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Spotlight on Massage and Lower Back Pain

Spotlight on Massage and Lower Back Pain

According to the National Institutes of Health, lower back pain is the second most common form of chronic pain after headaches. Experts estimate that approximately 80% of Americans will seek help for low back pain at some point during their lives. Public health officials and insurers estimate that Americans spend $50 billion each year on treatments that are often ineffective. The standard treatment for lower back pain is to take muscle relaxants, painkillers or anti-inflammatory medications, along with physical therapy and back exercises. However, few medical interventions relieve pain reliably, and continuing to take painkillers on a long-term basis is not advised. Massage, on the other hand, has been found to be an effective way of dealing with back pain on a regular basis.

Treatment for lower back pain accounts for approximately a third of all visits to a massage therapist. A study published in the Annals of Internal Medicine found that patients suffering from lower back pain of unknown origin were helped more by massage than by conventional medical treatment. Of 401 total study participants, 133 received traditional medical care with no massage, 132 received structural massage (which addresses particular muscular and skeletal structures that cause pain) and 36 received relaxation massage (a general form of massage, such as Swedish, intended for overall relaxation).

Participants in the massage groups received one hour-long massage once a week for 10 weeks. All participants completed a questionnaire at the beginning of the study, then again at 10 weeks, 24 weeks and a year after the beginning of the study to report on their perceived pain. Both kinds of massage groups reported greater pain relief and ease of motion after 10 weeks of treatment than the medical group.

An average of 37% of the patients in the massage groups reported that their pain was almost or completely gone, while only 4% of the usual care group reported similar results. This was also the case at 26 weeks. However, at the one-year mark, the benefits to all groups were about equal. The type of massage used did not seem to matter, with both massage groups experiencing comparable levels of pain relief. The massage groups were less likely to report having used medication for their back pain after the 10 weeks of intervention, and they also reported having spent fewer days in bed and had lost fewer days of work or school than those in the usual care group.

Dr. Richard A. Deyo, professor of family medicine at Oregon Health and Science University in Portland says of the study, “I think this trial is good news in the sense that it suggests that massage is a useful option that helps some substantial fraction of these patients. Like in most other treatments, this is not a slam dunk, and it’s not like a cure, but it’s something that seems to offer a significant benefit for a substantial number of patients.” Deyo sees massage as a way of people being able to break out of the pain-inactivity cycle. He notes, “I don’t see massage as the final solution, I see it as maybe a helpful step toward getting people more active.”

As always, chiropractic care shows the greatest success in the treatment of all types of back pain. We have found that chiropractic care combined with massage can be a very effective option for many of our patients. If you are currently experiencing back pain, be sure to call our office to schedule an appointment with Dr. Oblander. 406-652-3553

 

Unhealthy Lifestyle Linked to Headaches in Teens

Unhealthy Lifestyle Linked to Headaches in Teens

Most teens experience headaches at some point and many will suffer the debilitating impact of persistent headaches or migraines. Chronic headaches can prevent teens from engaging fully in school, work, and extracurricular activities. Yet little was known about what triggers headaches in teens until now.

A recent study indicated several lifestyle habits associated with migraine and tension headaches in teens. Researchers asked 1, 260 adolescents to fill out a survey on whether they had headaches and if so, the duration and type of headaches they experienced. Participants also responded to questions about their diet and lifestyle including:  their physical activity, consumption of alcoholic, nonalcoholic, and coffee beverages, eating patterns, and whether they smoked.

Nearly half of the teen surveyed had tension headaches, 10% had migraines, and 20% had a combination of the two.  A considerable amount of participants had unhealthy lifestyle habits like drinking, alcohol and skipping meals. However, 75% had never smoked and 43% didn’t drink coffee.

Researchers found that teens were more likely have migraines if they also drank alcohol, coffee, and/or had low levels of activity. Low physical activity was also associated with tension headaches. Teens that smoked were more likely to have a combination of tension and migraine headaches.

