Chiropractic Care and Your Sympathetic Nervous System

Chiropractic Care and Your Sympathetic Nervous System

While chiropractic physicians are generally thought of as experts in diagnosing and treating musculoskeletal problems (particularly those related to back and neck pain), chiropractic treatments can also help the body’s nervous system function more effectively. From freeing pinched nerves and relieving generalized pain to regulating the immune system and stimulating healing, chiropractic care can achieve a wide range of long-lasting health benefits. 

To understand how chiropractic care can have these broader benefits, it’s useful to know a little bit about how your nervous system works. Doctors use a few different frameworks for describing the structure and function of the nervous system. One of the most basic frameworks distinguishes between your autonomic nervous system (ANS) or “involuntary” nervous system and your somatic nervous system (SoNS) or “voluntary” nervous system. The remainder of this article is about the two main branches of the ANS, the sympathetic and parasympathetic nervous systems. 

The body’s autonomic nervous system is actually made up of three parts—the sympathetic nervous system, the parasympathetic nervous system and the enteric nervous system. All of these parts work together to act as a control system that regulates the functions of the internal organs, such as the heart, stomach and intestines. From a structural point of view, the ANS operates as a complex network of neurons that originates inside the spinal cord and extends throughout the body via a series of interconnected hubs (called “ganglia” or “trunks”).   

The ANS is active at all times and is responsible for unconscious regulation of our glands and organs. In very general terms, the sympathetic nervous system regulates the “fight or flight” responses during times of stress or anxiety, including increased awareness, heart rate, blood pressure, respiratory rate and sweating. In contrast, the parasympathetic nervous system coordinates processes associated with the “rest and recover” or “rest and digest” responses, such as salivation, tears, sexual arousal and digestion. 

The sympathetic and parasympathetic nervous systems have a complementary, push-pull relationship that allows the body to respond very swiftly when necessary (through the sympathetic nervous system’s quick mobilization) and to slow down to perform other, less urgent activities in the background when appropriate (through the parasympathetic nervous system’s more gradual dampening). Together, these systems act a bit like an accelerator and a brake for our bodies and also help to maintain balance, or “homeostasis.”   

During the fight or flight response, your body slows or shuts down many of the rest and repair processes so that more energy is available for the processes necessary for near-term survival. In nonemergency situations, the parasympathetic nervous system is supposed to go to work, conserving energy and directing it to rest and repair responses, including healing. This is where chiropractic care can be very helpful. 

While stress hormones and the physiological changes they trigger can be helpful (maybe even life-saving) when we’re facing real physical threats, they can do significant damage to our health over the long term if they’re switched on all the time. Certain types of chiropractic adjustments have been shown to affect the autonomic nervous system by helping to down-regulate the sympathetic nervous system and stimulate parasympathetic activity. Quieting the fight or flight responses in turn promotes healing, bolsters the immune system and helps relieve the immediate sensation of pain. 

There’s no doubt that chiropractors can help patients find relief from acute injuries and chronic musculoskeletal conditions. But we may also be able to help you address neurological problems. If you’re interested in learning more, we encourage you to call or visit the office today! 

 

Additional Resources 

Sympathetic and parasympathetic responses to specific diversified adjustments to chiropractic vertebral subluxations of the cervical and thoracic spine. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686395/ 

Short-term effects of cervical manipulation on edge light pupil cycle time: A pilot study. http://www.jmptonline.org/article/S0161-4754%2800%2981597-3/abstract 

Hormones: Chemical Messengers and the Chiropractic Link. http://www.theamericanchiropractor.com/articles-integrative-healthcare/4895-hormones-chemical-messengers-and-the-chiropractic-link.html 

Chiropractic Adjustments Help with Pain Relief

Chiropractic Adjustments Help with Pain Relief

Johns Hopkins Medicine defines pain as “an uncomfortable feeling that tells you something may be wrong.” Depending on its cause, this feeling can range from being mildly annoying to absolutely debilitating in nature, potentially preventing a person from having any quality of life whatsoever. Additionally, some pains are constant and steady, whereas others tend to come and go.

