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AMA: Chiropractic Effective for Acute Back Pain

AMA: Chiropractic Effective for Acute Back Pain

Statistics compiled by the American Chiropractic Association (ACA) tell us that back pain affects a large majority of the population, with roughly 80 percent of people enduring at least one back-related issue during the course of their lives. In fact, there are currently 31 million people in the U.S. alone dealing with chronic, daily back pain.

With these types of numbers floating around, chiropractic patients may feel as if their back pain is inevitable, making the seeking of treatment futile. However, one recently released study review says otherwise, that is, as long as the treatment plan includes chiropractic.

The Journal of the American Medical Association (JAMA) published a systematic review and meta-analysis conducted by 10 medical professionals from medical centers, universities, and healthcare systems across the U.S. The main question this group set out to answer was, “Is the use of spinal manipulative therapy in the management of acute (≤6 weeks) low back pain associated with improvements in pain or function?”

After taking a more in-depth look at 26 different randomized clinical trials occurring between January of 2011 and February of 2017, all of which involved spinal manipulative therapy (SMT), this set of researchers found that, in 15 of the studies, this particular treatment option provided “statistically significant benefits” for the 1,711 patient subjects when it came to lowering their levels of pain. In this same group of studies, almost half of the cases (12) also found major positive effects in regard to the level of function of the 1,381 participants when compared to sham chiropractic or other treatment methods.

It should also be noted that, while 50 to 67 percent of the participants in these studies reported experiencing headaches, muscle stiffness, or even increased pain after SMT, no serious adverse events occurred. This helps confirm chiropractic’s safety, making it a viable method of treating acute back pain episodes quickly and effectively.

These findings are extremely important as another statistic offered by the ACA is that approximately 50 percent of the working population has struggled with some type of back-pain issue in the previous 12 months. Thus, one very effective way to keep them earning an income and supporting their families in a manner that treats the symptoms and cause of their pain is regular and consistent chiropractic care.

This saves them both time off work and money due to unnecessary (and usually costly) medical bills, enabling them to spend both on the things they enjoy instead.

  • American Chiropractic Association. (n.d.) Back Pain Facts and Statistics.
  • Paige NM, Miake-Lye IM, Booth MS, Beroes JM, Mardian AS, Dougherty P, Branson R, Tang B, Morton SC, Shekelle PG. Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. 2017;317(14);1451-1460. doi:10.1001/jama.2017.3086
Today’s post was shared from the following website:https://www.chironexus.net/2018/01/ama-chiropractic-effective-acute-back-pain/
Chiropractic Safer than Medical Care for Elderly

Chiropractic Safer than Medical Care for Elderly

Many studies have found that chiropractic care is a safe and effective treatment method when dealing with a number of spine-related issues. The American Chiropractic Association even lists a number of research studies on their website that show that it is a valuable treatment method for easing (and sometimes completely resolving) back pain, neck pain, headaches, and more.

While all of this is good news for professionals that practice in the chiropractic field, some researchers wondered if chiropractic was just as safe for elderly patients as it is for younger patients experiencing these types of problems. So, they set out to find the answer, which they did via a retrospective cohort study funded by NIH and the National Center for Complementary and Alternative Medicine, and also which was subsequently printed in Spine upon its completion.

What researchers wanted to discover was whether the relationship between the risk of injury to people 66 years old and older when engaging in chiropractic care was higher than, lower than, or equal to the risk of injury to this same age group after undergoing medical care by their primary care physician. To find their answer, they studied data on Medicare B patients who went to the doctor in 2007 for a neuromusculoskeletal issue, evaluating their risk of injury seven days post-treatment.

They discovered that seniors that received chiropractic care had a 76% lower rate of injury within seven days of treatment when compared to the subjects that met with their primary physician as a result of a neuromusculoskeletal complaint. Researchers also pointed out that they found that males contained within the research group, older study participants, and those with a higher Charlson co-morbidity score were most at risk of injury within the week after acquiring a neuromusculoskeletal issue.

