back pain – Page 7

Chiropractor vs. Physical Therapist: Which Type of Doctor Is Better for Treating Back Pain?

February 2, 2016 oblanderchiropractic

chiropractic-physical-therapy-200-300 If you’re suffering from acute or chronic back pain–whether it’s been caused by an injury or some type of medical condition–chances are that you’re more interested in finding relief NOW than learning about the many different types of doctors who are part of the healthcare community. But the simple truth is that different types of doctors tend to approach their work in particular ways because of basic differences in their training and clinical experience. This means that it’s worthwhile for a back pain patient to understand at least a little bit about how a physician’s chosen discipline can influence his or her perspective and priorities when it comes to treatment.

The back and neck are very complex structures, and it can sometimes be difficult to identify the specific source of a patient’s pain and treat it effectively. This is why it is common for general practitioners to refer patients who are experiencing back problems more complicated than the typical muscle strain to physicians who specialize in diagnosing and treating musculoskeletal disorders. Depending on the circumstances, your general practitioner may recommend a chiropractor or a physical therapist. Some cases may also benefit from a multidisciplinary or integrated care approach that draws on the expertise of multiple specialists. So, in what ways are chiropractic physicians and physical therapists similar? And how are they different?

The Chiropractor

A doctor of chiropractic diagnoses and treats disorders of the musculoskeletal and nervous systems, and works with patients to prevent disorders from occurring. This type of healthcare professional will attempt to identify the underlying cause of back pain and treat it using a variety of techniques that realign the spine to relieve pressure, restore stability and improve function. Chiropractic treatments are usually referred to as “manipulation”, “adjustment” or “mobilization”. They involve applying varying degrees of highly-targeted force (either manually or with the help of specialized instruments) to move vertebrae back into their proper position.

When a patient is experiencing acute or chronic back pain and/or has lost function, a chiropractor will also use manipulation and mobilization techniques on the joints and other soft tissues in the affected area to increase range of motion.

The Physical Therapist

A doctor of physical therapy also diagnoses and treats back pain, though most often in connection with a specific injury or following surgery. His or her goal is usually to help a patient regain normal function by building strength and stamina, increasing balance and flexibility, and improving coordination.

Back pain that results from injury, disease, general wear-and-tear or other environmental factors can prevent a person from being able to lead a normal life by limiting their mobility. Day-to-day activities like walking, climbing stairs and getting into or out of chairs can become difficult or impossible. For athletes, the impact can be particularly profound–limiting their ability to train and compete. A physical therapist considers how the individual’s condition is impacting their ability to move and develops a therapy program intended to improve their condition. Where the chiropractor will often use manipulation and mobilization techniques as the foundation of a treatment plan and reinforce these with structured stretching and exercise programs, the physical therapist will tend to focus more on supervised exercise.

For patients with debilitating injuries and those who have recently had surgery, both chiropractic care and physical therapy can be very good options. Well-trained and experienced doctors will provide customized treatment plans designed to help patients recover as quickly and completely as possible. The diagnostic and treatment techniques each type of doctor uses (as well as their general philosophy) may differ to some extent, but there is also substantial overlap. Both kinds of physicians use non-invasive, hands-on treatment techniques as well as high-tech therapies such as low level laser therapy (LLLT) and transcutaneous electrical nerve stimulation (TENS) to relieve pain, reduce inflammation and accelerate healing.

When the time comes to make a decision to see one type of doctor or the other for back pain, patients often make their choice based on referrals from their primary care physician or on reviews from other patients. But the most important thing to remember is that you DO have options, and that having the RIGHT doctor matters just as much as having the right kind of doctor. We believe that our relationship with patients–especially the way we communicate–is just as important as our technical skills in diagnosing and treating your pain.

If you’d like to learn more about our approach, we invite you to call or visit our office today.

A Day in the Life of a Crash Test Dummy

January 28, 2016 oblanderchiropractic

Crash test dummies. You probably don’t think about them very much (if at all), but you may owe them much more than you realize when it comes to your health and safety on the nation’s roads. Automobile makers use crash test dummies—that is, inanimate, human-like mannequins—to simulate the type and scale of injury that may occur in an automobile accident. Car and truck manufacturers go to great lengths to design and build safe vehicles, and these “full-scale anthropomorphic test devices” or “ADTs” take a real beating day after day as they provide data regarding velocity of impact, crushing force, bending, folding, or torque of the body, as well as deceleration rates during test collisions.

