Browsed by
Category: Chronic Pain

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/

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.

Surprise: Chiropractors Can Treat These 5 Conditions

Surprise: Chiropractors Can Treat These 5 Conditions

Read on if you’re stressed, have a migraine or struggle with flexibility.

Chiropractors are trained as neuromusculoskeletal specialists, and one of the main focuses of chiropractic care is the positive impact it can have on a person’s nervous system.

You might think chiropractors are only able to help with back aches, stiff necks, slipped discs and whiplash injuries. If so, you’re not alone – but you’re missing out.

Chiropractic care – which is based on the understanding that, given the opportunity, the mind and body can heal itself – can treat many issues that might surprise you.

Here’s a look at the top five most surprising conditions a chiropractor can treat:

1. Migraines and tension headaches

Nine out of 10 Americans suffer from headaches. Some are occasional. Some are persistent. Some are dull and nagging, while others cause debilitating pain and nausea. Taking a painkiller and hoping your headache goes away is one option. But there’s a better one.

Research shows that spinal manipulation – the primary form of care provided by chiropractic doctors – is an effective way to treat tension headaches and headaches that begin in the neck.

In a clinical trial conducted at Macquarie University, 72 percent of migraine sufferers experienced either “substantial” or “noticeable” improvement after a period of chiropractic treatment.

In fact, most headaches are related to muscle tension in the neck, which is an increasingly common condition among Americans who spend hours in the same position or posture (such as in front of a computer or television), leading to joint irritation and tension in the upper back and scalp that cause headaches.

What Can a Doctor of Chiropractic Do?

  • Perform spinal manipulation or chiropractic adjustments to improve spinal function and alleviate stress on your system.
  • Provide nutritional advice, recommending a change in diet or the addition of vitamins.
  • Offer advice on posture, ergonomics, exercises and relaxation techniques.

2. Stress and anxiety

We perceive stress from three basic sources: our environment, our body and our emotions.

Environmental stress includes noise, weather, physical threats, time pressures and performance standards. Body stress includes disease processes, organ malfunction, poor nutrition, poor sleep and physical injury. And emotional stress is more difficult to define, but it encompasses our reactions, in both thought and emotion, to environmental and physical stressors.

Jobs today are increasingly complex as the business world becomes more and more competitive. Physical stresses such as sound, air and water pollution have also grown worse over the last century – especially in the United States – and so have emotional and psychological stresses caused by an increasing awareness of troubles and tragedies around the globe, brought to our attention every hour by the Internet and its 24/7 news cycle.

Many illnesses are caused or worsened by stress, which activates our “fight or flight” reaction. This systemic reaction affects almost every part of the body, as the hypothalamus in the brain stimulates the sympathetic nervous system, which causes an increase in heart rate, blood volume and blood pressure, redirecting blood away from our digestive system and extremities.

When prolonged, the long-term effects of this state can be disastrous to good health and cause high blood pressure, muscle tissue damage, diabetes, infertility, damage to the immune system and slowed healing from disease and injury.

Chiropractors work primarily with the spine – the root of the nervous system through which nerve impulses travel between the brain and the rest of the body – and can help the body manage and process this stress in a healthier way.

What Can a Doctor of Chiropractic Do?

  • Chiropractors can release muscle tension, one effect of chronic stress that leads to nerve irritation and creates uneven pressures on the body’s bony structures, which can cause the spinal column to become misaligned. This, in turn, helps the body return to a more balanced, relaxed state.
  • Chiropractic adjustments can reduce spinal nerve irritation and improve blood circulation, which can help signal the brain to turn off the “fight or flight” response and begin the healing process.
  • A doctor of chiropractic can suggest nutritional supplements, like B complex vitamins, to help the body cope with stress.
  • A chiropractor can also recommend relaxation techniques and discuss posture and environmental changes to help you recover from chronic stress.

3. Fibromyalgia

Fibromyalgia is a chronic disorder involving widespread pain and sensitivity throughout the entire musculoskeletal system. To be diagnosed with FM, a patient typically has a minimum of 11 out of 18 specific tender points on the body. In addition to pain, patients also report long-term fatigue and/or disturbed sleep and mood. Other disorders commonly associated with FM include irritable bowel syndrome, TMJ pain and dysfunction, psychological conditions and some autoimmune diseases.

Fibromyalgia is a widespread condition that affects about 2 percent of the United States, and medical science has yet to discover the cause of this condition.

Since those with FM often experience an altered mood, like depression, many experts focus on the psychological aspect of the disease. Others feel that FM is more physiological and has its origins in physical trauma or chronic postural alterations. Still others suggest that FM is a central nervous system disorder rooted in neurochemical imbalances, since those with FM are hypersensitive to even the slightest stimuli and often have a pain response to normally non-painful pressure or activity. Since all information from the outside world is collected and analyzed by the nervous system, it’s logical to assume that if a person with FM is sensitive to a stimulus that others are not, there may be something wrong with this system.