Additionally, certain medical conditions raised the risk of injury, even after chiropractic care. Therefore, chiropractic professionals should consider whether treatment via spinal manipulation is best for “patients with coagulation defects, inflammatory spondylopathy, osteoporosis, aortic aneurysm & dissection, or [those who have engaged in] long term use of anticoagulant therapy” as the increased risk may not be worth the benefits.

Whedon JM, Mackenzie TA, Phillips RB, Lurie JD. Risk of traumatic injury associated with chiropractic spinal manipulation. Spine 2014;Dec 9.

How Do Chiropractors Know If Your Spine is Out of Alignment?

How Do Chiropractors Know If Your Spine is Out of Alignment?

Views of the spine
Human Spine

Having a misaligned spine (also called a spinal subluxation) can negatively affect your daily life in a number of ways.  It can not only cause pain in the back and neck, but can also cause pain in the rest of the body because of the pressure that the misaligned vertebrae place on nerves in the spinal column.  For example, many people suffer from sciatica (a condition in which pain can be felt shooting down the leg as far as the foot) due to a misaligned vertebral disc putting pressure on the spinal nerve roots.  A chiropractor can diagnose if your pain is due to your spine being misaligned and can perform a spinal adjustment to restore proper alignment and range of movement, relieving pain.

Spinal subluxations are very common.  They occur when one or more of your 24 bony vertebrae (most people actually have 33 vertebrae counting the nine that are fused to form the sacrum and coccyx) are pulled out of alignment with one another.  This can happen for a variety of reasons.  Among the most frequent contributors to spinal misalignment are an injury, a sudden jar, fall or trauma, bad posture, stress, inactivity, obesity, repetitive motions and lifting something improperly.  When your spine becomes misaligned, your range of motion can become more restricted, with or without accompanying pain.  Although spinal misalignments can happen quickly (usually in the case of an accident or acute injury), they can also occur over time due to weak postural muscles. This is often the case with those who sit at a desk for hours each day.

A chiropractor may use a variety of different diagnostic techniques to determine if your spine is out of alignment.  Most chiropractors can easily spot a subluxation, as body posture reflects any misalignment.  For example, when lying down, one leg will appear shorter than the other.  When standing up, the body may lean to one side, or the head may tilt to the left or right.  Also, one shoulder or hip may appear higher than the other, and the distribution of body weight may favor one foot or the other.

Other things that your chiropractor may do to determine if your spine is out of alignment are to check your range of motion (reduced range of motion usually indicates a misalignment), press along your spine (called palpation) to evaluate joint function, perform strength testing and look for changes in muscle tone.  He or she may also order x-rays of the spine to be taken, so as to have a visual confirmation of your spinal subluxation.

Once the misalignment has been pinpointed, your chiropractor will perform a spinal adjustment that will move your vertebrae back into alignment, restoring correct posture and alleviating pain that may have been caused by the misalignment.

Neck Pain Causes

Neck Pain Causes

Cervical spine disorders.
Most Common Neck Pain Causes: Strains and Sprains

The most common causes of neck pain—strains and sprains—heal within a few days or weeks. A strain is when a muscle or tendon has been irritated by overuse or overextension. Similarly, a sprain is when a ligament has been irritated by overuse or overextension.

Common causes of neck strains and sprains include:

