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Category: Back health

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. 
Today’s article was written by Michael Melton and has been shared from the following website: https://www.chironexus.net/2018/02/auto-injuries-increase-risk-future-back-pain/
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.

 

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
Written by: Michael Melton on January 23, 2018.
Today’s post was shared from the following website:https://www.chironexus.net/2018/01/ama-chiropractic-effective-acute-back-pain/
Automobile Head Restraints Prevent Injuries—Use Them Correctly!

Automobile Head Restraints Prevent Injuries—Use Them Correctly!

Many people are under the mistaken impression that the head-sized extension at the top of your car’s seat is a head rest. It’s actually not a place to rest your weary head during a long drive, but rather a safety feature called a head restraint that is there to help prevent whiplash in the event of a rear-end collision. And having it adjusted properly can mean the difference between emerging unscathed and enduring weeks of neck pain, along with the cost and inconvenience of medical treatment. 

Whiplash is the most common type of injury in an auto accident. The Insurance Bureau of Canada has conducted studies showing that the proper use of head restraints can reduce the incidence of whiplash by as much as 40%. Russ Rader of the U.S. Insurance Institute for Highway Safety (IIHS) explains what happens when you are involved in a rear end collision: “The head restraint is designed to work with your vehicle’s seat; it keeps your body and head moving together. The problem comes in if your head lags behind your body and snaps backward. That’s what leads to neck injury, or what’s commonly known as whiplash. Modern head restraints are designed to prevent whiplash, and that’s why they’re so much taller than they used to be.” 

One problem is that some people find the newest head restraint designs to be uncomfortable. Some of the common complaints from users at Automedia.com include this one from the owner of a Volkswagen Jetta: “The front headrest points so forward that I get neck pain after just a few miles of driving.” Then there’s this one from a Subaru owner: “Unless you enjoy your face aiming toward your crotch, you may not be able to find a comfortable position for the headrest or your head.” 

One of the reasons for the above complaints is that, in order to get good reviews from the IIHS (many people check the IIHS’s ratings for vehicles before they purchase a car) and comply with the regulations established by the Federal Government for head restraints, auto manufacturers must provide head restraints that meet specific criteria. In particular, the head restraint must be no more than 2.2 inches from the driver’s head and it must be two or more inches higher than was previously required.  

A head restraint can prevent whiplash only if it is as close to your head as possible when a collision happens. When hit from behind, your head snaps quickly backward, then forward, which causes the muscles and tendons in the neck to overstretch and tear. If the head can’t snap back very far, there is much less chance of an injury occurring.  

Most head restraints adjust upward and downward, and some also tilt forward and back. The best position for a head restraint is one in which the head is as close to it as possible, ensuring it is no more than two inches away. The top of the head restraint should ideally be even with the top of your head and should never be any lower than your ears. 

Taking just a little time and effort to position your head restraint correctly can save you a lot of pain and suffering if you are ever in an auto accident. Your health and safety are worth it! 

 

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.

Today’s article was written by Michael Melton and is shared from the following website: https://www.chironexus.net/2017/10/why-teens-should-sit-up-straight/
Auto Accident Folklore—Being Thrown Clear and Bracing for Impact

Auto Accident Folklore—Being Thrown Clear and Bracing for Impact

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You have no doubt overheard someone at work or at a party telling his friends that he never wears a seat belt—and that he has some really good reasons.  The story usually goes something like this:  He heard from a buddy he knows that a friend of a friend who was not wearing a seat belt had a bad car accident and walked away from it because he was thrown clear of the car.  This is one of the most pervasive car safety myths out there. And if you believe this myth, you could be setting yourself up for serious injury or death.

Although there are a small handful of cases in which someone has survived a car accident after being thrown from the car, this is a very rare occurrence.  In fact, you actually have a 25 percent greater chance of being killed if thrown from the car.  Just consider the physics of the situation.  The force applied to your body when a collision occurs can be strong enough to propel you 150 feet, which is equivalent to about 15 car lengths.  And you would not just be flying gracefully through the air either.  First, your body may go crashing through the windshield, it may scrape along the rough asphalt for yards, and then you could end up getting crushed by your own car or someone else’s.  This is not to mention the other objects you may be hurled into when flung from the car.  Statistics from a study performed by researchers at James Madison University show that the proper use of a seat belt reduces serious injuries from traffic accidents by 50 percent and fatalities by 60 to 70 percent.  It’s a simple thing that can protect your health and save your life—wear seat belts.

Another common myth is that bracing for impact causes more damage to your body, and that it’s best to remain relaxed.  Of course, actually having the ability to choose one way or another about bracing has a lot to do with how much time you have before impact.   Many accidents occur in the blink of an eye, so suggesting that someone should “stay relaxed” has really limited practical value.  However, the most current science indicates that if you have time, bracing for impact will likely reduce the amount of injury, particularly to tendons and ligaments.

One of the most common types of injury from an auto accident is whiplash, which occurs in about a third of all collisions.  If you see a car approaching in your rear view mirror that you believe is going to collide with yours, the best thing to do is to press your body against the seatback, with your head pressed firmly against the head rest. This way you are less likely to suffer injuries to the ligaments in your neck, as your head will not be slammed back against the head rest, then flung forward.

Auto accidents are never pleasant, but by knowing the facts about auto safety you can help reduce your chances of sustaining a serious injury.  If you do end up in an accident, it’s always a good idea to get a medical evaluation promptly, even if you think you haven’t suffered any significant injuries.  Many auto injuries take time for their symptoms to become apparent or significant enough for victims to recognize how badly they may have been hurt.  By the time the symptoms are obvious, the victim and his or her doctor may have lost a valuable opportunity to treat the underlying injuries.  Please call or visit the office if you or someone in your family has recently been involved in an auto accident.

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