It’s often difficult for patients to find solutions for all of their symptoms, but recent studies show that chiropractic adjustments combined with a soft tissue technique called ischemic compression can help FM patients.

In one study, 60 percent of the subjects treated by a chiropractor experienced a significant improvement: reduced pain, improved sleep and decreased fatigue.

What Can a Doctor of Chiropractic Do?

  • Chiropractors are trained as neuromusculoskeletal specialists, and one of the main focuses of chiropractic care is the positive impact it can have on a person’s nervous system. Therefore, chiropractic adjustments can improve a FM patient’s nervous system, which gives them a better chance for recovery.
  • Chiropractic care can treat pressure points, back pain, neck pain, shoulder pain, headaches and pain from musculoskeletal injuries.
  • Chiropractors can also reduce a patient’s overall pain through spinal adjustments that increase the mobility between spinal vertebrae, which have become restricted, locked or slightly out of proper position, thereby increasing cervical and lumbar range of motion.

4. Weak immune systems

The nervous system, endocrine system and immune system are inextricably linked. Together they share tiny messenger molecules that mediate communication between them, creating optimal responses for the body to adapt and heal appropriately.

Until recently, one of these messenger molecules, IL-2, was thought of as an immune system molecule. But recent studies have clearly shown its presence and activity in the nervous system, leading researchers to believe that neural dysfunctions due to spinal misalignments are stressful to the body and can cause abnormal changes that lead to a poorly coordinated immune response.

Subluxation is the term for misalignments of the spine that cause compression and irritation of nerve pathways, affecting the body’s organs. Subluxations are an example of physical nerve stress that affects neuronal control. According to researchers, such stressful conditions lead to altered measures of immune function and an increased susceptibility to a variety of diseases.

It’s important to note here how the endocrine system also impacts the immune system by producing cortisol in the adrenal glands – endocrine glands that are directly connected to the nervous system through the sympathetic nervous system – a stress hormone that inhibits the immune system.

If the sympathetic nervous system is too “switched on” due to stress and subluxation, it can increase the adrenal glands’ synthesis of cortisol, in turn affecting the immune system.

What Can a Doctor of Chiropractic Do?

  • Chiropractic care is the only way to detect and eliminate subluxation, and chiropractic adjustments have been shown to reduce the stress on the nervous system, thereby boosting the coordinated responses of the nervous and immune systems.
  • One research group found that when an adjustment was applied to a subluxated area, the white blood cell count collected rose significantly.
  • Another study measured the effects of six months of regular chiropractic care on the immune system function of HIV patients. At the end of six months of care, the patients who had received regular adjustments showed a 48 percent increase in the number of CD4+ T cells, whereas patients who had not been adjusted showed an 8 percent decrease in CD4+ T cells.

5. Flexibility

When we’re younger, it’s easy to take our extensive range of motion and flexibility for granted. As we age, a number of health conditions – and the cumulative effects of wear and tear – can affect our ability to move the way we used to.

But a decrease in range of motion and flexibility can result in a downward spiral of disability.

For example, an injury or degenerative condition that causes pain, swelling and stiffness, may limit our flexibility and range of motion. When this happens, we may avoid activities that involve the affected body parts, either consciously or unconsciously.

This then becomes a classic case of “use it or lose it.” Without regular exercise, the muscles and joints stiffen, adhesions and scar tissue can form, and mobility may be further reduced. Eventually, a person can become completely incapacitated, and ordinary tasks such as picking up something off the floor or tying your shoes can become extremely challenging or painful.

Regular chiropractic can help increase both range of motion and flexibility.

A study performed by researchers at the Phillip Chiropractic Research Centre of RMIT University in Melbourne, Australia, and published in the Journal of Manipulative and Physiological Therapeutics found that chiropractic adjustments increased range of motion in the 105 patients who participated in the study. There were three phases of this study, in which each of the participants was given no adjustments, fake adjustments or true adjustments. In each phase, the patients who were given the true adjustments showed a significant improvement in range of motion, which was not the case for the other two groups.

What Can a Doctor of Chiropractic Do?

  • A chiropractor uses spinal adjustments and manipulations to other parts of the body to realign the bones and joints so as to reduce pain, restore range of motion and improve flexibility, balance and coordination.
  • Your chiropractor can also recommend specific exercises that can be done at home to increase your strength and flexibility so that you’re able to maintain and build upon the gains from your chiropractic adjustments.
  • Regular chiropractic care can reduce or eliminate the source of your back and joint pain, allowing you to resume your normal activities and to remain more flexible into your golden years.