    • Sleeping in wrong position. Often referred to as a “crick” in the neck, a person might wake up in the morning with neck pain due to sleeping in an awkward or atypical position that overextended the neck.
    • Sports injury. A person could move the neck suddenly and/or in an unusual way in a new sport, or a player could have a collision or fall. A common sports collision injury is a stinger, which happens when nerves in the neck/shoulder are impacted and pain, numbness, and weakness can radiate down the shoulder, arm, and hand.
    • Poor posture. Whether it’s at work, home, and/or commuting, poor posture can lead to neck problems. If a person’s head is often tilted forward for long periods of time, then the neck’s muscles, tendons, and ligaments need to work harder. Poor posture can be problematic during any number of activities, including working at a computer, watching TV, riding the train, reading a book, gardening, and more. Text neck, for example, is an increasingly common problem that develops in anyone who spends hours looking down at the phone while texting.
    • Repetitive motions. Turning the head in a repetitive manner, such as side to side while dancing or swimming, may lead to overuse of the neck’s muscles, tendons, and ligaments.
    • Holding the head in unusual position. Anything that requires holding the head in an unusual way for long periods of time could cause neck strains and sprains. Some examples include having a long conversation while cradling a phone between the head and shoulder, or spending an afternoon looking up at an air show.
    • Whiplash. In a whiplash injury, the head and neck are forced suddenly backward and immediately forward with a great deal of force. The soft tissues along and near the cervical spine can be torn or ruptured as a result. This type of injury commonly occurs in an auto accident that involves a rear-end collision.

Causes of Chronic Neck Pain

Neck pain is considered chronic when it persists for more than 3 months. These conditions tend to stem from problems in the cervical spine either with a facet joint or disc. Common causes include:

  • Cervical degenerative disc disease.
    Everyone experiences wear and tear on the cervical spine over time. It’s natural for the discs to gradually lose hydration and the ability to cushion the spine’s vertebrae. If a disc degenerates enough, it can lead to painful irritation of a cervical nerve in various ways, such as a herniated disc, pinched nerve, or changes in the facet joints that can cause arthritis.
  • Cervical herniated disc A cervical disc is herniated when its jelly-like inner layer, the nucleus pulposus, leaks out through a tear in the disc’s protective outer layer. This could result from an injury or aging. A herniated disc may press against or pinch a cervical nerve, or the inflammatory proteins of the nucleus pulposus may come close enough to a nerve to cause irritation.
  • Cervical osteoarthritis
    When the cartilage in a cervical facet joint wears down enough, it can lead to cervical osteoarthritis, also known as cervical spondylosis. Rather than having the facet joints move smoothly along cartilage as intended, they might grind bone on bone. The joint could become enlarged from inflammation and bone spur growth, causing a nearby nerve to become pinched or pressed
  • Cervical spinal stenosis with myelopathy Spinal stenosis occurs when the spine’s degeneration leads to a narrowing of the spinal canal, such as from a herniated disc that pushes into the spinal canal or bone spurs that grow into the canal. When the spinal canal narrows enough to compress the spinal cord—a large bundle of nerves that runs inside the spinal canal—myelopathy can result. Myelopathy is when compression of the spinal cord starts causing symptoms, such as weakness or problems with coordination in the arms, hands, legs, or feet.
  • Cervical foraminal stenosis This condition occurs when the foramina—the holes in the vertebral construct through which nerve roots that branch off from the spinal cord can exit the spinal canal—become narrowed. This narrowing of the hole can cause irritation for the nerve root that runs through it. Foraminal stenosis is associated with radiating pains in a pattern specific to the nerve that is pinched by the narrowing. In some situations, there is a combination of the cervical stenosis causing myelopathy, as well as the specific nerve pattern associated with a cervical foramen being narrowed.

Other Causes of Neck Pain

While not the most common causes of acute or chronic neck pain, other causes of neck pain could include:

    • Emotional stress. Sometimes muscles in the neck can tighten up and ache in response to stress, anxiety, or depression.
    • Infection. If part of the cervical spine becomes infected, then inflammation could cause neck pain. One example would be meningitis.
    • Myofascial pain. This chronic condition has trigger points, which result from achy muscles and surrounding connective tissues, typically in the upper back or neck. Trigger points can be chronically painful or only painful to the touch. The pain might stay in one spot or it can be referred pain that spreads to/from another area in the body.
    • Fibromyalgia. Fibromyalgia is hard to diagnose, but it typically involves pain in the muscles, tendons, and ligaments in several areas of the body, including in the neck.
    • Spinal tumor. A tumor, such as from cancer, could develop in the cervical spine and press against a nerve. These types of tumors more commonly occur as cancer that has started in another part of the body metastasizes.
    • Spondylolisthesis. This condition occurs when one vertebra slips over the one below it. It can be due to a tiny fracture in the vertebra, or possibly from advanced disc degeneration, or ligament laxity.
    • Ankylosing spondylitis. This progressive arthritis of the spine and pelvis can cause widespread inflammation, pain and stiffness throughout the spine, including the neck.

