debilitating.
So, what exactly is pregnancy-related osteopathic manipulation treatment? It is the therapeutic application of manually guided forces by an Osteopathic Physician to improve physiologic function and/or support homeostasis that has been altered by your pregnancy. Your doctor will move your muscles and joints using techniques including stretching, gentle pressure, and resistance. For additional information about general osteopathic manipulation, click here.
As Osteopathic Physicians, both Dr. Chappell and Dr. Edwards at In2it Medical are specially trained in osteopathic manipulation treatment. Dr. Edwards—who is an Assistant Professor of Osteopathic Manipulative Medicine at Rocky Vista University in Ivins, Utah, when not seeing patients—also has extensive experience in providing OMT for pregnancy-related pain and discomfort. Early on in his practice, Dr. Edwards noted that many of his patient referrals came from a nearby OB/GYN clinic:
“Being pregnant results in similar complaints that I was seeing in my elite athletes. I have had great results providing natural and safe treatment for pregnant women in pain. I have also had the opportunity to provide postpartum care, immediately following labor and delivery, with excellent results while still in the hospital.”
Your pregnancy should be all about your excitement and anticipation as you prepare for your new baby, not struggling to make it through each day as you suffer from pregnancy-related back or pelvic pain. If pain is clouding your journey to parenthood, let In2it Medical help you find relief so you can focus on what matters the most.
1. Lavelle, John M. “Osteopathic Manipulative Treatment in Pregnant Women.” The Journal of the American Osteopathic Association, June 2012, Vol. 112, 343-346.
If you’ve ever had a bout of tennis elbow, swimmer’s shoulder, or jumper’s knee, you know that professional athleticism is not a pre-req for developing pain and stiffness in these joints and others such as the hips and ankles. In fact, any repetitive motion or sudden trauma can bring with it a classic case of tendinitis. But did you know that there is another—and more likely—culprit responsible for your tendon pain? Studies have shown that in many cases suspected tendinitis is actually tendinosis.
Although they sound similar and both affect the fibrous tendons that connect muscle to bone, there are distinct differences in their symptoms which can help you identify what you are experiencing. Their underlying causes and, more importantly, their treatments are also different. Let’s start with an overview of the two conditions:
Tendinitis—tendinitis occurs when repetitive movement, injury, or strain (such as carrying a heavy object) causes microtears in your tendon, resulting in inflammation and pain.
Tendinosis—tendinosis occurs when overuse of a tendon causes the collagen (the substance tendons are made of) to break down. This compromises the structural integrity of the tendon and causes pain.
Which is it? Check your symptoms!
If both conditions result in tendon pain and decreased strength and stamina, how can you know which one you are experiencing? Your biggest clue will be the presence or absence of inflammation. If the injured area is reddish, warm to the touch, or swollen, you are likely experiencing an inflammatory response which only occurs with tendinitis. (The suffix -itis literally means inflammation.)
Your recovery time will also be an indicator because tendinitis typically resolves within 1 to 6 weeks with proper rest, while tendinosis can take 6 to 10 weeks if caught early, or 3 to 6 months if it has developed into a chronic condition.
However, if you are unsure if you are experiencing swelling or suspect you may have tendinosis, don’t wait several weeks—see your doctor! They can confirm whether it is tendinitis or tendinosis through a simple ultrasound and set you up with the proper treatment plan.
For recovery, a correct diagnosis is key
Having a correct diagnosis is crucial before beginning treatment because what works for one condition may actually hinder recovery for the other. There is some treatment overlap, with both cases benefitting from resting the injured tendon and receiving massage therapy, but that is usually where the similarities end.
With tendinitis, the inflammation is often treated with ice and nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or a stronger corticosteroid injection. As we mentioned before, tendinosis is not accompanied by inflammation. Thus, the goal in treating tendinosis is not to reduce inflammation but to boost collagen production to allow the tendon to heal itself. NSAIDs have been shown to inhibit collagen production, effectively slowing the healing process for tendinosis. This makes a proper diagnosis so important.
Rather than benefitting from anti-inflammatories, tendinosis could require physical therapy to strengthen the surrounding muscles, a brace to reduce stress on the tendon, and collagen-promoting nutrition or platelet-rich plasma injections to encourage healing. Regenerative medicine, like the stem cell injections or prolotherapy offered at In2it Medical, is also used to treat tendinosis, including cases where the tendinosis did not respond to physical therapy.
