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Opiates Ineffective for Chronic Back or Hip Pain

Opiates Ineffective for Chronic Back or Hip Pain

A new study just published in the Journal of the American Medical Association finds that opioids are not an effective solution for chronic pain.

In this article, researchers from the University of Minnesota studied 240 patients who had chronic back, hip, or knee arthritis pain. Half of the study subjects received opiates; the other half received non-opiate pain medications. Patient progress was evaluated at 3-months, 6-months, 9-months, and one year.

The study found:

  • There was no difference in pain-related function between the two groups.
  • At 12 months, the nonopioid patients had less pain than did those who received opiates.
  • “The opioid group had significantly more medication-related symptoms over 12 months than the nonopioid group”

The study authors write:

“Among patients with chronic back pain or hip or knee osteoarthritis pain, treatment with opioids compared with nonopioid medications did not result in significantly better pain-related function over 12 months. Nonopioid treatment was associated with significantly better pain intensity, but the clinical importance of this finding is unclear.”

Previous research has found that about 20% of patients with musculoskeletal pain are prescribed narcotic pain medications for their symptoms, and another recent study found that 36% of people who overdosed from opiates had their first opioid prescription for back pain.

Another recent study found that chiropractic patients are less likely to use opiates for their pain than are medical patients.

From this research, it seems clear that it’s risky to prescribe opiates for musculoskeletal pain. Chiropractic care is a proven safe and effective approach for both chronic and acute back pain.

Krebs EE, Gravely A, Nugent S, Jensen AC, DeRonne B, Goldsmith ES, Kroenke K, Bair MJ, Noorbaloochi S. Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial. JAMA. 2018 Mar 6;319(9):872-882. doi: 10.1001/jama.2018.0899.

Today’s article was written by Michael Melton and is shared from the following website: https://www.chironexus.net/2018/03/opiates-ineffective-for-chronic-back-or-hip-pain/

Auto Injuries Increase Risk of Future Back Pain

Auto Injuries Increase Risk of Future Back Pain

The National Highway Traffic Safety Administrations reports that more than two million people are injured every year in auto-related accidents involving either a passenger vehicle, large truck, or motorcycle. Furthermore, that number appears to be climbing at an alarming rate, increasing more than five percent between 2014 and 2015 alone.

Certainly, being involved in this type of incident can have long-lasting effects. For instance, one study published in the journal Psychosomatic Medicine found that “a substantial minority” of subjects questioned reported experiencing anxiety when traveling in a motor vehicle post-accident, with 10 percent developing post-traumatic stress disorder (PTSD), a condition that, in some cases, plagued them for years.

Well, another recently published study has found that being in a car crash can also result in long-term physical ramifications as well. Specifically, it discovered that back pain can linger or appear long after the vehicle has been fixed and the debris has been cleaned out of the roadway.

In April of 2017, the European Spine Journal presented a study involving 789 adults, all of whom reported experiencing mild low back pain or no pain at all. Upon entering the study, each person was asked whether or not he or she had been in a motor vehicle accident resulting in low back pain, making note of whether their level of pain increased, decreased, or stayed the same six and 12 months down the road.

Approximately 74.8 percent of the participants responded at the six month mark, with 64.5 percent providing input at 12 months. Of those who did respond, researchers noticed a positive correlation between those who had previously been involved in an auto accident and the incidences of low back pain at a later date. In other words, having a car crash in your past may increase your risk of back pain in the future.

This is partially why being assessed right after a car wreck is so critical. While this is relatively standard when it comes to auto injuries that can be seen or easily felt, damage done to the musculoskeletal system isn’t quite so visible or easy to pinpoint, which also makes it easier to ignore.

Educating patients is the first step to helping them resolve any subsequent back issues. The second step is to regularly ask them whether they’ve been involved in a crash, no matter how small. If they have, addressing that issue first and foremost can keep their quality of life from being compromised months, years, or even decades later.