Risk Factors for Developing Neck Pain

Some research indicates that getting unhealthy amounts of sleep, being inactive, and smoking can all raise the risk of developing neck pain.2 In addition, working longer hours or being in a labor-intensive occupation, such as the military, health care support, or installation and maintenance, may increase the risk for neck pain.3

References

  1. Croft PR, Lewis M, Papageorgiou AC, et al. Risk factors for neck pain: a longitudinal study in the general population. Pain. 2001; 93(3):317-25.
  2. Yang, Haiou PhD; Haldeman, Scott DC, MD, PhD; Nakata, Akinori PhD; Choi, BongKyoo ScD, MPH; Delp, Linda PhD, MPH; Baker, Dean MD, MPH. Work-related risk factors for neck pain in the US working population. Spine. 2015. 40(3):184-192.
The Positive Effects of Chiropractic Care!

The Positive Effects of Chiropractic Care!

We know that our patients who get adjusted regularly see the wonderful side effects! Their backs are not the only beneficiary of their adjustments! Here is a study that confirms that keeping the spine adjusted has more positive effects than just your back or neck feeling better!:

A retrospective study conducted in Sweden [1] has determined that about one in four chiropractic patients experiences some form of “positive nonmusculoskeletal side effect” after spinal manipulative therapy (SMT).

In addition, the percentage of patients who experience positive side effects increases with the number of spinal regions adjusted. The Swedish researchers asked all members of the Swedish Chiropractors Association (SCA) to participate in the study. Eighty-one percent of the SCA membership complied. Each doctor of chiropractic gathered data from 20 patients over a three-week period for a total of 1,504 valid patient questionnaires. Patients were included if they had been previously adjusted within the last two weeks for musculoskeletal complaints. The patients were asked if after their previous visit they ìexperienced any positive changes that do not seem to have anything to do with your back problem?

At least one positive side effect or reaction was reported by 23 percent of the respondents. The more spinal areas that were adjusted, the better their chances of experiencing at least one positive reaction:

The positive, nonmusculoskeletal reactions appear to cluster into a number of system/organ-related classifications. Of those patients who experienced them, here is the breakdown by percentage:

 

  • Respiratory System: 26%

  • Digestive System: 25%

  • Circulatory System/Heart: 14%

 

  • Eyes/Vision: 14%

The benefits experienced can also be broken down into subcategories:

 

  • Easier to Breathe: 21%

  • Improved Digestive Function: 20%

  • Clearer/Better/Sharper Vision: 11%

  • Better Circulation: 7%

  • Changes in Heart Rhythm/Blood Pressure: 5%

 

  • Less Ringing in the Ears/Improved Hearing: 4%


The authors, as is typical in research papers, are careful to point out the limitations of extrapolating the findings. They note that the study does not demonstrate whether the statistical link between treatment and reaction is causal. They assert that ìthe absence of an untreated control group makes it impossible to say whether these reactions are treatment-specific, or if they simply represent normal fluctuations of common symptoms of physiologic function. While these results are very exciting, it is clear that additional research is needed.

Reference:

The Types of Improved Nonmusculoskeletal Symptoms Reported After Chiropractic Spinal Manipulative Therapy
J Manipulative Physiol Ther 1999 (Nov);   22 (9):   559–564

The Abstract

OBJECTIVE:   To investigate the frequency and types of improved nonmusculoskeletal symptoms reported after chiropractic spinal manipulative therapy.