U.S., car accidents kill more than 30,000 people each year and injure many more. However, manufacturers work continually to make cars safer and accidents more survivable through crash-testing programs. According to the National Highway Traffic Safety Administration, from 1994 to 2009, the fatality rate decreased from 23 to 16 fatalities per 100,000 licensed drivers. Crash test dummies have played an important part in that achievement as a result of their role in car testing and design. They’ve also played an important part in reducing the severity of auto accident injuries.

In order to survive a car accident and walk away with minimal injuries, drivers and passengers must be able to withstand the changes in kinetic energy that occur when bodies in motion suddenly come to a stop or when bodies at rest are suddenly accelerated. A car’s safety features, including seat belts and air bags, are made to help mitigate the damage that these abrupt changes can cause to the human body. Crash test dummies allow safety engineers to identify how the changes in kinetic energy caused by car crashes affect the human body and its musculoskeletal system. Researchers use this data to identify areas where changes could improve a car’s safety rating. Additionally, the data is useful to gauge the effectiveness of these improvements once they have been made.

Anthropomorphic test devices, or ATDs, have become enormously sophisticated since the first crash test dummy was created. Dubbed Sierra Sam, the first ATD was made in 1949 to test how ejection seats in aircraft affected people. Today’s crash test dummies are designed to simulate human anatomy in great detail, and to respond as the human body would respond to the forces and impacts generated by auto accidents. Using a wide variety of advanced materials and sensor technologies, they can tell a researcher what types of injuries would likely have been sustained by vehicle occupants in a crash—anything from surface skin abrasions and contusions to soft tissue damage, broken bones and life-threatening internal injuries.

Combined with sensors in the test car itself and an array of slow-motion video cameras, ATDs have helped designers and engineers understand better than ever before exactly what happens in different kinds of accidents so that they can protect vehicle drivers and passengers. And there’s no doubt they’re very valuable members of the safety team—they can cost anywhere from $100,000 to $400,000!

ATDs are built in a variety of shapes and sizes to mimic human differences. However, they’re also used in ways that allow carefully controlled testing from crash scenario to crash scenario and from vehicle to vehicle. Before each test, engineers paint different parts of the crash test dummy’s body with different colors, allowing them to identify how each part of the body impacts parts of the vehicle’s interior.

Car accidents can be particularly hard on the musculoskeletal system—injuries to the back, neck, and extremities are common. Unfortunately, many of these injuries may go undetected immediately after a collision, when adrenalin is flowing and participants are generally eager to leave the scene and move on with their lives. Symptoms may appear days, weeks or even months afterward. Plus the injuries sustained in a car crash may cause a host of ongoing health complications, such as recurring headaches, neck stiffness, TMJ, dizziness and chronic back pain as well as reduced mobility.

Chiropractic physicians are specially trained to diagnose and treat the types of musculoskeletal injuries that many people suffer as a result of care accidents. If you or someone you care about has been involved in a car accident, it’s very important that they receive a prompt medical evaluation from a qualitied healthcare professional—even if they feel fine or are only experiencing minor symptoms. Detecting injuries as soon as possible often allows auto accident victims to recover more quickly and more completely, with less pain and less disability.

Do Ergonomic Snow Shovels Really Make a Difference?

December 11, 2015 oblanderchiropractic

men-shoveling-snow-200-300 While it seems like such a commonplace activity, shoveling snow is notorious for being one of the most dangerous things you can do in the winter. The physical exertion it involves, coupled with cold temperatures, can put excessive strain on both your heart and back. Nearly 200,000 Americans were treated in emergency rooms for conditions related to snow shoveling between 1990 and 2006.

Dr. Randy Zusman, director of the hypertension program at Massachusetts General Hospital’s Heart Center, says “Lifting heavy snow is like heavy weight lifting. It puts a strain on the heart, and the blood pressure and heart rate go up in response to it.” In addition, having cold hands contributes to excess strain on the heart. Zusman says “most people don’t realize that when their hands get cold, it causes blood vessels in the heart to constrict and reduce the blood supply to their heart. I always tell people to invest in the best pair of gloves they can afford and remember to be all buttoned up before going outside.”