References

  • Mayou R, Tyndel S, Bryant B. Long-term outcome of motor vehicle accident injury. Psychosomatic Medicine 1997;59(6):578-84.
  • Nolet PS, Kristman VL, Côté P, Carroll LJ, Cassidy JD. The association between a lifetime history of low back injury in a motor vehicle collision and future low back pain: a population-based cohort study. European Spine Journal 2017;doi:10.1007/s00586-017-5090-y
  • Traffic Safety Facts. (August 2016). 2015 Motor Vehicle Crashes: Overview. National Highway Traffic Safety Administration. 
Exercise, Chiropractic More Effective Than Medicine

Exercise, Chiropractic More Effective Than Medicine

You may remember your grammar school gym class where the PE teacher would lead you in jumping jacks, push-ups, sit-ups and arm circles. If you’re like a lot of baby boomers, you probably look back and assume it really didn’t do much for the health of the students — just kept the class busy for an hour.

Elementary school days may be way behind you, but exercise carries many benefits now that it couldn’t offer a younger you, especially if you’re battling pain from an injury or chronic condition.

The Journal of Manipulative and Physiological Therapeutics published a report on randomized controlled trials, or RCTs, looking at the result of exercise as treatment for patients experiencing intense pain from soft tissue injuries in the hip, thigh or knee. Success was measured by the following factors:

  • Intensity of pain
  • Recovery
  • Quality of life
  • Psychological outcomes
  • Adverse events

“One RCT found statistically significant improvements in pain and function favoring clinic-based progressive combined exercises over a ‘wait and see’ approach for patellofemoral (anterior knee) pain syndrome,” the study says. “Patients with patellofemoral pain syndrome or groin pain had the best results with clinic-based exercise programs.”

Head to Head to Head

An ABC News blog posted study results comparing the outcome of three different forms of treatment for pain. Results show that patients treated by chiropractic professionals and the individuals who received home exercise advice, referred to as HEA, had higher rates of success than those who turned to medication for relief. Just 13 percent of the patients who took medication reported a satisfactory reduction in pain, whereas, about two-thirds of those who were treated through either chiropractic care (32 percent) or HEA (30 percent) said they were pain-free.

A total of 272 patients, ages 18-65, who were suffering from recent-onset neck pain took part in the study, which the National Institutes of Health spearheaded.

“I always prescribe exercises and/or physical therapy for neck pain,” wrote Dr. John Messmer from Penn State College of Medicine. “I also tell patients that the exercises are the treatment and the drugs are for the symptoms.”

Dr. Lee Green, professor of family medicine at the University of Michigan, also talked to ABC News. “Doesn’t surprise me a bit,” Dr. Green said. “Neck pain is a mechanical problem, and it makes sense that mechanical treatment works better than a chemical one.”

The study, which was published in the Annals of Internal Medicine, singles out the effectiveness of spinal manipulation therapy, or SMT, to provide relief for patients with neck pain. Researchers found that in both the short-term and long-term statistics, SMT had the most effective outcome. The report adds that HEA proved equally effective at some points in the study.

Participants rated their pain at several intervals: 2, 4, 8, 26, and 52 weeks. This enabled scientists to draw specific conclusions, such as the evidence showing that 12 weeks of SMT provided greater pain relief than up to one year of medication.

Chiropractic Benefits

Your chiropractor can not only provide pain releif and preventatiive therapies, they can also guide you in choosing exercises that target the areas you need treating. Chiropractic visits, in addition to home exercise practices, are a way to double down on your odds of successful treatment.

The Mayo Clinic website says there are multiple benefits to using exercise in addition to chiropractic care for your joints, as well as improving general wellness. In combination they serve to:

  • Strengthen the muscles around your joints
  • Help you maintain bone strength
  • Give you more energy to get through the day
  • Make it easier to get a good night’s sleep
  • Improve your balance

We’re not talking about the kind of punishing calisthenics that win you the Presidential Physical Fitness Award, but something to just curb your symptoms and add some range of motion. Consulting with a chiropractor and incorporating some exercise seems to be the best way to get a passing grade in pain relief.

This article was written by Martha Michael and is shared from the following website: exercise-chiropractic-more-effective-than-medicine

Friday Funny

Friday Funny

We thought we would end the week with some Chiropractic humor! We hope you get a giggle out of today’s post! Humor is great for your health! If you have been out shoveling all that snow that we have received recently and your back is not feeling “humorous”, be sure to give us a call and get adjusted by Dr. Oblander before those aches and pains get too out of hand! Our office number is 406-652-3553. Have a wonderful weekend and stay safe and warm!

Why Do Chiropractors Use “Palpation”?

Why Do Chiropractors Use “Palpation”?