What does the future hold?
With proper treatment, those experiencing both tendinitis and tendinosis can expect to reduce their pain, improve their strength and range of motion, and return to normal activities. Tendinosis recovery may vary on a case-by-case basis since it involves damage on the cellular level. If you’re experiencing tendinosis, your main recovery goal may be to prevent further deterioration and surgical intervention, and you could be prone to re-injury in the future. Always discuss your specific treatment plan and goals with your doctor.
How can these injuries be prevented?
If you have a job or participate in activities or sports that leave you at risk for tendon strain or overuse, be sure to take preventative action. Warming up properly before engaging in physical activity, using the correct body mechanics and technique when both active and sedentary, taking regular breaks, and resting at the first signs of discomfort can all contribute to keeping you safe and free of pain.
Experiencing tendon, joint, or muscle pain? Come see us at In2it Medical so we can get you started on the road to recovery!
Bass E. (2012). Tendinopathy: why the difference between tendinitis and tendinosis matters. International journal of therapeutic massage & bodywork, 5(1), 14-7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312643/
We're thrilled to have Mike Nelson as part of our medical team here at In2it Medical. In this video you'll hear more about his background and you'll also hear why we love his approach to patient care!
For both onlookers and athletes, there’s nothing quite like the thrill of sports to bring people together. But nothing can end a game faster than a sports injury. Anyone can experience sports injuries when participating in physical activity, which often take the form of strains, sprains, and breaks. Knowing how to prevent them can go a long way in making sure you stay healthy and game ready. Here are 5 ways to prevent sports injuries and 5 ways to treat them when they do happen.
How do I prevent a sports injury?
Engage in proper conditioning: Long before game day, be sure that your body is ready. Become educated on activity-specific exercises that will make sure you’re ready for the required straining, endurance, and repetitive motion of your chosen sport.
Have downtime: Although training is very important, so is taking time to rest. Without rest days, your joints, muscles, and tendons will not have time to strengthen and recuperate, leaving them weakened and vulnerable when it’s time to play.
Warm up: “Warm” muscles typically stretch under pressure, while “cold” muscles may strain or spasm. Getting the blood flowing first with stretching and cardio will not only prevent injury but will help you perform better and be mentally prepared.
Don’t play through pain: Sudden onset pain is the body’s best alarm to let you know something is wrong. Rather than making you a team player, continuing to play with pain can quickly turn a simple injury into a complex one with a lengthy recovery.
Use proper technique and gear: Understanding the proper way to hold yourself, exert force, and even crash or fall will protect your body from the strain and impact of sports. Using the proper gear will also ensure an added layer of protection as you interact with the environment and other players.
How do I treat a sports injury?
A widely accepted method for treating a minor sports injury in the first 2-3 days after it occurs is the
Rest: As you recover from an injury, avoid any motion, activity, or weight bearing that reproduces your pain. This allows for healing while also avoiding further damage.
Ice: Swelling often appears soon after pain, restricting the movement of an injury and delivering healing cells to the area. Excessive swelling, though, can cause additional discomfort and weaken muscles. Applying ice—alternating 10 minutes on and 10 minutes off with a covered ice pack—to the affected area will reduce swelling. Never apply heat in the first 2-3 days following an acute injury.
Compression: Compression with an elastic bandage can also combat swelling and immobilize the injured area. However, you can apply a bandage too tight and interrupt blood flow, so if you see a blue or purple tinge to the surrounding areas, loosen the bandage immediately. Research proper techniques or seek medical advice if you are unsure how to bandage.
Elevation: When possible, keeping the injured body part raised above the level of your heart will help to reduce pain, swelling, and throbbing.
A 5th step in addition to the RICE method is:
Medication: Over-the-counter medications can help you manage the pain, and non-steroidal anti-inflammatories such as ibuprofen, aspirin, and naproxen reduce inflammation as well. Always check with your pharmacist or doctor if you have questions about dosage or drug interactions.
Should I see a doctor?