Regardless of the type, intensity, and consistency of the pain, at some point in our lives, we all experience this feeling in one form or another. However, whether or not we’re able to effectively handle it is largely determined by our individual pressure pain thresholds. In other words, the higher our thresholds, the less impact these pains have on our lives, and one fairly new study has found that chiropractic may just increase that limit.

In December of 2016, Chiropractic & Manual Therapies published a piece of research which set out to determine what effect, if any, spinal manipulation therapy (SMT) had on pressure pain threshold. Individuals were recruited from Murdoch University campus in Western Australia and, ultimately, 34 subjects ranging in age from 18 to 36 qualified for inclusion. Twenty of the participants were male, with the remaining 14 being female, all of whom were assessed at the beginning of the study and declared asymptomatic.

Using an algometer with a 1cm2 rubber probe, the participants’ deep mechanical pain sensitivity was assessed multiple times at four different sites on the body (calf, lumbar, scapula, and forehead) by asking each one to indicate the point in which the pressure turned into pain. The average of the second and third recordings was used as a baseline.

Once the initial data was recorded, each participant was then subjected to a high-velocity, low-amplitude spinal manipulation using the hypothenar mammillary push while the subject lay on his or her side. Furthermore, the thrust was aimed at the portion of the participants’ spine located between the L5 and S1 vertebrae. Upon completion, the pressure pain threshold was collected again, and then again at 10, 20, and 30 minutes after the conclusion of the treatment session.

Researchers found that, after engaging in just one session of SMT, subjects reported increases in pressure pain threshold in the calf and lumbar spine areas, with no notable reduction in the scapula or forehead. Additionally, the thresholds that did increase did so at a higher rate on the right side of the participants’ bodies than on the left.

This study shows promise for patients dealing with chronic pain issues as chiropractic adjustments seem to provide an instantaneous reduction in pain. Further research with a larger group of test subjects is warranted.

Dorron SL, Losco BE, Drummond PD, Walker BF. Effect of lumbar spinal manipulation on local and remote pressure pain threshold and pinprick sensitivity in asymptomatic individuals: a randomized trial. Chiropractic & Manual Therapies 2016;24:47.10.1186/s12998-016-0128-5

What is Pain/Types of Pain Treated?  Johns Hopkins Medicine: Blaustein Pain Treatment Center.

Good Workplace Ergonomics Matter! Lessons from Medical Lab Technicians

Good Workplace Ergonomics Matter! Lessons from Medical Lab Technicians

Are the bad ergonomics of your workplace causing you chronic back or neck pain? If so, you’re not alone. Work-related musculoskeletal disorders (WRMSDs) are one of the leading causes of occupational injuries and disability throughout the world. In the United States, WRMSDs cause over 647,000 days of lost work every year and result in workman’s compensation claims costing anywhere from $45 billion to $60 billion. They also account for 34% of all work-related injuries and illnesses. Examples of WRMSDs include chronic back and neck pain, carpal tunnel syndrome, sprains, and hernias. While you might assume that these types of injuries are the result of unrelated incidents or isolated situations playing out in many different environments across the country on any given day, there is actually a pattern. Many of them are caused by badly designed workplaces.

This pattern became evident in a study recently published in the Journal of Back and Musculoskeletal Rehabilitation. The researchers wanted to analyze the postures of workers in a high-tech medical laboratory to determine the prevalence of work-related musculoskeletal disorders and to investigate the relationship of these musculoskeletal disorders to workers’ individual factors, their work characteristics, and their working postures.

They gathered data from the medical lab technicians, using the Nordic Musculoskeletal Questionnaire (NMQ, a standardized scale for measuring musculoskeletal disorders and occupational health), the Visual Analogue Scale (VAS, a type of self-reporting measurement), and RULA (Rapid Upper Limb Assessment, a self-reported scale by which workers assess the postures that most accurately reflect their working positions). They then assessed the positions that the technicians’ lab workstations and equipment forced them to adopt for long periods of time each day and compared them with the technicians’ medical problems.