Palpation is the most frequently used diagnostic technique in chiropractic care and is a clinical cornerstone of most physicians’ practice. It is a manual, non-invasive method of determining where a patient has structural or functional problems in the body.

In palpation, chiropractors use their hands and their detailed knowledge of anatomy to effectively see what is happening in the spine and its supporting structures, such as the muscles, tendons and ligaments. As your chiropractor palpates your spine, he or she will look for subluxations in your vertebrae, which are misalignments that may be causing pressure on spinal nerves, or other abnormalities that may be causing problems in your musculoskeletal system.

There are essentially two forms of palpation—static and motion. As the name suggests, in static palpation the patient remains still while the chiropractor palpates the spine and tissues to identify any misaligned vertebrae, protruding disks, and areas of pain or inflammation. In motion palpation however, the patients joints are mobilized, bending and flexing under the expert eye and hand of the chiropractor. He or she will move various joints through different planes, observing the patient’s range of motion and where a joint may “lock up.” They will also measure the patient’s amount of flexibility, muscle strength, stiffness, reflexes and general neurological function.

Palpation may be used at every visit to your chiropractor so they can quickly determine whether your condition has improved or not since your last visit and they can see which areas need the most care and attention. Based on what your chiropractor finds during palpation, he or she may then order additional diagnostic tests—an x-ray, MRI or CT scan, for example—to get a more detailed view of your condition.

Your chiropractor will also perform a visual examination to detect any swelling or abnormal curvature of the spine, and will observe your gait to see the coordination of your head, neck and pelvis as you move. They will also take a full medical history and ask about the location, frequency and severity of any present and past conditions.

Based on all these diagnostic tools, your chiropractor can better determine the type and frequency of treatment necessary to resolve your condition in a way that is holistic, drug-free and non-invasive. Palpation is simply another tool in the chiropractor’s arsenal of techniques to keep you moving well and pain-free.

With all of the snowy weather we have had, you may need your back palpated! Be sure to schedule an appointment with Dr. Oblander by calling 406-652-3553.

 

The New Science of Slips and Falls: What the Research Tells Us

The New Science of Slips and Falls: What the Research Tells Us

While we’ve all seen the old banana peel skit, slips and trips in the real world are no laughing matter. Simply falling to the floor or pavement from an upright position causes a great many serious injuries—and even deaths—each year. No one really knows for certain how many falls could actually be prevented, but the topic is of growing interest to a wide variety of people, from public health officials, designers, architects and community planners to business owners, workplace supervisors and employees. Senior citizens are perhaps the most at risk. The U.S. Centers for Disease Control and Prevention (CDC) presents several statistics that highlight this point:

  • One out of three older adults (those aged 65 or older) falls each year, but less than half talk to their healthcare providers about it.
  • Twenty to thirty percent of people who fall suffer moderate to severe injuries such as lacerations, hip fractures, or head traumas. These injuries can make it hard to get around or live independently, and increase the risk of early death.
  • Among older adults, falls are the leading cause of both fatal and nonfatal injuries. In 2010, about 21,700 older adults died from unintentional fall injuries. Over 95% of hip fractures are caused by falls. In 2010, there were 258,000 hip fractures.
  • Many people who fall, even if they are not injured, develop a fear of falling. This fear may cause them to limit their activities, which leads to reduced mobility and loss of physical fitness, and in turn increases their actual risk of falling.
  • In 2010, 2.3 million nonfatal fall injuries among older adults were treated in emergency departments and more than 662,000 of these patients were hospitalized. In 2010, the direct medical cost of falls, adjusted for inflation, was $30 billion.

Walking is a very complex activity, and science has only recently begun to understand the biomechanics involved. Shirley Wang wrote in a recent Wall Street Journal article, “Scientists are finding that maintaining stability and balance with each step we take requires complex coordination of foot placement, arm movement, trunk angle and neck and head motion.” At the same time, researchers are also learning how other factors like sloping, uneven or slippery surfaces and obstructions come into play. There are many variables to consider. Even when the body’s movements are perfectly coordinated, small things about environment can still foil our best efforts to remain upright.

We know from nervous system studies that the body is capable of reacting within milliseconds. Science has shown that a person’s balance is maintained by simultaneous feedback from the body’s visual system, proprioceptive system and inner ear. If one of these systems becomes less efficient or fails altogether, then the other two can usually compensate to keep us balanced. If two fail, then balance becomes far more difficult. Aging frequently leads to poorer eyesight and troubles with the inner ear, so it’s small wonder that seniors are more likely to fall.