Of course, even if you have a strong heart, your back can still take a beating while shoveling snow. Some tout the use of ergonomic shovels as a way of reducing the risk of back injury. But do they really make any difference? Well, it seems to depend on what kind of shoveling you’re doing. Ideally, you need two shovels: one for pushing the snow, and one for lifting it.

Snow shovels with those funny-looking bent shafts are theoretically intended to help keep you from bending over when you lift a load of snow, and they’re supposed to be better for pushing snow out of the way. But the handles of most of these types of shovels tend to be too short, so you still have to bend over to get leverage for lifting. In addition, the bent handle makes the level of the scoop lower than in a straight-handled shovel, meaning your forward hand has to lift the load higher than it would otherwise. It’s also more difficult to throw snow off to the side when the shaft is bent.

A Canadian study found that the “ergonomic” shovel was not significantly better for your back than a conventional shovel taking all these factors into account. The researchers also found that both shovels strained different upper arm muscles. Your best bet is to find a lightweight shovel that is still sturdy (with an aluminum shaft, for example), rigid, and has a straight shaft that is long enough to keep you from bending over while pushing snow. This will allow you to exert the least amount of force with each movement.

Shoveling technique matters, too—probably more than the design of the shovel itself! The best way to shovel is to do it like you are advised to lift anything heavy: Bend at the knees, keeping your back as vertical as possible, and then lift with your thighs. In additional, follow these other tips to help reduce the risk of injury while shoveling snow:

Make sure your feet are firmly planted and place one hand as close to the scoop as possible while lifting.
Shovel only small amounts of snow and don’t throw it over your shoulder, as this type of loaded twisting can injure your back.
Take breaks frequently and remember to drink plenty of fluids (except for coffee, which increases your heart rate), as you can become dehydrated even in the cold.

If you’ve got preexisting heart or back problems, shoveling snow is something you should probably avoid doing at all if there are other alternatives available. Ideally, you could use a snow blower or pay a neighborhood kid a few dollars to shovel for you.

Remember—shoveling snow can be hard work. Whatever type of shovel you decide to use, some common-sense precautions can go a long way toward preventing injuries!

Can Poor Posture Really Cause Back and Neck Pain?

December 4, 2015 oblanderchiropractic

In a word, yes!

Unless your back or neck pain has been caused by some type of over-exertion or acute trauma, it’s actually very likely that poor posture is at least a contributing factor. The alignment of the spine—from the neck through the lower back and hips—is critical to the body’s ability to support its own weight and move efficiently, so posture problems (which are often chronic) can gradually lead to pain and reduced mobility.

When it comes to pain in your back or neck, the relationship between poor posture and injury can also be a complicated one. On the one hand, having poor posture makes it more likely that you will suffer an injury. On the other hand, suffering an injury can also affect your posture. Mary Ann Wilmarth, DPT, spokeswoman for the American Physical Therapy Association explains, “Little things add up. You can increase the pressure on your back by 50% simply by leaning over the sink incorrectly to brush your teeth. Keeping the right amount of curvature in the back takes pressure off the nerves and will reduce back pain.”

How posture problems contribute to neck pain

One of the most common posture problems is a “forward head and shoulder posture”. This occurs when someone “hunches over” and places their head in front of their neck. The weight of the head towards the front stresses the lower neck vertebrae, and leads to overworking of the upper back muscles to compensate for the pull of gravity on the head. Many people with this posture problem also have a rounded upper back and rounded shoulders, which can lead to further stress and shoulder pain. Often, poor desk and chair ergonomics contribute to these problems, but even slouching on the couch or at a table with your mobile phone can lead to hunching over.

How posture problems contribute to back pain

The “forward head” posture described above causes stress on the lower cervical vertebrae, which may end up sliding forward relative to each other as a result of gravity. This is a particular problem for people who have jobs requiring them to look forward or downwards all day. Eventually, the prolonged pressure on the cervical vertebrae will irritate the ligaments and soft tissues, radiating downwards to the upper back. This process can lead to disc degeneration, cervical osteoarthritis and herniated discs.