What they found was that poor lab workstation design was causing musculoskeletal problems in 73.3% of the workers. The poorer their posture was on the VAS and RULA scales, the more musculoskeletal problems they had. In addition, there was a significant difference between pre-work and post-shift reports of neck, lower back, and knee pain. In summation, the workplace design was definitely causing the WRMSDs.

There is a very real possibility that your own workplace is just as likely to put you at an increased risk of developing musculoskeletal disorders. Symptoms of WRMSDs are not limited to back and neck pain—they also include joint discomfort, muscle tightening and swelling, stiffness, and feelings of numbness or “pins and needles.”

If you or your fellow workers have noticed such symptoms, you should report them to your employer and expect that they will take steps to correct any problem-causing ergonomics. In the interim, you can take some steps on your own to protect yourself from WRMSDs. You don’t have to sit at a desk that is too high or low or in a chair that puts you in an uncomfortable and unhealthy position. Modern desks and their accompanying desk chairs have controls that can be used to lower or raise them. The same applies to computers or other equipment you use every day—you can put your monitor on top of some books so that it’s more in your line of sight or make other changes to help make your workspace more ergonomic. A good place to start looking for tips on how to improve the ergonomics of your office workspace is the Occupational Safety & Health Administration Computer Workstations guide. OSHA also has similar guides for other types of work environments.

 

Chiropractic Patients Less Likely to Suffer Drug Reactions

Chiropractic Patients Less Likely to Suffer Drug Reactions

 

Most people experience back pain, and many of these patients use drugs for pain relief. A 2014 study1 found that of older adults with chronic back pain, 72% of them were using some kind of analgesic to help cope with the pain. Another study2 found that 32% of back pain patients in their analysis were using prescribed opiates for relief.

It’s unfortunate that so many patients depend on drugs for musculoskeletal aches and pains, especially when chiropractic is an effective and safe way to not only relieve pain, but also prevent future pain episodes.

Now a new study3 shows that chiropractic also is linked to a lower risk of adverse drug reactions in patients with back pain. In this study, the authors looked at the medical records of over 19,000 adults in New Hampshire who had at least two doctor visits for back pain. 9.810 of these patients used chiropractic care; 9,343 patients used regular medical care. The researchers analyzed the number of adverse drug effects (ADEs) experienced by the two groups.

The authors found:

  • Younger patients were more likely to use chiropractic care.
  • Non-chiropractic patients tended to have more health problems, in general, when compared to those who used chiropractic.
  • Chiropractic patients experienced 51% fewer adverse drug reactions (.4% vs .9%) compared to medical patients.
  • 15 non-chiropractic patients were diagnosed with drug withdrawal, while zero chiropractic patients had drug withdrawal.

This study had some limitations, as the study data didn’t included details about the types of drugs the patients were using or how frequently they were using medications. But the authors conclude that the “utilization of chiropractic care may be associated with reduced risk of ADEs; however, no causal relationship has been established.”

Another study by the same group of researchers found that chiropractic patients were 55% less likely to be prescribed opiates for their pain and had lower health care bills.

With the opiate epidemic in the US, it’s critical that we find non-opiate approaches to back pain treatment. Chiropractic is about restoring health without the use of drugs. By helping the body heal naturally, chiropractic can help you stay well and help you avoid unnecessary adverse drug reactions, too!

  1. Enthoven WT, Scheele J, Bierma-Zeinstra SM, Bueving HJ, Bohnen AM, Peul WC, van Tulder MW, Berger MY, Koes BW, Luijsterburg PA. Analgesic use in older adults with back pain: the BACE study. Pain Medicine 2014 Oct;15(10):1704-14. Doi: 10.1111/pme.12515.
  2. Ashworth J, Green DJ, Dunn KM, Jordan KP. Opioid use among low back pain patients in primary care: Is opioid prescription associated with disability at 6-month follow-up? Pain. 2013 Jul;154(7):1038-44. doi: 10.1016/j.pain.2013.03.011.
  3. Whedon JM, Toler AWJ, Goehl JM, Kazal LA. Association Between Utilization of Chiropractic Services for Treatment of Low Back Pain and Risk of Adverse Drug Events. Journal of Manipulative & Physiological Therapeutics 2018 May 26. pii: S0161-4754(17)30136-7. doi: 10.1016/j.jmpt.2018.01.004.
Unintended Consequences: Marijuana Use Tied to Changes in the Brain