Canadian researchers at Simon Fraser University used video cameras in a long-term care facility to see if seniors were right about “tripping” or “slipping” being the reasons for their falls. What they found was surprising. Tripping actually accounted for only 20% of events. The nearly 3-year study of 227 falls involving 130 people showed that the single largest cause (41%) was from improper weight shifting, such as leaning over too far. This seems to indicate a failure in the seniors’ proprioceptive system.

There are a few ways you can help to prevent slips and falls. Be sure to keep walkways clear of clutter, and consider adding non-skid material to flooring—especially to floors that are more likely to become wet. Maintaining your strength helps too. Upper body strength is particularly important for catching yourself before or during a fall. Even when there’s nothing to grab onto, having the sort of upper body strength that helps you to do push-ups can soften the blow to more sensitive parts of the body. Reaching out with hands and flexing elbows upon impact can slow the fall or stop it altogether. The late Jack LaLanne, fitness guru, was still doing fingertip pushups at age 93. Don’t say it can’t be done!

Balance requires that every part of the body works well together. Dr. Oblander can help you maintain this balance by ensuring you have a healthy spine and nervous system.  He can also recommend specific exercises that maintain or increase your upper body strength.  So if you or someone you care about is interested in avoiding slips and falls, we can help you take advantage of the latest research!  Just call or visit our office today: 406-652-3553!

 

Tips for a Healthy Spine

Tips for a Healthy Spine


A healthy spine is an often overlooked and essential part of a healthy lifestyle. People who suffer from back pain, particularly if it is long-term, are generally less healthy than those who do not. In fact, back pain costs are staggering not only financially, but also in terms of lost time from work and because of psychosocial problems that arise during the healing process associated with long-term back pain.

Unfortunately, approximately 80-90% of the population suffers from spinal pain at some point. People who are overweight or obese, and who smoke, lift heavy objects, or had a previous episode of back pain, are more likely to experience back pain.

Because so many people suffer from spine pain, it’s important for you to try to keep your spine as healthy as possible. Following simple posture, lifting, and healthy lifestyle guidelines can help you keep your back in good shape. One of the best things you can do for your spine is to get regularly adjusted. If you are in need of an adjustment, be sure to call our office at 406-652-3553 and schedule an appointment with Dr. Oblander. In the meantime, here are some good ways to take care of your spine:

The American Chiropractic Association recommends the following spinal health tips:

Standing

• When standing, keep one foot slightly in front of the other, with your knees slightly bent. This position helps to take the pressure off your low back.

• Do not stand bent forward at the waist for prolonged periods of time. The muscles in your low back become deconditioned in this position, which may lead to pain.

Lifting

• At all times, avoid twisting while lifting. Twisting is one of the most dangerous movements for your —spine, especially while lifting.

• If the item is too heavy to lift, pushing it is easier on your back than pulling it. Whenever possible, use your legs, not your back or upper body, to push the item.

• If you must lift a heavy item, get someone to help you.

Sitting

• Keep your knees slightly higher than your hips, with your head up and back straight.

• Avoid rolling your shoulders forward (slouching).

• Try to maintain the natural curve in your low back.

Reaching and Bending

• When reaching for something above shoulder level, stand on a stool. Straining to reach such objects may

not only hurt your mid-back and neck, but it can also bring on shoulder problems.

• Do NOT bend over at the waist to pick up items from the floor or a table.

• Instead, kneel down on one knee, as close as possible to the item you are lifting, with the other foot flat on the floor and pick the item up.

• Or bend at the knees, keep the item close to your body, and lift with your legs, not your back.

Carrying

• When carrying objects, particularly if they are heavy, keep them as close to your body as possible.

• Carrying two small objects—one in each hand—is often easier to handle than one large one.

Healthy Diet and Exercise

• While the proverbial jury is still out, we suspect that extra weight puts undue strain on your spine. Keep within 10 lbs. of your ideal weight for a healthier back.

• “Beer belly” is likely the worst culprit, as it puts unwanted pressure on the muscles, ligaments and ten- dons in your low back.

• The most efficient and effective way to reduce weight is by eating a sensible diet and exercising regularly.

• Consult with your doctor before beginning any exercise program, particularly if you have a health condition.