Tips for improving poor posture and relieving back and neck pain

Poor posture is typically the result of habits that have been developed over long periods of time performing the same activities over and over again. Here are just a few of the most common culprits:

Staring at computer monitors or mobile devices that are badly positioned.
Sitting in poorly designed office chairs.
Sleeping on mattresses that don’t provide the necessary support.
Carrying heavy backpacks or purses.

But how do you know which activities are contributing to your poor posture and causing you pain? The clues are usually fairly easy to spot once you know what you’re looking for. For instance, the pain in your neck or back may be worse at some times during the day than at others, or it may come and go with changes in your body position. If you experience fatigue or pain when you first wake up in the morning or after you’ve been sitting at your desk for a couple of hours, it might be time for a new mattress or new office furniture.

The good news is that once you become aware of the activities that are contributing to your posture problems and pain, most can be fixed relatively easily, with no need for either medication or surgery. Learn to recognize when you’re hunching over your computer, slouching in your chair or craning your neck to look at your mobile phone. Then sit up straight, aligning your hips, shoulders and ears in one vertical line.

Sometimes, however, the solution is not so simple—especially when poor posture has caused structural changes in the spine and neck. In these cases, a chiropractor can help by designing posture correction and spinal rehabilitation programs to restore the spine’s normal curvature. These programs will usually involve a combination of mechanical techniques that actively remodel the spine (including the use of braces and molding blocks), exercises and stretches that strengthen postural muscles and restore range of motion, and lifestyle changes to address the root causes.

As experts in diagnosing and treating musculoskeletal conditions, chiropractic physicians are specially trained to recognize and correct postural problems. If you’re suffering from neck or back pain and suspect that your posture may be at least partially to blame, call or visit our office today. We can help!

Top 5 Low-Impact Aerobic Exercises for Winter Fitness

November 21, 2014 oblanderchiropractic

Everyone knows that exercise is essential to maintaining your health. However, not everyone is able to perform the kinds of high-impact exercises that are hard on the joints. Whether your particular concern relates to aging, injury, or some type of chronic musculoskeletal problem, there are several low-impact aerobic exercises that can help keep you fit throughout the winter.

Walking—This simple activity costs absolutely nothing, requires no additional equipment and can be done in most any weather conditions. If walking seems too boring, then try different routes. Mix it up! If you have hills nearby, include them for greater aerobic challenge. Make certain you have good footwear before taking on anything other than flat terrain. If walking isn’t giving you enough of a challenge, add ankle weights or carry barbells. If you don’t have nearby hills, then take to the stairs. Your local high school or college likely has a stadium with steps that can increase your workout intensity.

Swimming—If you have access to an indoor pool, count your blessings. Swimming is not only one of the lowest impact exercises there is, but it may also be the best full-body workouts around. Swimming involves even less impact than walking, and merely staying afloat (without pool floats) requires far more energy than just standing still. Do laps. Time yourself. There are numerous swimming strokes available, plus aerobic activities and games that you can play in the water. Whether you bring friends or go it alone, swimming can give you just as much aerobic “bang for your buck” time-wise as any other activity, and maybe more.

Cycling—Whether you take to the cycle in your gym or take your bicycle out for a spin, this activity produces virtually zero impact and delivers lots of aerobic benefit. Going nowhere in the gym may seem tedious and even boring to some, so take to the bike lanes or walkways with your bicycle. Once you’ve built up your strength, climbing hills can give your legs a good burn. Inside, no helmet is required. Outside, always protect your head when cycling.

Dancing—This might well be the most fun, low-impact aerobic exercise you can do (at least in public). Of course, many dance routines require a partner, but that’s what makes it all so much fun. Don’t be afraid to go beyond the simple waltz. Try the foxtrot for a little variety. Or try salsa, tango and other more strenuous styles to test your timing, finesse and stamina. A good dance routine can get your heart pumping. Performed well, it can even be downright sexy. And if you don’t like being on the dance floor alone with a partner, there’s always line dancing. It’s a great opportunity to work on your timing and coordination while getting a low-impact workout!

In-Line Skating (Rollerblading)—Protective gear is essential for your safety, as is choosing the best path. Most sidewalks have bumps and imperfections that can prove challenging… or disastrous. An empty parking lot might offer a better alternative for beginners. Some parks also have paths that are perfect for this kind of low-impact activity. Taking to the blades can burn more calories than many other exercises. Until you get your balance perfected, you might want to squat down to keep your center of gravity lower to the ground. Take shorter strides when starting out. Don’t go too fast until you’ve perfected your ability to maneuver, slow down and (yes) stop!

