JAMA recommends chiropractic as first means of back pain treatment

(KTVI) – Medical doctors and chiropractors are often at odds with each other. The Journal of the American Medical Association now recommends chiropractic as a first means of treating back pain.

Dr. Alex Vidan wasn’t going to let that pass by without a comment. He stops by FOX2 with his pal Mr. Spine with more information.

The JAMA`s recommendation comes on the heels of a recent study out of the medical journal Spine where sufferers of lower back pain all received standard medical care (SMC) and half of the participants additionally received chiropractic care. The researchers found that in SMC plus chiropractic care patients, 73% reported that their pain was completely gone or much better after treatment compared to just 17% of the SMC group.

For additional information visit: The JAMA Network

Car accident facts!

TAMPA – Widespread pain that persists a year after a motor vehicle accident
actually begins within weeks of the insult and should be treated as early as
possible, researchers suggested here.
Car Accident
About 10% of individuals injured in motor vehicle accidents suffer pain that –
instead of decreasing within the first 6 weeks after the incident – develops
into nonremitting pain that may increase, reported June Hu, MA, a statistician
with the TRYUMPH Research Program at the
University of North Carolina in Chapel Hill.

“Over four million adults present to U.S. emergency departments each year after
motor vehicle collisions,” Hu told MedPage Today at her poster presentation
during the annual meeting of the American Pain Society.
“The great majority of these individuals are discharged to home after emergency
department evaluation, but a subset of these individuals develop motor vehicle
collision-related widespread pain
which is characterized by substantial suffering and functional loss.”

“We believe that this research indicates that doctors have to start treating
these individuals with persistent widespread pain very early, and not wait for
the pain to resolve in itself,” she told MedPage Today.

Hu and colleagues identified 895 individuals injured in motor vehicle accidents
who presented at the emergency department and then were discharged home after
evaluation. Of that group, 78 people had widespread pain at 1 year, she said.

She explained that the majority of individuals who were evaluated after the
accident with widespread pain saw their pain reduced substantially at 6 weeks,
and it was virtually nonexistent at 6 months.

But in the other group, pain intensified in the 6 weeks after the accident, and
then remained constant, still reaching intensity at 1 year that was similar to
the pain felt immediately after the accident. Hu described this as a
“non-recovery” model of widespread pain.

She said researchers determined that individuals with persistent widespread pain
followed a non-recovery trajectory – that is, their pain experience failed to
remit after the initial pain-causing accident. “Determining the course of motor
vehicle collision widespread pain development would advance understanding of
this vexing and poorly understood disorder,” Hu said.

In this study, researchers analyzed data from a cohort of adult European
Americans who presented to the emergency departments after motor vehicle
collision – a median of 74 minutes after the crash. Participants completed an
interview evaluation in the emergency departments and at 6 weeks, 6 months, and
1 year following the motor vehicle collision.

Evaluation at each time point included an assessment of pain in 19 body regions.
If pain in a body region was reported, the motor vehicle collision-relatedness
of the pain was assessed. Only motor vehicle collision-related pain was included
in analyses. Relatively few individuals experienced a substantial increase in
the number of body regions with pain from 6 weeks to 1 year.

“Further studies are needed to determine biopsychosocial factors that mediate
the development of early motor vehicle collision widespread pain and
non-recovery,” Hu reported. “Such understanding will inform the development of
secondary preventive interventions.”

Hu had no relevant relationships with industry.

Primary source: American Pain Society

Source reference: Hu J, et al “Most widespread pain present 1 year after motor
vehicle collision (MVC) begins in the early aftermath of the MVC: Results of a
multicenter prospective cohort study” APS 2014; Abstract 237.

ANOTHER GREAT REVIEW

Thank you.

Your staff was very helpful. My praises and thanks to all of them, doctors as well as staff. They are very professional, accommodating, tactful and friendly. They took care of all my needs, put my worries to rest and helped me immediately when I needed it. Due to their timely reaction to my needs, dedication and help they provided, the consequences of my accident were minimized. I would recommend them to anyone who finds him/herself in my situation.

Croatia is a small country, with number of citizens smaller than a big city, but has great athletes and long, famous and exciting sport tradition.

Croatian soccer team will donate one quarter of all their earnings to the fund helping victims of the recent flood in Croatia.

We hope for the good games and honest and fair referees for the rest of the championship.

At the end, thank you for helping.

Sincerely,

Sanja Pirsl

New Relationship Found Between Antibiotics and Asthma

A new study suggests infants prescribed antibiotics have a higher risk of developing asthma later in childhood. However, the findings suggest that these children may have a specific genetic variation that increases their risk of asthma, rather than the antibiotics themselves causing the disorder.