While the study indicates correlation rather than causation, the results do suggest strong links between unhealthy lifestyle and the presence of persistent headaches in adolescents. Researches recommended that further research be done to asses whether educational programs could influence teens’ behavior and experience with headaches. If you’re a teen with persistent headaches or someone you love is, consider consulting with a doctor of chiropractic about healthy lifestyle and nutritional choices that can prevent further pain.

Special Note: One of the best things you can do for headaches is see your chiropractor. Be sure to schedule an appointment with Dr. Oblander if you or your child are having frequent headaches! You can call our office at 406-652-3553.

Fiore, Kristina. “Diet and Lifestyle Linked to Headaches in Teens.” Medpage Today. June 7, 2010. Accessed October 26, 2011. http://www.medpagetoday.com/Neurology/Migraines/20521.

Milde-Busch A, et al “Associations of diet and lifestyle with headache in high-school students: results from a cross-sectional study” Headache 2010; DOI: 10.1111/j.1526-4610.2010.01706.x.

Article written by Michael Melton and shared from www.chironexus.net

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.

Why Chiropractic is Superior for Musculoskeletal Pain

Why Chiropractic is Superior for Musculoskeletal Pain

Countless studies have demonstrated that chiropractic care is a safe and effective way to treat musculoskeletal complaints like back pain, neck pain, or sciatica. Now a new study from Switzerland has looked at the relative benefits of chiropractic compared to medical care for the most common types of pain issues.

In this study, the authors examined data from people who reported spinal, hip, or shoulder pain. 403 patients saw a medical doctor for relief; 316 people saw a chiropractor. Four months after treatment, the patients were asked to fill out a survey reporting on their recovery.

The authors found that:

  • “Patients initially consulting MDs had significantly less reduction in their numerical pain rating score…”
  • Patients who saw MDs  were significantly less satisfied with the care they received and the outcome of that care.
  • Patients who saw a chiropractor had significantly lower healthcare costs for their treatment.

The authors conclude that patients should first be sent to a chiropractor for musculoskeletal problems, rather than a medical doctor:

“The findings of this study support first-contact care provided by DCs as an alternative to first-contact care provided by MDs for a select number of musculoskeletal conditions. Restrictive models of care in which patients are required to contact a medical provider before consulting a chiropractic provider may be counterproductive for patients experiencing the musculoskeletal conditions investigated and possibly others. In addition to potentially reducing health care costs, direct access to chiropractic care may ease the workload on MDs, particularly in areas with poor medical coverage and hence enabling them to focus on complex cases. The minority of patients with complex health problems initially consulting a chiropractic provider would be referred to, or comanaged with, a medical provider to provide optimal care.”

Houweling TAW, Braga AV, Hausheer T, et al. First-Contact Care With a Medical vs Chiropractic Provider After Consultation With a Swiss Telemedicine Provider: Comparison of Outcomes, Patient Satisfaction, and Health Care Costs in Spinal, Hip, and Shoulder Pain Patients. Journal of Manipulative and Physiological Therapeutics 2015;38(7):477-83.

Neck Cracking and Grinding: What Does It Mean?

Neck Cracking and Grinding: What Does It Mean?

Most people at some point have heard cracking or grinding noises in their neck upon movement. These sounds, also called crepitus, are usually painless and typically do not represent anything serious.

However, if the neck cracking noise is accompanied by pain, swelling, or some other concerning symptoms, then it may represent a problem that should be checked by a qualified health professional.

Possible Causes of Neck Cracking

Crepitus, sometimes called crepitation or cavitation, refers to any type of noise or sensation such as a cracking, popping, snapping, or grinding sound that is heard during neck movement. For example, feeling a cracking sensation in the neck when turning the head to back up the car.

Crepitus can occur in any moveable joint in the body, and there are many moveable joints in the neck. The neck joints are bathed in an oily-like substance call synovial fluid, which allows motion to freely occur in between the bones.

The underlying cause of crepitus in the neck is still not yet fully understood.