Curve Rehabilitation and Posture Correction Programs

September 23, 2014 oblanderchiropractic

As unfortunate as it is, loss of normal spinal curvature and poor posture are extremely common. Given the amount of time we spend staring at various screens—whether sitting at an office desk or walking down the street—it’s not surprising that our bodies are being affected. It’s also not surprising that back and neck pain has become the second most frequent reason for visiting a doctor.

Many people presenting with back and neck pain also suffer from a loss of normal spinal curvature. Luckily, there are a number of treatment options that can be used to restore the normal curve and to help patients relearn good posture. Broadly speaking, loss of the normal curve most commonly involves one of three conditions: lumbar hyperlordosis, scoliosis, and abnormal kyphosis. Each has a number of curve rehabilitation techniques associated with it.

Lumbar Hyperlordosis

Patients with lumbar hyperlordosis (also known as “swayback” or “saddle back”) have developed an exaggerated arch in the lower back (the lumbar region of the spine) that typically makes the buttocks and belly appear more prominent. The treatment approach will often depend on the severity of the abnormal curve and the amount of mobility that still exists in this area of spine. If the curve is not flexible, then it is more likely that treatment will be necessary.

Since hyperlordosis places unusual stress on the vertebrae and spinal discs, failing to seek treatment increases the risk of accelerated spinal degeneration, disc herniation and other structural problems. These, in turn, can cause pain and limit function. Over time, other areas of the body—including the hips, legs and internal organs—may also be affected.

Chiropractors are experts in diagnosing and treating a wide range of musculoskeletal conditions that affect the back and neck. Depending on the situation, they may use a combination of chiropractic adjustments, spinal molding blocks and foam rolls to restore the normal curve. They will also work closely with patients to make postural adjustments, strengthen core muscles and increase range of motion. When a child has hyperlordosis, treatment may involve a brace, which helps to ensure that the abnormal curve doesn’t worsen as he or she grows.

For the most severe and painful cases of hyperlordosis, surgery may be necessary. The objective of this surgery is to correct the severity of the curve and provide additional support for the body’s frame. Such surgery may involve metal rods, hooks, or screws. Surgeons may also use a bone graft to stimulate new growth and strength.

Scoliosis

The word “scoliosis” is more widely recognized than hyperlordosis among the general public. It refers to an abnormal c- or s-shaped lateral curvature of the spine—one that is apparent while looking at an individual from the front or back. In some cases, a patient’s head may appear off-center or one shoulder or hip may be higher than the other.

In about 80% of cases, the cause of scoliosis is not known. This is generally referred to as “idiopathic”. Scoliosis may also be “functional” (an abnormal curve develops because of a problem elsewhere in the body), “neuromuscular” (a curve is caused by abnormally formed vertebrae) or “degenerative” (the curve is the result of deterioration, damage or weakness in the spine’s supporting structures—bone or soft tissue—during later years).

Treatment options for scoliosis depend on the severity and location of the curve, its cause and the likelihood of it getting worse as the patient gets older. Treatment typically involves braces for children and adolescents if their spinal curves are between 25 and 40 degrees. However, the brace’s straightening effect only lasts as long as the patient wears it. Those with a curve beyond 40 degrees to 50 degrees are often candidates for scoliosis surgery. As WebMD puts it, “The goal is to make sure the curve does not get worse, but surgery does not perfectly straighten the spine. During the procedure, metallic implants are utilized to correct some of the curvature and hold it in the correct position until a bone graft, placed at the time of surgery, consolidates and creates a rigid fusion in the area of the curve. Scoliosis surgery usually involves joining the vertebrae together permanently—called spinal fusion.”

Abnormal Kyphosis

Abnormal kyphosis is an outward curvature of the thoracic spine (middle back) that results in a “hunched forward” or “hunchbacked” appearance. It is often caused by poor posture. In these cases—referred to as “postural kyphosis—a chiropractor can reduce the hump by prescribing lifestyle changes and strengthening exercises that improve posture. He or she may also use a variety of spinal adjustment techniques to reduce pain and inflammation, calm muscle spasms, restore range of motion and slow the rate of disc degeneration in the middle back.