Researchers from Manchester, London studied over 1,000 children from birth to age 11. They found that children with severe asthma at age 11 were more likely to have been given antibiotics before they were one year old. These children were also twice as likely to have severe wheezing problems or be hospitalized for asthma, compared to children not given antibiotics before the age of one.

But the scientists kept uncovering additional facts in this study. They tested their levels of cytokines (messenger molecules that stimulate the immune system to begin fighting against infection from viruses). The children with the severe asthma and wheezing had low levels of these cytokines, implying they may have already immune-deficient prior to receiving the antibiotics.

This may seem like the scientists were splitting hairs, but actually, it’s a pretty important discovery – one that could let the antibiotics off the hook for ‘causing’ asthma.

Looking even deeper into the subject, the scientists then went to the genetic level and found altered two genes located at 17q21 in the children. This means it’s possible that the infants were either born with the genetic variations that made them more susceptible in the first place – or something caused those genes to be different during their life.

Of course, more studies have to be done to find the true cause… but from the chiropractic point of view, there are a couple of things to note and speculate about.

First of all, chiropractic spinal manipulation has been found to be beneficial for immunity; studies have found that chiropractic adjustments decrease pro-inflammatory cytokines and an increase in antibodies involved in the immune response. In an ideal world where children received chiropractic care from an early age, it’s possible that the asthma study results might be different. Perhaps the risk of the children developing viral infections and needing the antibiotics in the first place would be lower. The one way to find out would be to run the same study again and add a separate group of children – those who were also receiving chiropractic care.

Secondly, chiropractors are always concerned about nutrition. New studies on vitamin D in the last decade have even found that some babies have deficient levels of the vitamin. A vitamin D deficiency clearly is linked to lower immunity. While the researchers are testing the additional group of children for chiropractic care, they could also be testing everyone in the study for vitamin D levels. It’s possible that both nutrition and chiropractic matter more than anything else in this puzzle of immunity.

Once scientists begin using lateral thinking skills to comprehend more of the big picture in health instead of only a few variables, we will make greater progress in leaps and bounds. And that’s when the world of health will truly change. In the meantime, discuss your child’s immune system with your chiropractor.

Some recent case studies have suggests that chiropractic has benefited some children with asthma.

Reference

Semic-Jusufagic, A., et al. Assessing the association of early life antibiotic prescription with asthma exacerbations, impaired antiviral immunity, and genetic variants in 17q21: a population-based birth cohort study. Lancet Respir Med 2014 May 14. (epub ahead of print)

Written by: Donna Schwontkowski on June 4, 2014.
Last revised by: Marissa Luck

Teenagers: They’re in more pain than you think

Although the analogy of “aches and pains” is often used to describe growing older, some researchers from Australia wondered how prevalent these issues are in adolescents. Shockingly, what they found is that our children may be in more pain than we realize.

For the purposes of this study, researchers reviewed a health survey of 404,000 school-aged children between nine and 17 years old. Boys and girls were asked about their experience with headaches, stomach aches, and/or back pain at regular intervals during the course of the previous six months.

The Pain-Filled Results

The results showed that more than half of these youngsters experienced regular headaches (54.1%) with a slightly smaller amount (49.8%) reporting that they had stomach pain. Back pain came in last, but the rate of kids suffering with this type of issue was still high, with 37% of them reporting some sort of pain or discomfort.

What is worse is that a lot of the children had more than one type of pain that they were contending with. For example, 31% had both headaches and stomach aches, 12.1% were dealing with headaches and backaches, and a whopping 35.7% reported experiencing all three types of pain!

The Pain-Free Solution

Chiropractic care can help children and adolescents live a pain-free life by correcting any spinal issues that may be causing them the discomfort that they are obviously feeling at alarmingly high rates. And, the best part is that it doesn’t involve the use of potentially harmful drugs, so it is a completely natural solution without negative side effects.

Making our children pain-free should be our ultimate goal, now that we realize that it is a greater issue than we once thought.

Reference

Swain M, et al. An international survey of pain in adolescents. BioMed Public Health 14:447. doi:10.1186/1471-2458-14-447.

Written by: Christina DeBusk on June 11, 2014.
Last revised by: Marissa LuckJune 20, 2014.

Overweight with Back Pain? It’s About Your Spinal Discs

Why do obese and overweight patients have a higher risk of back pain? A new study has a partial answer to the question: the height of spinal discs.

The results show additional risks suffered from those who are obese – an actual loss of disc height in certain segments of the lumbar spine. Reduced disc height means that the cushioning in the spine has deteriorated, leaving an opportunity for a disc to bulge or other debilitating back problems to develop.

By analyzing MRIs, researchers measured disc height in 72 adults. At the L1-2 and L3-4 levels, people categorized as obese had an average disc height of 4.16 cm compared to 4.57 cm in people with healthy weights. Obese participants were also more likely to suffer from back pain. However, there were no major differences in space at the lumbosacral junction. Still, the study established a relationship between obesity, disc height, and back pain.