When dealing with sports injuries, it’s never a bad idea to see a doctor, even just to rule out something more serious. Immediate medical attention may be needed if you hear a popping sound at the time of injury; if you can’t place any weight on the injury; if you experience severe pain, or your pain worsens or doesn’t improve after a few days; or you experience a neck or back injury accompanied by radiating pain or numbness.
Seeing a doctor of sports medicine can help you recover faster with better outcomes. Even if you aren’t a serious athlete, seeking help early in your recovery can help you prevent the development of a chronic condition, which can affect not only your athletic performance but your ability to comfortably perform everyday tasks. Dr. Chappell and the team at In2it Medical can guide you down the correct rehabilitation path for your specific sports-related injury, with many treatment options including nutrition and exercise recommendations, physical therapy and manual manipulation, and regenerative injections. The sooner you get help, the sooner you can return to the activities you love!
We recently had the opportunity to submit an article to UtahValley360.com and it is currently being featured on their homepage!
In the article we share about how Dr. Chappell uses ultrasound to diagnose carpal tunnel and how he does ultrasound guided carpal tunnel release. He's the only doctor in Utah that can perform this specialized carpal tunnel release so we're thrilled that we can share the In2it Medical difference to this site.
If you'd like to see the article go here: https://utahvalley360.com/2019/03/25/carpal-tunnel-syndrome-treatment-at-in2it-medical-accelerates-recovery-time/
For more information about our carpal tunnel diagnosis and treatment options go here:
Big news at In2It Medical this month! Dr. Craig Chappell and the In2It Medical team just completed their 100th Micro-Invasive Carpel Tunnel Release with the SX-One MicroKnife. Dr. Chappell is only the second doctor in the country to reach this milestone and the only doctor in Utah that performs this specialized carpel tunnel release designed to decrease recovery time. It’s an ultrasound-guided procedure that allows the In2It Medical team accuracy and insights to diagnose and perform the procedure. If you’d like to learn more about this type of Carpel Tunnel Release, go to:
When it comes to using imaging to diagnose your pain, bigger is always better . . . right? According to that logic, an MRI—with its bulky equipment, lengthy scan time, and sizeable price tag—is your best bet for receiving the most comprehensive answers about your health. However, MRIs have their limitations, and, especially in the field of musculoskeletal injuries and conditions, may not be giving you the whole picture. Keep reading to discover three things your MRI is not telling you, and how a musculoskeletal ultrasound may be able to fill in the blanks.
But first, let’s identify the basic differences between MRI and ultrasound technology:
Magnetic resonance imaging (MRI) scanners use radio waves and powerful magnets to align water cells in the body in such a way that a computer can produce an image of both hard and soft tissue and organs. Although MRIs do not use radiation, due to the magnets, they are contraindicated for patients with metal embedded in their bodies.
Ultrasound (or sonography) sends high-frequency sound waves through a transducer (applied directly to the body) and the returning echo is captured by the transducer and translated into an image by the computer. Ultrasounds also do not use radiation and are less physically restrictive for patients.
Now, let’s get back to our discussion of MRIs and ultrasounds, which has been divided into three categories here: movement, timing and totality.
Movement: How movement is affecting your pain and diagnosis
Have you ever had recurrent pain in a joint that only manifested when you were actually using it? Like going to the doctor for a persistent cough only to have the cough disappear two minutes before the doctor comes in, having pain that is only present in certain conditions can be frustrating to properly diagnose and treat if those conditions can’t be replicated. MRI is considered a static imaging technique, meaning it is a still image. In fact, patient movement during an MRI may invalidate the findings. An ultrasound, however, can capture movement as it is happening. This can help your doctor understand if the pain is caused by the movement itself or by another issue, which may be invaluable for determining a correct diagnosis.
Timing: What your injury looks like at the time of your examination or procedure
Although an MRI is a powerful tool, it is also a snapshot of your body. As with any type of snapshot, the moment an image is captured, it starts to become outdated: our bodies continue to age and change with every minute that goes by (whether we like it or not). Logistically, it’s not practical to have MRI machines in exam rooms to be used at a moment’s notice or for care providers to be scanning while simultaneously administering injections. However, when performing in-office procedures or targeted treatments, bedside imaging is incredibly useful. Rather than providers working from dated images and using anatomic landmarks to locate approximate treatment points, ultrasound imaging allows them to ascertain the most current state of the injuries being treated and can guide providers in delivering the most accurate subdermal treatments.