Chiropractic Care and the U.S. Department of Veterans Affairs (VA)

September 15, 2014 oblanderchiropractic

After years of fighting in Iraq and Afghanistan, large numbers of U.S. servicemen and women have returned home with a wide range of physical and psychological injuries. While the American media has done a great deal to raise awareness of many of the challenges they face, from traumatic brain injuries and lost limbs to hearing loss and PTSD, other health issues have received much less attention. Back pain–often serious and sometimes debilitating–is one of them. “We see quite a bit of spine pain among returning veterans,” said Tom Kotsonis, a staff physician in physical medicine and rehabilitation at the Zablocki Veterans Administration Medical Center in Milwaukee. “The vast majority of young combat veterans we see are suffering from neck and back pain.”

In fact, the Spine Journal has reported that “There have been 10 times as many long-term spinal pain casualties unrelated to combat injuries among Iraq and Afghanistan veterans compared with blast injuries. After being medically evacuated from Iraq with non-battle-related spinal pain, patients have less than a 20% chance of returning to their unit and regular duty. [In addition,] 60% of veterans seeking care for spine problems have serious psychological distress.”

These kinds of statistics raise a number of questions that deserve answers. What’s causing this increased incidence of back and neck pain among the troops? And what’s being done about it?

According to the Milwaukee, Wisconsin-based Journal Sentinel, many U.S. Army infantry men and women on tour in Iraq and Afghanistan carry 50 to 60 pounds (or more) on their backs for hours daily while performing foot patrols. Heavy helmets, body armor, gear, weapons, and extra ammunition all weigh them down, causing considerable stress on the neck and spine. “The number of people getting evacuated from war zones for back pain has been as high as 60% of the wounded,” explains Eugene Carragee, an editor for The Spine.

Faced with these kinds of experiences in the field, many veterans are looking for help from their own: the U.S. Department of Veteran Affairs (VA). The Foundation for Chiropractic Progress (F4CP) reports that a VA policy allows veterans access to chiropractic care. In fact, the VA has begun providing veterans chiropractic care by employing chiropractic doctors on staff at VA hospitals.

From the F4CP: “The VA now provides chiropractic care (via hired or contracted staff) at approximately 40 major VA treatment facilities within the United States. Unfortunately, an overwhelming majority of America’s veterans still do not have access to chiropractic care because the VA has taken no action to provide chiropractic care at approximately 100 of its major medical facilities.”

This is indeed unfortunate—according to Military.com, VA hospitals with chiropractors on staff are in just 23 states: California, Maine, Connecticut, Florida, Illinois, Georgia, Kansas, Montana, New York, Ohio, Iowa, Wisconsin, Nevada, Tennessee, South Carolina, Washington, Michigan, New Mexico, Mississippi, Pennsylvania, Texas, South Dakota, and West Virginia.

Retired Brigadier General Rebecca S. Halstead has been a vocal advocate for expanding chiropractic care among America’s military personnel. She understands first-hand the physical wear and tear that comes with serving in both combat and support roles. Plus, her own struggles with fibromyalgia and experience with chiropractic care have also helped to shape her perspective.

“They set me on a path of getting well. I’m the healthiest I’ve been in 10 years. I was taking eight or 10 prescription drugs in 2008. The more I went to the chiropractor, the less prescriptions I needed.”

“When I retired, my pain was easily a 9 or 10 (on a 10-point scale) every single day. My pain now is a 2 or 3, and maybe even sometimes a 1. I don’t think I’ve hit a 10 since I started regularly seeing a chiropractor.”

“If I had known how much chiropractic care would help me when I was a commander in Iraq and in the United States, I could have taken better care of my soldiers.”

There are two congressional bills that, if signed into law, could help veterans get expanded access to the help they need, according to the American Chiropractic Association. The first is H.R.921, the Chiropractic Care Available to All Veterans Act. If signed into law, H.R.921 would require the VA to have a chiropractic physician on staff at all major VA medical facilities by 2016. In addition, there is S.422, Chiropractic Care Available to All Veterans Act of 2013, which would also require the same as HR 921. Neither of these bills have yet been passed, but any citizen can contact their Congressman or Congresswoman to voice their support for those men and women who have served their country.