For decades, doctors and chiropractors have been advising overweight and obese patients to lose weight. Doctors knew there was a correlation of back pain with obesity, and if the person lost weight, the back pain vanished. But the scientific reasons behind that process weren’t fully understood. Now a growing body of research is answering the “why” question, while showing how important weight is in the cause and treatment of back pain.

In the last decade, scientists have discovered more and more health problems associated with carrying extra weight. For example, extra fat is not simply inert – sitting there on the belly and body doing nothing – but instead is actively producing hormones and substances that interfere with immunity.

Chiropractic medicine offers a way to improve spinal health for all individuals, regardless of size or weight. And with continued advancements in the science of nutrition, many chiropractors may also be able to assist patients by providing recommendations on safe diets. Chiropractors can help to relieve your back pain now, and assist you in developing healthier habits to prevent it from recurring in the future.

Reference

Urquhart DM, et al. Obesity is associated with reduced disc height in the lumbar spine but not at the lumbosacral junction. Spine 2014.

Written by: Donna Schwontkowski on June 9, 2014.
Last revised by: Marissa LuckJune 20, 2014.

Back Pain

Hitting the Gym Could Stop Your Neck Pain

Chronic neck pain is typically treated with specific methods that focus on the affected area, thereby decreasing the level of tenderness and increasing range of motion. However, News Medical recently reported that a new study published in the International Journal of Rheumatic Diseases suggests that treating the whole body via regular physical exercise may bring about better results.

The Research

Researchers set out to discover whether level of physical fitness or status of mental health (via depression and anxiety) has any effect on persons with chronic neck pain. They studied 160 participants, 80 of whom had no neck pain and 80 of whom reported chronic neck pain. Each group consisted of 40 males and 40 females.

They tested each participant in several areas to ascertain their strength, flexibility, pain threshold, disability level, depression levels, anxiety levels, and overall quality of sleep. They then compared the results of the group with chronic neck pain to the group that had no reported neck pain and they found some significant differences between the two – especially when separated by sex.

The Results

Women with chronic neck pain were weaker, had lower pain thresholds, and reported a lower quality of life than the group with no reported neck issues (regardless of gender). The females studied also tended to experience higher levels of depression and anxiety, and they reported getting less-than-restful sleep. Men with chronic neck pain also reported a lower quality of life, generally had higher body fat percentages, and their sleep quality was affected as well.

This study suggests that it takes a whole-body approach when treating chronic neck pain. Therefore, in addition to participating in regular chiropractic visits to realign the cervical vertebrae and treat the cause of the pain, both male and female patients should be encouraged to participate in an exercise program to further enhance the benefits.

Doing so can potentially increase their quality of life, make them stronger, lower their body fat percentages, and allow them to engage in more restful sleep. Additionally, regular physical exercise helps lower anxiety and depression, making it an effective tool for improving quality of life as well as reducing neck pain. Combining chiropractic with specific exercises is particularly effective for spinal pain, research suggests.

Reference

Yalcinkaya, H et al. Do male and female patients with chronic neck pain really have different health-related physical fitness, depression, anxiety, and quality of life parameters? International Journal of Rheumatic Diseases. May 9, 2014.

Written by: Christina DeBusk on June 6, 2014.
Last revised by: Marissa LuckJune 4, 2014.blog1

Prognostic Factors Determining Whiplash Associated Disorders

Perhaps you have been involved in a car accident and experienced whiplash; or you know someone who has.  Try to remember back then… how long did it take them to recover?  Did they recover back to 100%? More often than not, you’re never the same after being in a car accident – especially when you experience whiplash or, as us doctors know it “whiplash associated disorder” because whiplash is mechanism of injury – not the diagnosis.  In this study performed in Canada, researched correlated government data from over 5000 cases of whiplash… their results may shock you..

Whiplash 2Individuals presenting with chronic pain were more likely to:

(1) be female

(2) present with lower limb pain or nonorganic signs

(3) have returned to work

(4) have retained a lawyer;

(5) have undergone previous spinal surgery,

The same individuals were less likely to:

(1) present with neck or midback pain;

(2) live in Ontario or Nova Scotia;

(3) have modified duties upon return to work.

Reference: Dufton JA, Bruni SG, Kopec JA, Cassidy JD, Quon J. “Delayed recovery in patients with whiplash-associated disorders.” Injury. 2012 Jul;43(7):1141-7. doi: 10.1016/j.injury.2012.03.006. Epub 2012 Apr 2.

Sitting Tied to Increased Risk of Disability

eldermanlowbackpainSitting is the new smoking, and here’s another reason why: a new study shows that every hour you spend sitting during the day increases your likelihood of suffering from a disability.