Sleeping

• Sleeping on your back puts approximately 50 pounds of pressure on your spine. Other positions may be better

.
• Placing a pillow under your knees while lying on your

back cuts the pressure on your spine roughly in half.

• Lying on your side with a pillow between your ——– knees may also reduce the pressure on your back.

• Never sleep in a position that causes a portion of —- your spine to hurt. Most often, your body will tell you what position is best.

Quit Smoking

Smokers have more spine pain than nonsmokers, and they also heal more slowly when they have an episode of back pain because the chemicals in tobacco smoke restrict the flow of blood to the tissues in and around your spine.

While following these instructions is no guarantee that you’ll be free from back pain for your entire life, it can certainly reduce your risk of developing it. These simple steps will help you keep your spine in good shape, making you a healthier, happier person.

Lawrence H. Wyatt, DC, DACBR, FICC, Professor, Division Of Clinical Sciences, Texas Chiropractic College, Writer

Nataliya Schetchikova, PHD, Editor

This health article was shared from the following website: http://www.chiroworkscarecenter.com/documents/Articles/ACA_healthy_spine.pdf

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/
Overcome the Fear of Movement After Auto Injury! Find out why… Author: Michael Melton No Comments Share:

Overcome the Fear of Movement After Auto Injury! Find out why… Author: Michael Melton No Comments Share:

Imagine what happens when you injure your neck in an auto injury…

Your muscles contract, there’s a burst of pain, and a soreness that makes you want to avoid moving your neck too much or turning too far. You may worry about re-injuring yourself or you may think, “I could do more harm than good by moving my neck.” Unfortunately, not moving your neck after an auto injury can actually be worse for your recovery, especially for people after a car accident.

A new study examined the effects of fear of movement on neck disability and range of motion in 98 patients after a car crash!

While the patients’ injuries ranged in severity, all of the patients had pain for under a month and all were injured in an auto collision. Researchers measured patients’ levels of fear using two different scales. They also examined neck range of motion and degree of neck disability. Patients were evaluated after one, three, and six months after the injury.

Patients who were more afraid to move their neck had more severe neck disability and reduced range of motion. Increased fear also prolonged the symptoms. In contrast, patients with lower levels of fear were more likely recover before the six month follow up.

Maintaining movement after an injury does more than just reduce anxiety. It also ensures that tissues don’t become more tense, restricted or damaged. Chiropractic can help you with recovery, because chiropractic works by restoring the normal movement and function of your neck and back.

Conclusion

If you’ve been in a car crash, don’t wait to get treatment. It’s important to get your spine moving again as soon as possible! Chiropractic can help you on the path to recovery! If you are in a car accident, be sure to call our office and schedule an appointment with Dr. Oblander to make sure that you are getting the appropriate treatment you need and to make sure you get the best possible care.

This article was written by Michael Melton and is shared from the following website: https://www.chironexus.net/2017/10/fear-movement-after-auto-injury/

Why teens should sit up straight

Why teens should sit up straight

How many times did you hear, “Sit up straight!” as a child? How many times have you said this to your own child? There’s  a reason behind that famous advice: poor posture early in life may lead to a number of back problems and pain later on. That’s why researchers conducted a study to better understand slouching in adolescents.

Researchers had 1,5092 adolescents complete questionnaires about their lifestyle and experience with back pain. Their sitting posture,  body mass index (BMI), and back-muscle endurance were also measured. Researchers discovered that boys were much more likely than girls to slouch. Watching TV, having a higher BMI, and having lower self-efficacy also increased a teen’s likelihood of slouching.

Teens who slouched also tended to have lower back-muscle endurance and non-neutral standing position. Some teens noticed their back pain increased while sitting, and those teens often had poorer scores on a child-behavior test.

These findings suggest that whether or not a child slouches isn’t simply about whether they remember to sit up straight. Encouraging healthy lifestyle habits and a strong self-esteem could also play a big role in helping your teen develop good posture. A doctor of chiropractic can evaluate your child’s sitting and standing posture to help them avoid future back pain.

O’Sullivan PB, Smith AJ, Beales DJ, Straker LM. “Association of Biopsychosocial Factors With Degree of Slump in Sitting Posture and Self-Report of Back Pain in Adolescents: A Cross-Sectional Study.” Physical Therapy 91.4 (2011): 470-83.