General Halstead herself sees this as a priority. “Until we’ve done that we have not fulfilled our leadership responsibility,” Halstead said. “If you want to help them, see a congressman and ask ‘aren’t our men and women getting these benefits?’

For High School Athletes, Sports-Related Back Pain Starts Early

August 12, 2014 oblanderchiropractic

People often assume that lower back pain (LBP) is just a problem just for the elderly, or for middle-aged adults who have a history of physical wear and tear. But this is simply untrue. The fact is that over 31 million Americans live with lower back pain on a regular basis, and a great number of them are adolescents.

Recent studies have indicated that many high school students who participate in sports programs are at high risk for developing lower back pain—and worse, few of them seek or receive proper chiropractic treatment. This is increasingly recognized as a legitimate public health concern: A 25-year-long study of adolescent risk factors for LBP, published in 2000, revealed that students who had lower back pain at age 14 were likelier to have back pain 25 years later than students who didn’t have LBP when they were teenagers. This study suggested that prevention of back pain in youth may contribute to the absence of back pain in adulthood.

14 years later, not much has changed. A recent study published in the British Journal of Sports Medicine examined Finnish teenage athletes participating in a variety of sports. Researchers looked at the experience of 464 male and female athletes representing 22 basketball, floorball (a type of floor hockey popular in Nordic countries), ice hockey, and volleyball teams. They found that 255 athletes (55%) had experienced lower back pain in the past year. 51 players (11%) had suffered for longer than four weeks, and 80 (17.2%) had pain so severe that they had to miss training. However, only about 73 of them (29% of those with back pain) had received any medical attention for LBP.

Another study of 12,306 adolescent soccer players found that a significant percentage of them were likely to suffer injuries that cause lower back pain, resulting in the loss of 10,265 training days and—more importantly—putting them at higher risk for LBP as they age. The study also concluded that the likelihood of injury resulting in LBP increased dramatically if a young athlete received no medical attention, then returned to play before the injury had healed.

Parents of teenage athletes should weigh all of this information carefully if their son or daughter begins to complain of lower back pain. Don’t let them ignore it and go back to playing without having the condition treated. Remember—“walking it off” today could have longer-term health consequences that go beyond the discomfort or pain they’re feeling in the moment. Parents should also know that other studies have found chiropractic care to be the safest, most effective form of LBP treatment. Your chiropractor can help relieve your child’s pain today and help prevent a lifetime of lower back pain in the future, without drugs and without surgery. Call or visit our office today to learn more.

Head-to-Head: Chiropractic Adjustments or NSAIDs for Acute Lower Back Pain?

June 2, 2014 oblanderchiropractic

Lower back pain (LBP) is so widespread that it was listed in the 2010 Global Burden of Disease report as being the single leading cause of disability worldwide. Over half of all working Americans have lower back pain symptoms each year, resulting in lost work time and enormous expense – Americans spend over $50 billion each year to treat their back pain.

So it’s not surprising that a great deal of research is being conducted to determine the most effective methods for treating acute LBP. Much of this research has sought to compare the effectiveness of spinal manipulation (the sort of adjustments performed by Doctors of Chiropractic) with nonsteroidal anti-inflammatory drugs (NSAIDs). While these studies have generally not produced definitive findings one way or the other, they have served to highlight potential safety concerns related to NSAIDs. For example, investigators in one study found that diclofenac (an NSAID commonly used to treat LBP) increased the risk of gastrointestinal complications by 54% and posed other risks to the kidneys.

Given the added concern about NSAID side effects, researchers and clinicians have had a renewed interest in learning whether drug-free manual therapies—chiropractic care, in particular—can really be just as effective, but safer. According to a recent study published in the April 2013 edition of the journal Spine, the answer is YES! In fact, the research team that conducted the study found that chiropractic adjustments were both safer and FAR MORE EFFECTIVE.

In this study, investigators divided a total of 101 patients suffering from acute lower back pain into three groups. One group received chiropractic spinal manipulation plus a placebo (sham) version of the NSAID diclofenac (meaning that the only treatment actually being offered was chiropractic care). A second group received sham spinal manipulation and real diclofenac (meaning that the NSAID was the only treatment being employed). And a third group received the same sham spinal manipulation plus placebo diclofenac (meaning that no treatment was actually being offered – this was the “control group”). All treatments were “blinded,” meaning that the patients did not know whether they were receiving real or sham spinal manipulation or real or placebo diclofenac. Outcomes were measured based on a combination of patient self-reporting, physical examination, missed work time, and the amount of rescue medication (paracetamol tablets) participants required over a 12-week period.