DESIGN:   Retrospective information obtained by chiropractors through standardized interview of patients on return visit within 2 weeks of previous treatment.

SETTING:   The private practice of 87 Swedish chiropractors (response rate 81%).

SUBJECTS:   Twenty consecutive (presumably naive) patients per chiropractor (1504 valid questionnaires returned, 86% of optimal number of replies).

INTERVENTION:   Spinal manipulation with or without additional therapy provided by chiropractors.

MAIN OUTCOME MEASURES:   Self-reported improved nonmusculoskeletal symptoms (reactions).

RESULTS:   At least I reaction was reported after the previous treatment in 21% to 25% of cases. Of these responses, 26% were related to the airway passages (usually reported as “easier to breathe”), 25% were related to the digestive system (mostly reported as “improved function”), 14% were classified under eyes/vision (usually reported as “improved vision”), and 14% under heart/ circulation (about half of these reported as “improved circulation”). The number of spinal areas treated was positively associated with the number of reactions.

CONCLUSION:   A minority of chiropractic patients report having positive nonmusculoskeletal reactions after spinal manipulative therapy but such reports cluster predominantly around specific symptoms. It would be interesting to find out if these can be verified objectively and, if so, to investigate if they are caused by the treatment or if they are signs of natural variations in human physiology.

 

Second Impact Syndrome Explained

Second Impact Syndrome Explained

The Mayo Clinic describes second impact syndrome (SIS) as a complication arising from a concussion. It occurs when someone experiences a second concussion prior to fully recovering from the initial one. With SIS, “typically fatal brain swelling” occurs. R.C. Schneider first described this condition in 1973, but it wasn’t until 1984 that someone gave it the name, “second impact syndrome”. The condition is rare enough that only 21 cases had been cited in the literature up until 2003.

When a concussion takes place, the levels of various chemicals in the brain are changed. This altered state is believed to contribute to a person’s susceptibility to second impact syndrome. Because it normally takes approximately one week for the chemical levels in the brain to return to normal after a concussion, the patient should wait at least this long before returning to any activity that might result in another concussion. But one week is a minimum. The time it takes to recovery fully from a concussion is highly variable and depends on both the nature of the injury and the patient involved. For this reason, it is vitally important that athletes not return to sports while symptoms of a concussion persist and that they receive clearance from an appropriately trained healthcare professional before resuming any sort of risky activity.

NHL star Sidney Crosby learned a lot about concussions first-hand. While playing with the Pittsburgh Penguins in January 2011, he received a concussion. He suffered from a second one only four days later. It took him 11 months to fully recover. Crosby said, “With concussions there is not generally a time frame or a span where you’re feeling better. You feel like you’re getting better and it can be one day and you’re back to where you started. It’s a frustrating injury.” It wasn’t until he was treated by chiropractic clinical neurologist, Ted Carrick, DC, that Crosby recovered from all his symptoms.

Even the mildest of concussions can lead to second impact syndrome, because it’s not the strength of the impact that is the greatest danger. An impact of any force while the brain is still recovering can result in the catastrophic swelling attributed to the syndrome.

Most cases attributed to SIS occur in those who are not yet fully grown. Children and adolescents are thought to be the most susceptible with adolescent athletes at greatest risk for second impact syndrome.

Some researchers have recently raised questions about whether or not SIS actually exists. In their own analysis, they concluded that a majority of cases they examined did not actually meet the diagnostic criteria for SIS. They also found that in some cases the reports of first impact were incorrect or unreliable. While their findings have led to some controversy in the medical community, it should be pointed out that no one has disproven the existence of the syndrome.

Whatever the controversy, it’s difficult to argue against prevention and an abundance of caution given the potential dangers associated with concussions (and multiple concussions). If you’re an athlete, the first step is to wear appropriate safety equipment for the sport you’re playing. For certain activities (such as football, baseball and cycling), a helmet is essential. On-field awareness and proper technique can also go a long way toward preventing head injuries. However, it’s important for players, parents and coaches to recognize that even helmets, good supervision and expert training are no guarantee against initial concussions. They are a risk that can be managed but never wholly eliminated.