Unintended Consequences: Marijuana Use Tied to Changes in the Brain

Over the past few decades, growing numbers of people in the U.S. have come to think about marijuana as harmless. Others have even embraced it as beneficial under certain circumstances, pointing to its purported medical value. So it’s not too surprising that long-running legalization efforts in some states have recently led to marijuana’s decriminalization and increased availability.  However, a study published in the Journal of Neuroscience sheds new light on the subject—and its findings come out against the commonly held belief that marijuana use is completely innocuous. Researchers at Northwestern University Feinberg School of Medicine have found that even casual use of marijuana can cause structural changes to areas of the brain that control emotion, motivation, and reward.

The study analyzed 40 students between the ages of 18 to 25 in the Boston area. Half of the subjects used marijuana recreationally—at least once a week—and the other half did not use it at all. Psychiatric interviews and tests revealed that none of the students met the criteria for drug dependence, and their cannabis use did not interfere with their studies, work, or social habits. However, when using MRI scans to study the students’ brains, the researchers found changes to the volume, shape, and density of the neurons in two important areas: the amygdala and the nucleus accumbens. The changes were found to be more pronounced in people who reported using marijuana more frequently during an average week. Study leader Dr. Hans Breiter said of the findings, “There was a direct, consistent relationship between how much marijuana they used and the abnormalities we saw.”

While the brain abnormalities and their relationship to marijuana use are clear, it’s less clear what these changes to the brain’s structure might actually mean for these individuals. Breiter continues, “These are two brain regions you do not want to mess around with. All parts of the brain are important, but some, like these, are more fundamental. It raises a very serious issue, given that we saw these changes in casual marijuana users.” Previous studies had revealed similar changes in brain structure among heavy users of cannabis, but this is the first study that indicates that even casual use can alter a person’s brain.

“The earlier the onset of marijuana use in a kid, the worse potential implications you could be seeing,” Breiter said. Another study author, Jodi Gilman of the Massachusetts General Hospital Center for Addiction Medicine, says, “We just don’t know how much is safe. It’s not harmless. We don’t know the harm, but it’s not free from harm.”

Breiter also commented that the concentrations of THC (the psychoactive component of cannabis) are not the same as they used to be: “Levels of THC are about sevenfold what they used to be. That’s a substantial change in the dosing of THC that these young people are getting. The experience of people in the ’60s and ’70s may not be the same experience as people today.”

Interestingly, some proponents of cannabis decriminalization have welcomed the research findings. Paul Armentano, deputy director of the pro-marijuana advocacy group NORML, says that his group presents an argument for legalizing marijuana but tightly regulating it, as alcohol, tobacco, and prescription drugs are. He says, “It’s precisely because of these consequences that these products are legally regulated, and their use is restricted to particular consumers and specific settings. A pragmatic regulatory framework that allows for the legal, licensed commercial production and retail adult sale of marijuana but restricts its use among young people—coupled with a legal environment that fosters open, honest dialogue between parents and children about cannabis’ potential harms—best reduces the risks associated with the plant’s consumption or abuse.”

Marijuana consumption in the Netherlands—where cannabis use has been condoned but controlled since the 1980s, just as Armentano recommends for the U.S.—certainly supports his case. Despite its availability, fewer than 26% of the Dutch population has ever tried marijuana, compared with 41.9% of Americans, and the Netherlands has the lowest problem drug rate in Europe.

But this is a touchy subject, with scientific and humanitarian arguments often clashing with economic interests and many people’s moral judgments about any type of drug use. The trend toward marijuana decriminalization in America—for both medical and recreational use—seems at this point to be irreversible. The one new issue this study brings to the already heated debate is that cannabis use is NOT necessarily without long-term impact, especially on young people. More studies are needed to determine exactly what the effects of this drug actually are so that society can balance the risks and manage the costs that will inevitably come with decriminalization. Whether it’s legal or illegal, though, it’s critical for people to understand the potential consequences of marijuana use.