Today’s article was written by Dr. David L. Starr is the founder of Starr Physical Therapy, Chiropractic and Acupuncture in New York City, where he has successfully practiced chiropractic for the past 18 years. A native New Yorker, Starr graduated from Life College in Atlanta, Georgia and donated his skills to Flying Doctors of American in the Dominican Republic before returning to New York City and establishing a successful, multidisciplinary office in Union Square.

Today’s article is shared from the following website: https://health.usnews.com/health-news/patient-advice/articles/2015/11/30/surprise-chiropractors-can-treat-these-5-conditions

Nine Reasons to Lose Weight That Have Nothing to Do with Fitting into Your Skinny Jeans

Nine Reasons to Lose Weight That Have Nothing to Do with Fitting into Your Skinny Jeans

We talk a lot about the importance of reaching a goal weight and how to stay motivated. Sometimes, though, it still seems like a laborious task. If you’re carrying extra weight, you probably already know there are a myriad of health-related reasons to slim down. While it may seem impossible, little steps will carry you bit by bit down your weight loss path to your ultimate goal.While keeping your eyes on the big prize, it may help you to realize that even small changes in your weight may improve blood sugar, blood pressure, heart health, reduce cholesterol, and decrease your chances of developing diabetes. We’ve shared many motivational tips, but did you know that when you lose 10% of your bodyweight, you are instantly healthier? There’s no doubt that dropping weight will make you look and feel better, but there are numerous other benefts that you can realize while on your weight loss journey, which have nothing to do with how you look in your skinny jeans. Read more: Strategies for successful maintenance after weight loss.

Fewer Asthma and Allergy Symptoms

The link may not be immediately obvious, but new research has found that for some people, being overweight can make their asthma and allergy symptoms worse. Carrying excess weight on your body puts a burden on the adrenal glands, and your adrenal glands help manage asthma and allergies. In addition, being overweight strains your respiratory system and can make allergy symptoms worse.

Arthritis Relief

Not only does losing weight help relieve arthritis pain, it can also help keep you from developing arthritis—the less you weigh, the less stress on the joints. In addition, recent studies have shown that when you have arthritis and you lose weight, your pain is reduced and your joint functionality significantly improves.

Less Foot Pain

You may not really think about it, but excess weight can put a lot of pressure on your feet, even if you don’t have arthritis. In a recent study, people who had lost an average of 90 pounds found that their incidence of foot pain lowered by 83%. This is understandable because your feet support your entire body, and therefore your entire body’s weight. Relief from foot pain is motivation enough for losing weight.

Glowing Skin

There are numerous ways being overweight may affect your skin, which is the body’s largest organ. Both skin elasticity and color can be altered by lack of proper nutrition, and a diet high in carbohydrates and sugar can cause pale skin and skin tags. Darkness around the eyes can also signal poor nutrition, such as iron defciency, diabetes, protein anemia, or stress.

Better Mood

When you are overweight, your entire system will be out of balance, including the hormones that affect your mood. Losing weight may increase your overall sense of well-being and decrease feelings of depression. Many overweight people suffer from extreme depression, and depression may increase a person’s chances of being overweight, setting up a cycle that is hard to break.

Improved Cognition and Memory

A recent study found that older adults who were overweight scored worse on cognitions tests than adults who were at a healthy weight. Past studies have linked excess weight in animals to cognitive decline, but little has been previously understood about the interaction between obesity and the brain. However, new research suggests that being overweight weakens the blood-brain barrier, and this allows substances manufactured by fat to flow to the brain. Researchers also discovered that 12 weeks after weight loss, memory significantly improves.

Sounder Sleep

If you’ve ever suffered from insomnia, you understand the benefits of a good night’s sleep. During sleep, your cells are repaired and your brain processes and remembers the day’s events. In fact, the most common prescription for sleep apnea is weight loss. In studies involving people with diabetes and sleep apnea, those who lost a greater amount of weight had the most significant drop in sleep apnea symptoms. It only takes a weight loss of 5% in obese people to start seeing results.

Reverse Type 2 Diabetes

Almost everyone has either heard or read about the global epidemic of type 2 diabetes and its link to obesity. It may be a surprise for many to learn how effective losing weight can be at reversing the impact of type 2 diabetes. In fact, many people can avoid the disease altogether by achieving and maintaining a healthy weight. Studies have shown that type 2 diabetes patients on a restricted eating plan, such as the doctor-supervised ChiroThin Weight Loss Program, were able to lower their blood sugar and insulin levels to normal within seven days. If you have type 2 diabetes, reversing the condition and avoiding future complications could just be the best benefit of your weight-loss journey.