Some likely causes of the neck cracking sound include:

Synovial joint fluid pressure changes
Various studies have been performed purposely cracking the synovial joints of the fingers, but the conclusions in medical literature as to what is actually making the noise have been mixed. In particular, a study published in 1971 indicated that the cracking sound of a joint was caused by the bursting of a gaseous bubble in the joint’s synovial fluid.1 However, a study published in 2015 reported that the cracking sound was actually from the bubble being created.2

Ligament or tendon moving around bone
Another possible factor in neck cracking could be the snapping sound of ligaments and/or tendons as they move over bones or other muscles or tendons located in the neck region.

Bone on bone grinding
While an uncommon cause of neck cracking, it’s possible for bone to grind against bone if the cartilage has worn down. This condition is called osteoarthritis. It occurs gradually with the normal aging process, or it can be accelerated if there has been a traumatic injury such as whiplash or a sports-related injury

This type of crepitation is typically accompanied by pain, limited neck motion, and the cracking sound is usually repeated over and over with each movement. This experience is in contrast to the typical gas bubble formation crack, where it typically takes about 20 minutes before cavitation, or the cracking, can again occur.

Endurance Sports Provide a Boost to the Body’s Nervous System

Endurance Sports Provide a Boost to the Body’s Nervous System

woman-running-in-cold-arid-land

It’s well known that training in certain sports can improve a person’s endurance. If you’re a runner, for example, you know that as you continue to run every day or according to whatever training schedule you follow, you gradually develop the ability to run further, faster, and for longer periods of time. But did you know modern science doesn’t have a complete understanding of why or how this actually happens? Experts still have a lot of unanswered questions about the exact mechanisms at work when an endurance sport triggers these kinds of performance improvements.

When it comes to muscle strength, there’s certainly an element of adaptation at work—it’s clear that the phrase “use it and strengthen it” is every bit as true as “use it or lose it”. But muscle strength isn’t the whole story. Many long-distance runners would probably tell you that their coordination and ability to deal with rough surfaces and obstacles also seem to increase with practice. To them, it seems as if their muscle-brain communication has improved along with their muscle strength.

According to a study conducted at the Biozentrum of the University of Basel, not only may the runners’ perception be correct, but researchers may also have found one of the mechanisms that cause the improvements the runners are noticing. Their research suggests that endurance sports not only change the condition and fitness of your muscles, they also improve the neuronal connections to individual muscle fibers, based on a type of muscle-induced feedback, all accomplished through increased levels of a blood protein called PGC1α.

PGC1α seems to play a major role in muscle adaptation because it regulates the genes that cause muscle cells to change to keep up with the greater demands being placed on them. When your muscles are inactive (or diseased), they contain a low concentration of PGC1α. When the muscles are more challenged, however – for example when running for long distances – PGC1α levels increase. Professor Christoph Handschin and his colleagues in Basel have been able to show that this increase in PGC1α not only increases muscle size and strength, it also improves upstream synaptic nerve connections to and from the muscles.

The presence of more PGC1α improves the health of the synapses that link the muscles to the brain, allowing the muscles to change and develop new activation patterns, based on changing requirements placed upon them by the exercise. In effect, the more you train, the more PGC1α is in your muscles, and the more quickly they are able to “learn” how to become stronger and more adaptable to challenges.

However, the most surprising part of this study, published in the journal Nature Communication may be that Professor Handschin and his colleagues were able to induce this same improvement in synaptic communication by introducing higher concentrations of PGC1α into the muscles artificially. As the researchers increased PGC1α levels, the muscles became stronger and the neuronal connections became stronger, just as if the subjects had been performing endurance training.

These findings are seen as possibly having therapeutic applications in the treatment of diseases such as muscle wasting and amyotrophic lateral sclerosis (ALS or Lou Gehrig’s Disease). As Handschin explains, “In patients, whose muscles due to their illness are too weak to move on their own, an increase in PGC1α levels could strengthen muscles and nerves until the patients can move enough to finally do some physical therapy and to further improve their mobility.” Then after some improvement to their muscles as the result of pharmacological treatment, the patients could continue to improve their muscle strength through practicing endurance sports.