When it comes to preventing subsequent concussions, though, there are three additional steps many communities have taken to protect young athletes:

  • Requiring responsible adults to receive concussion-awareness training so that they can recognize the signs of a potential concussion.
  • Requiring officials, coaches and managers to remove injured players from the field when a concussion is suspected.
  • Requiring the approval of an appropriately trained healthcare professional before allowing any athlete with a suspected/actual concussion to return to sports-related activities.
What Are “Manual Therapies” and How Are They Used?

What Are “Manual Therapies” and How Are They Used?

Manual therapies have been used to treat musculoskeletal disorders for thousands of years. Practitioners around the world—in countries with many different cultural influences and diverse medical traditions—have used their hands to manipulate various parts of the body to stimulate healing. “Manual” literally means “by hand.” Thus, manual therapies consist of healing techniques that use the hands. There are more than two dozen techniques used worldwide. Among the most commonly known are acupressure, chiropractic, massage therapy, physiotherapy, reflexology, Rolfing and shiatsu.

There are also dozens of other, lesser-known manual therapies, including the Bowen technique, cranio-sacral therapy, the Dorn method, manual lymphatic drainage, muscle energy technique, myofascial release, myotherapy, naprapathy and zero balancing. We examine the most common therapies here:

Acupressure

Using the hand, the elbow or various devices, an acupressure practitioner applies a light force on various parts of the body following the patterns found in traditional Chinese medicine and acupuncture. More than half of the scientific studies on acupressure showed that this technique was effective, but some critics have claimed “a significant likelihood of bias.”

Chiropractic

Most chiropractic work involves manipulation of the spine to achieve better vertebral alignment. Lower back pain is perhaps the primary complaint which leads patients to a chiropractor. Chiropractors are expert at treating musculoskeletal conditions without the use of drugs or surgery. Among others, many top athletes swear by their chiropractor’s hands to keep them performing at their best and help them avoid injuries.

Massage Therapy

This is perhaps the oldest of the manual therapies. Massage was (and still is) used in ancient Egypt, China, Mesopotamia, and other parts of the world that gave rise to early civilizations. Massage practitioners chiefly use their hands, but also other parts of their body to apply pressure, rolling motions and other techniques to muscles and joints, to stimulate circulation and relax the patient. In today’s high-stress world, massage is proving ever more popular.

Physiotherapy

Physiotherapy has been used for years as standard treatment for patients suffering from musculoskeletal conditions. A physical therapist uses a variety of techniques to help their patients regain function—particularly mobility. Repetitive, assisted motion can help the patient strengthen muscles that have been damaged through injury or disease. Assisting the patient in the performance of targeted exercises can help a patient regain greater range of motion.

Reflexology

A trained reflexologist applies pressure to various parts of the feet, hands or ears to stimulate organs within the body associated with the part to which pressure is being applied. It is a Chinese therapy with a philosophy that is similar to acupuncture—using points on the body to restore energy flow. Although there is not yet much scientific evidence to support its effectiveness, anecdotal evidence shows that patients are happier and more relaxed after treatment.

Rolfing Structural Integration

Rolfing specifically targets the body’s connective tissue to release tension, realign and balance the body. Rolfing techniques involve deep-tissue massage to achieve therapeutic benefits such as better posture and greater freedom of movement, including reducing stress and relieving pain.

Shiatsu

A traditional Japanese therapy, the term Shiatsu means “finger pressure,” but can include palm pressure and other approaches to massage. A Shiatsu practitioner uses touch, comfortable pressure and manipulative techniques on specific points of the body (similar to the meridians of Traditional Chinese Medicine) to adjust the body’s physical structure and balance its energy flow. Anecdotal evidence shows it to relieve patients of stress, nausea, muscle pain, depression and anxiety.

 

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