Researchers publishing in the Journal of Physical Activity and Health analyzed the health records of 2,285 adults over the age of 60 who wore accelerometers to track their daily physical activity levels. Their disability levels were calculated based on their capacity to complete Activities of Daily Living (ADL). The average adult spent 9 hours per a day sitting during their waking hours, even after adjusting for moderate physical activity levels, socioeconomic status, and health concerns. The researchers discovered that each waking hour of sitting resulted in a 46% increase in the risk of ADL disability. The results add to earlier research linking sitting to an elevated risk of diabetes, early death, and heart disease.

“These findings support programs encouraging older adults to decrease sedentary behavior regardless of their engagement in moderate or vigorous activity,” the researchers concluded.

But it’s not just older adults who are victim to the negative health effects of a sedentary lifestyle. Recent research suggest that nearly 80% of Americans fail to meet the recommended guidelines for physical activity levels, putting them at risk for a variety of diseases, musculoskeletal disorders, and obesity.

Even increasing your activity level by 20 minutes a day can make a difference in the health of obese patients,another recent study showed. Chiropractors can advise you on building a safe, effective exercise program to prevent and reduce chronic pain.

Reference:

Sedentary time in US older adult associated with disability in activities of daily living independent of physical activity. Journal of Physical Activity and Health 2014. http://journals.humankinetics.com/jpah-in-press/jpah-in-press/sedentary-time-in-us-older-adults-associated-with-disability-in-activities-of-daily-living-independent-of-physical-activity

Written by: Marissa Luck on February 27, 2014.on February 28, 2014.

Chiropractic as Effective as Epidural Injections for Lumbar Disc Herniation

 

Chiropractic adjustments were just as effective as epidural injections for patients with back pain in a new study — without the risks and at lower cost.

The findings show that chiropractic can significantly reduce pain in patients with lumbar disc herniation, and is less expensive than medical treatment.

Lumbar epidural injections are frequently used for back pain and sciatica in patients with lumbar disc herniation, failed back surgery syndrome, and spinal stenosis. During the procedure, a physician injects a high dose of pain medication, and sometimes steroids, into the area of the lumbar spine around the damaged nerve. This temporarily reduces inflammation and pain.

Although the injections are widely used, controversy lingers due to the lack of a studies with placebo controls, and questions about the effects of steroids versus anesthetic alone. Side effects of steroids include a weakening of muscles and spinal bones around the affected nerve and a disruption of the body’s natural hormone balance. It’s also unclear whether epidural injections are more effective than other conservative treatments for lumbar disc herniation.

While a number of studies have established the efficacy of chiropractic for low-back pain, fewer have tested its comparative effectiveness with other treatments for lumbar disc herniation.

In a new study from the Journal of Manual and Physiological Therapeutics, researchers from Switzerland compared the effects of chiropractic spinal manipulative therapy (SMT) and epidural nerve root injections (NRI). The study included 102 with symptomatic, MRI-confirmed lumbar disc herniation who were treated with either SMT or NRI.

After one month of treatment, both groups experienced significant improvements. Of the patients under chiropractic care, 76.5% said they were “much better” or  “better” compared to 62.7% of NRI patients. Sixty percent of chiropractic patients had a significant reduction in pain compared to 53% of NRI patients. These slight differences were not statistically significant.

While none of the chiropractic patients received surgery, three of the NRI patients eventually opted for an operation.

Since the treatments were considered equally effective, the cost analysis became even more important for comparing both treatments, the researchers pointed out.  On average, one month of chiropractic adjustments was less expensive than NRI ($558 vs. $729). Their analysis included only the “minimum cost” of NRIs, and did not take into account other costs that are frequently tacked on like additional consultations with clinicians, multiple injections, or possible surgery. Additionally, treatment cost for chiropractic patients may have been slightly higher than normal since they were required to receive an MRI to be in the study. Many chiropractic patients do not receive MRI because imaging guidelines do not recommend MRIs for patients with lumbar disc herniation in most cases. In contrast, MRIs are typically performed before injections or other more invasive procedures.

Although randomized trials are needed to confirm these results, the authors concluded that, “There were no significant differences in outcomes between the more universally accepted treatment procedure of NRI compared to SMT.”

This study suggest that patients can experience substantial relief from chiropractic care without worrying about the side effects of steroids or drugs. It may even save them money, sinceresearch suggests that chiropractic patients have lower annual medical costs compared to patients under traditional care.

Reference

Peterson, CK, et al. Symptomatic Magnetic Resonance Imaging-confirmed lumbar disk herniation patients: a comparative effectiveness prospective observational study of 2 age- and sex-matched cohorts treated with either high-velocity, low-amplitude spinal manipulative therapy or imaging-guided lumbar nerve root injections. Journal of Manipulative and Physiological Therapeutics 2013; doi: 10.1016/j.jmpt.2013.04.005.

Written by: Marissa Luck on June 3, 2013.on June 11, 2013.