But for healthy people, there’s a much simpler message—certain types of sports normally associated with endurance-building also build muscle coordination and adaptability.  Not only is this type of exercise good for cardiovascular and musculoskeletal health, it also seems to pay big “fitness dividends” for your body’s nervous system.

 

Chiropractic Care and Professional Baseball: The Philadelphia Phillies and Dr. Michael Tancredi

Chiropractic Care and Professional Baseball: The Philadelphia Phillies and Dr. Michael Tancredi

When it comes to helping elite athletes prevent and recover from injuries—as well as achieve peak performance—chiropractic care can offer many advantages. That’s why large numbers of professional and college sports teams throughout the U.S. have turned to chiropractors over the past decade. The Philadelphia Phillies is one such team, and Dr. Michael Tancredi is one such chiropractor. As a Doctor of Chiropractic, a Certified Chiropractic Sports Physician, an Active Release Technique Instructor and Practitioner, and a certified athletic trainer, Dr. Tancredi clearly understands the valuable role that chiropractic care can play in keeping teams healthy and performing at their best.

By almost any measure, Dr. Tancredi has had a long and successful career in sports medicine. He has worked extensively with the Philadelphia Eagles, Philadelphia Phillies, and Villanova University. While Dr. Tancredi has accomplished a great deal in his professional life (and he continues to work with patients through his practice in Broomall, Pennsylvania), he is perhaps best known as the chiropractor who went all the way to the 2008 World Series as a consultant with the Philadelphia Phillies. From 2008 through 2010, he was a chiropractor and Active Release Technique provider for the team.

Cole Hamels, a member of the 2008 Phillies team, has been very vocal about the difference chiropractic care has made for him. “Being introduced to chiropractic care has definitely helped my game. When you add it with a lot of the physical therapy exercises and the in-game exercises, I think it just prevents a lot of injury. I went through a lot of injury in my career, and the first time I actually was introduced to chiropractic care, it pretty much kept me on the field. It’s something that helps me feel much better when I’m on the field and off the field.”

As a pitcher, Hamels is particularly aware of the complex biomechanics involved in throwing a baseball, and recognizes how the larger muscle groups—not just the shoulder and elbow—must work together to perform well. “Your body starts from the ground up, and in order to pitch, you have to use everything. You have to have a good back in order to get the good torque. Most of your power comes from your core.”

It’s a challenge staying healthy through a 162-game regular season, and players at the elite major-league level do what they can to avoid injuries. Hamels recalls how chiropractic care became popular among his teammates and coaches. “It’s another way to help us get out on the field… We’ve seen more and more players start to go in to get adjustments, to get the ART. And I think that’s good for our whole team because you want them to be able to go out on the field every day because we’re very good at what we do, but you’re not going to help the team out when you’re not playing.”

In a brief interview published in ACA Today, Dr. Tancredi described his own experience with the Phillies and explained why chiropractic care is such a good fit for professional baseball. “It was a dream job and a dream season. The whole sports medicine staff was phenomenal. They were all really open to the benefits of chiropractic care. Athletes at this level rarely have an acute injury. However, a little hamstring pull can turn into a major problem when they have no time off. Baseball’s schedule is grueling in that the players are on the field 28 out of 30 days a month, so we have to do what we can to help them heal while keeping in mind the long-term consequences. Chiropractic has cut the injury rate; the players love it, the athletic trainers see how effective it is and the orthopedic surgeon is totally open to my suggestions—it’s a win-win situation.”

Whether you’re playing professionally or at an amateur level, baseball puts unique demands on the body’s musculoskeletal system, from asymmetrical movements (throwing and hitting) and extreme acceleration and deceleration to sudden impacts. Take it from the Phillies and Dr. Michael Tancredi, chiropractic care can help players stay healthy and perform at their best.

If you need to make chiropractic a part of your success protocol, be sure to give our office a call at 406-652-3553 to schedule your appointment with Dr. Oblander!

 

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.
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