Economic Savings

Many complain that eating a healthy diet is costly, and sometimes it does seem like fast food, junk food, and convenience food is cheaper. However, in the long run, slimming your waist can plump up your wallet. When you calculate the cost of medical bills, missed days at work, short-term disability, low-productivity, workers’ compensation, and more, there is a real difference between the financial health of obese people and their peers who have healthier weights. There’s nothing wrong with wanting to look good in your clothes, but the harsh reality is that being overweight can take up to 20 years off your life. Reducing your weight by even 5% can have a positive effect on your health, and it is a great beginning for your transformation. If you are ready to start your weight loss journey, call our office at Oblander Chiropractic to find out more about the doctor-supervised ChiroThin Weight Loss Program.

 

The office phone number is 406-652-3553

 

 

 

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.

Chronic Pain and Depression

Chronic Pain and Depression

Pain serves an important function in our lives. When you suffer an acute injury, pain warns you to stop the activity that is causing the injury and tells you to take care of the affected body part.

Chronic pain, on the other hand, persists for weeks, months, or even years. Some people, often older

adults, suffer from chronic pain without any definable past injury or signs of body damage. Common chronic pain can be caused by headaches, the low back, and arthritis. Unfortunately, there is scant objective evidence or physical findings to explain such pain.

Until recently, some doctors who could not find a physical cause for a person’s pain simply suggested

that it was imaginary—“all in your head.” This is unfortunate because we know that all pain is real and not imagined, except in the most extreme cases of psychosis.

Emerging scientific evidence is demonstrating that the nerves in the spinal cord of patients with chronic pain undergo structural changes.

Psychological and social issues often amplify the effects of chronic pain. For example, people with

chronic pain frequently report a wide range of limitations in family and social roles, such as the inability to perform household or workplace chores, take care of children, or engage in leisure activities. In turn, spouses, children, and co-workers often have to take over these responsibilities. Such changes often lead to depression, agitation, resentment, and anger for the pain patient and to stress and strain in family and other social relationships.

How is depression involved with chronic pain? Depression is the most common emotion associated with chronic pain. It is thought to be 3 to 4 times more common in people with chronic pain than in the general population. In addition, 30 to 80% of people with chronic pain will have some type of depression.

 

The combination of chronic pain and depression is often associated with greater disability than either depression or chronic pain alone. People with chronic pain and depression suffer dramatic changes in their physical, mental, and social well-being and in their quality of life. Such people often find it difficult to sleep, are easily agitated, can-not perform their normal activities of daily living, cannot concentrate, and are often unable to perform their duties at work. This constellation of disabilities starts a vicious cycle—pain leads to more depression, which leads to more chronic pain. In some cases, the depression occurs before the pain.

Until recently, we believed that bed rest after an injury was important for recovery. This has likely resulted in many chronic pain syndromes. Avoiding performing activities that a person believes will cause pain only makes his or her condition worse in many cases.

Depression associated with pain is powerful enough to have a substantial negative impact on the outcome of treatment, including surgery. It is important for your doctor to take into consideration not only biological, but also psychological and social issues that pain brings.

What is the treatment for chronic pain and depression? The first step in coping with chronic pain is to determine its cause, if possible. Addressing the problem will help the pain subside. In other cases, especially when the pain is chronic, you should try to keep the chronic pain from being the entire focus of your life.

  • Stay active and do not avoid activities that cause pain simply because they cause pain. The amount and type of activity should be directed by your doctor, so that activities that might actually cause more harm are avoided.
  • Relaxation training, hypnosis, biofeedback, and guided imagery, can help you cope with chronic pain. Cognitive therapy can also help patients recognize destructive patterns of emotion and behavior and help them modify or replace such behaviors and thoughts with more reasonable or supportive ones.
  • Distraction (redirecting your attention away from chronic pain), imagery (going to your “happy place”), and dissociation (detaching yourself from the chronic pain) can be useful.
  • Involving your family with your recovery may be quite helpful, according to recent scientific evidence.

Here are some Signs of Chronic Pain that may help you determine if you need further assistance:

• Pain beyond 6 months after an injury
• Allodynia—pain from stimuli which are not normally painful and/or pain that occurs other than in the stimulated area
• Hyperpathia—increased pain from stimuli that are normally painful
• Hypersensation—being overly sensitive to pain
Here are the Signs of Major Clinical Depression: (These symptoms will occur daily for 2 or more weeks)
• A predominant feeling of sadness; feeling blue, hopeless, or irritable, often with crying spells
• Changes in appetite or weight (loss or gain) and/or sleep (too much or too little)
• Poor concentration or memory
• Feeling restless or fatigued
• Loss of interest or pleasure in usual activities, including sex
• Feeling of worthlessness and/or guilt

Be sure to call Oblander Chiropractic at 406-652-3553 and schedule an appointment to talk to Dr. Oblander if you feel that you need to address any symptoms of chronic pain and/or depression.

 

Information for this post was obtained from the following source: http://chiroworkscarecenter.com/documents/Articles/ACA_ChronicPain_Depression_806patient.pdf