Perhaps unsurprisingly, about half of the participants in the “control” group receiving no treatment dropped out of the study because of intolerable pain. Comparing the remaining no-intervention subjects and the two remaining intervention groups, researchers found that the group receiving chiropractic high-velocity low-amplitude (HVLA) manipulation fared significantly better than the group being treated with diclofenac and the control group.

Researchers reported a clear difference between the two intervention groups: “The groups receiving spinal manipulation showed a faster and more distinct reduction in the RMS [root mean square, a standardized test of flexibility and mobility]. Subjects also noted a faster and quantitatively more distinct reduction in their subjective estimation of pain after manipulation.” They also found that the group treated only with the NSAID diclofenac required more rescue medication (paracetamol) than the spinal manipulation group, taking 3 times as many tablets and for twice the number of days. No negative effects were reported from the spinal manipulation group, but several negative effects were reported from the diclofenac group.

So, overall, this study indicates a clear “win” for chiropractic in the treatment of acute lower back pain. Not only does HVLA spinal manipulation avoid the potential safety concerns of NSAID medications such as diclofenac, it has been found to be far more effective. Remember this the next time you experience lower back pain, and consider seeing your chiropractor first. This one simple decision may help you recover more quickly and more completely while also helping you avoid the negative side effects of NSAIDs.

Can Chiropractic Care Really Reduce Your Sensitivity to Pain?

April 28, 2014 oblanderchiropractic

Chronic back pain is a worldwide problem. According to the 2010 Global Burden of Disease report, it is the single leading cause of disability worldwide. In America, an estimated $50 billion is spent each year to treat back pain. And that figure doesn’t even take into account broader economic or societal costs that come with lower productivity and wages lost to work absences. As a result, chronic pain (whether it’s located in the back, neck, head or elsewhere in the body) and its treatment is an issue—either directly or indirectly—affects all of our lives.

Over the years, there have been tens of thousands of anecdotal reports from patients who found relief from their chronic pain as the result of chiropractic spinal manipulation therapy (SMT). There have also been a number of research studies that documented pain relief after receiving spinal adjustments, especially with regard to decreased sensitivity to pain. But critics have always been able to suggest that the pain relief experienced in these studies might be due more to the placebo effect and “expecting” relief than to the therapy itself.

New research from the University of Florida, published in the February issue of the Journal of Pain, provides demonstrable proof that the pain relief from spinal manipulation therapy is the result of the therapy itself, and not simply the result of patient expectations. In this study, researchers worked with 110 participants suffering from chronic back pain. They assigned them randomly to four groups. A control group received no intervention at all, the SMT group received real spinal manipulation therapy, a third group received placebo SMT (non-chiropractic manipulations designed to simulate treatment) and the fourth group received “enhanced” placebo SMT accompanied by instructions that said “The manual therapy technique you will receive has been shown to significantly reduce low back pain in some people.” Patients then received their therapies or mock therapies six times over a period of 2 weeks. Pain sensitivity was assessed at the start and the end of the experiment.

The study design was thus intended to determine how much of any pain relief experienced by the test subjects was due to the placebo effect. Patients in the real SMT group experienced much more significant reductions in their sensitivity to pain than the control group (as expected), but also more pain reduction than either of the placebo SMT groups, including the group that had been “implanted” with the expectation that it would relieve their pain. The researchers suggest that real spinal manipulation therapy created changes to central nervous system response or the processing of neural pain input that the placebo treatments did not. They attributed the pain relief to “the modulation of dorsal horn excitability and lessening of central sensitization. This suggests potential for SMT to be a clinically beneficial intervention.”

These results should not surprise either chiropractors or their patients, who have had first-hand experience with spinal manipulation for years and understand its potential to reduce pain sensitivity in patients. But it is useful information to those who still doubt chiropractic’s ability to provide real relief without drugs or surgery. The pain alleviation produced by chiropractic adjustments has been determined to be a real and valuable alternative to other types of treatment than may involve far more risk and expense.

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