Totality: The whole picture of your condition
So, can bigger ever be better when it comes to imaging? In many cases, the answer will be, yes. However, due to the nature of the large MRI scanners and how they capture images, musculoskeletal ultrasounds have actually been found to be more effective at capturing the entire length of longer structures like tendons, nerves and muscles. The ultrasounds’ agile transducer can also be maneuvered into more awkward angles to capture views that the larger scanners cannot, giving your provider even more insight into your condition.
At the end of the day, ultrasounds are not here to completely replace MRIs. In fact, ultrasounds can’t penetrate bone and they can’t accurately visualize gas- or air-filled organs such as the lungs or bowels. But when it comes to understanding and capturing aches and pains related to the musculoskeletal system, ultrasounds are uniquely suited to the task, not to mention they are more affordable, more convenient and more comfortable for patients.
Want to see a musculoskeletal ultrasound in action? Click here to watch Dr. Chappell demonstrate an ultrasound’s ability to capture movement and guide a procedure.
Peck J, Gustafson KE, Bahner DP. Diagnosis of Achilles tendon rupture with ultrasound in the emergency department setting. Int J Acad Med [serial online] 2017 [cited 2019 Jan 30];3, Suppl S1:205-7. Available from: http://www.ijam-web.org/text.asp?2017/3/3/205/204947
The aggressive marketing approach currently used by practitioners and clinics regarding various birth tissue products as safe and effective "stem cell therapy" is not supported by the existing scientific literature.
As practicing physicians, scientists, and regulatory experts we have increasingly observed aggressive advertising and sales tactics being used by alternative health clinics (chiropractors, naturopaths, and acupuncturists) as well as physicians and mid-level providers to market “stem cell” treatments derived from birth tissues. The products used are derived from birth tissues such as umbilical cord blood and/or Wharton’s Jelly or amniotic fluid/membrane. Many patients spend thousands of dollars on these therapies to treat orthopedic problems and/or a myriad of other incurable diseases.
Research has found that these amniotic and cord blood products did not contain live or functional stem cells. In addition, research groups found that many of the growth factor levels in these products were significantly lower than those found in common autologous orthobiologic products like platelet-rich plasma.
Here at In2it Medical we only use autologous (or patient-derived) orthobiologic products such as bone-marrow aspirate and platelet-rich plasma to ensure we are providing our patients with the best possible outcomes.
Here is the link to the full Consensus Statement,
One of our patients, Norm, had wrist pain and had seen a number of different doctors to find relief. Once he found Dr. Chappell and heard about the carpal tunnel procedure using the Sonex SX-One Microknife. Hear what he has to say about the procedure and his quick recovery.
Regenerative injections are not a band aid or a “quick fix” but rather a long-lasting and potentially permanent reparative process. In this video Dr. Craig Chappell shares how we use a variety of regenerative treatments to help with chronic pain and healing. Treatments include Prolotherapy, Platelet Rich Plasma, Stem Cells and more. With Dr. Chappell's expertise in regenerative medicine and the use of ultrasound technology, In2it Medical can diagnose and treat a variety of ailments and pain including osteoarthritis, tendinosis, instability, sports injuries and more.
Learn how we diagnose and treat carpal tunnel syndrome with an innovative and proven procedure.
One of the most common pain we treat in our clinic is SI Joint Instability which is more common in women than men, but can be equally painful and debilitating. Also commonly called sacroiliac joint instability, there is pain relief without invasive surgery. In this video Dr. Craig Chappell from in2it medical talks about why pain may exist, how he diagnoses this pain and common treatments available in the clinic. If you have lower back pain of any kind, call our office at 801-610-7321 for more information.
We know that you have a number of choices when it comes to getting treatment for your pains and ailments. At In2it Medical, we specialize in non-invasive treatments that help you get treated and back into your favorite activities. Dr. Chappell is triple board certified, and his team of medical professionals are educated, experienced and committed to your well being. We also use state of the art ultrasound and imaging to get a good look at what you're experiencing. If you have a pain that hasn't been diagnosed, or you've tried a number of treatments without resolution, call us and come see for yourself. 801-610-7321
In this blog we discuss 8 key considerations when you are considering stem cell treatment for your condition.