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Opiates Ineffective for Chronic Back or Hip Pain

Opiates Ineffective for Chronic Back or Hip Pain

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

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

The study found:

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

The study authors write:

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

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

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

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

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

Why Teens Shouldn’t Rely on Painkillers

Why Teens Shouldn’t Rely on Painkillers

It seems as if you can’t check the news without finding at least one story of a life being lost to drugs. What is perhaps most concerning is that, all too often, the person who succumbed tragically for drug-related reasons is fairly young. And, a study released in the journal Addiction found that opioids — or narcotic painkillers like Vicadin, oxycodone, codeine, and morphine — are largely to blame.

The study shows that there were almost 6,000 opioid-related deaths in Onatario, Canada alone,  between 1991 to the end in 2010.  That represented a 242% increase from the beginning of the study. Overall, 25-34 year olds accounted for one in eight deaths. But it’s not just Ontario that has this problem: The CDC says that opioid-related deaths have more than tripled in the US since 1990, and younger patients aren’t immune.

What Is Causing This Trend?

Certainly, the issue of drug use is multi-faceted and cannot be isolated to just one cause, but it would be remiss to not consider that one possible contributor is the rise in the number of prescriptions being given to our youth. For instance, a previous study published in the Journal of Adolescent Health highlights the fact that out of 8,000 adolescents who sought medical treatment for headaches, opioid prescriptions were given approximately 46% of the time. That’s not the worst of it.

In 48% of the cases, the teens who presented with head-related pain were given two different opioids to manage their pain and 29% of the adolescents got three prescriptions or more. Rather than prescribe these highly-addictive painkillers, why not treat teens with a drug-free solution first?

Chiropractic is a great natural remedy for headache,  back, neck, and leg pain, amongst the several other benefits it offers. Not only does it actually take care of the problem, but it also reduces exposure to drugs at an early age.

References

Gomes T, et al. The burden of premature opioid-related mortality. Addiction. July 7, 2014.

DeVries A, et al. Opioid Use Among Adolescent Patients Treated for Headache. Journal of Adolescent Health. February 26, 2014.

 

When Are Antibiotics Appropriate and When Should I Avoid Using Them?

When Are Antibiotics Appropriate and When Should I Avoid Using Them?

People are becoming increasingly aware of the dangers that can result from the overuse of antibiotics. When antibiotics were first discovered in the early 20th century, researchers believed that they had found the key to conquering many deadly diseases. Since that time, antibiotics have certainly helped to cure diseases that once wiped out large parts of the population. However, there is growing evidence that antibiotics are now being used too frequently, and that they are often being used in inappropriate circumstances. This has led to many previously curable diseases becoming antibiotic-resistant, which means that a cure now requires the use far stronger antibiotics. In fact, some diseases have now become resistant to nearly all antibiotics. It is obvious that if antibiotic use continues in this way, we may have a major health crisis on our hands.

The first thing to be aware of is that antibiotics are not effective in the treatment of viruses. They only treat bacterial infections, certain fungal infections and parasites. For diseases such as the common cold, flu or bronchitis, antibiotics are completely ineffective and their use in cases such as these will only contribute to the development of antibiotic-resistant bacteria. You should not ask your doctor to prescribe antibiotics if you have a sore throat or the stomach flu, for instance. According to the Centers for Disease Control and Prevention (CDC), antibiotics were prescribed for an acute respiratory infection in 68% of visits to the doctor. However, 80% of those prescriptions were unnecessary.

Antibiotics are often an appropriate treatment for conditions such as severe sinus infections that last longer than two weeks, ear infections, bladder infections and skin infections. These are frequently due to a bacterial or fungal infection, and treating them with antibiotics is effective.

If you have been prescribed an antibiotic, it is very important that you take it exactly as directed by your physician. If your symptoms happen to clear up before the entire course of antibiotics is completed, you must still continue to take them as prescribed. This is because there may still be a few lingering bacteria in your system, and—if they are not all killed—the strongest ones may survive to produce new generations of ever stronger bacteria that might make current antibiotics less effective.

Some doctors feel pressured by their patients to prescribe something, whether it’s really going to be helpful or not. A study published in the journal Pediatrics found that pediatricians will prescribe antibiotics for children 62% of the time if parents expect them to, and only 7% of the time if the parents do not expect an antibiotic prescription. Do not put pressure on your doctor to prescribe antibiotics for your condition. He or she is the best judge as to whether antibiotics are appropriate.

Also, keeping adjusted helps keep your immune system at its best. To avoid catching colds and other viruses, be sure to keep you and your family adjusted! Call our office at 406-652-3553 if you need to schedule an appointment with Dr. Oblander!

The Side Effects from Drugs/Pharmaceuticals is NOT Funny Business

The Side Effects from Drugs/Pharmaceuticals is NOT Funny Business

We know that many people feel that it is easier to take a pill than to take care of themselves. It may seem easier in the short term but in the long run, it is never the solution for maximizing your health and longevity. It is now estimated that 95% of all cancers are life-style related. Other health such as heart disease. diabetes, and arthritis are most often related to a person’s lifestyle as well. If you want to be healthy and to age gracefully, the best way is to start improving your lifestyle choices today! If you have any questions on how you might do that, be sure to contact our office!

Today, we are sharing a great article from the Sparman Clinic Blog!:

THE NEGATIVE SIDE-EFFECTS OF PRESCRIPTION MEDICATION

Many side-effects associated with prescription medication can be more detrimental than the condition they are treating. The best way to avoid having to take prescription medication is to take care of yourself through diet, exercise, and natural preventative supplements.

Why the Push For Prescription Medication?:

The pharmaceutical industry is a booming business. Americans spend over $200 billion per year on prescription medication. While many of these medications have helped people recover and live healthy lives, there is a potentially dangerous situation that can result from over-medication (taking an excessive amount of prescription drugs) or using drugs that come with a high-risk of hazardous side-effects. These side-effects can be overlooked when it is seen as a solution to a painful or life-threatening health condition.

What are Some Potential Side-Effects?:

Depending on the type of medication you are choosing, many may only mask or slow the symptoms of a condition, rather than heal. In the process, some negative side-effects can emerge, causing discomfort or health risks.  Depending on other medications or a person’s physical make-up, there can be different reactions with different people.

How Can You Reduce Your Risks?:

The best way to reduce your risk of negative side-effects with prescription medication is not taking any! While there are some conditions where this is not an option, many health conditions and diseases can be prevented through diet, exercise, and the use of natural supplements. Preventative care is essential to a long and healthy life free from reliance on prescription medication. Make sure your diet is full of raw, organic fruits and vegetables that provide the essential vitamins and minerals needed for healthy body functions. Exercise should be a regular part of your routine; this keeps your heart pumping.

Why Choose Natural Supplements?”:

If you are looking for additional ways to keep your heart healthy as you age, a good choice can be a natural supplement. These supplements may supply vitamins, minerals, and antioxidants to help you meet your nutrient needs. Using a natural supplement in conjunction with a healthy lifestyle can greatly reduce your risk of heart disease and improve your quality of life.

Overall, your health is in your hands. There is a lot of controversy in the pharmaceutical industry and what works for someone else, may not work for you. Reduce your risk of dependence on medication which could come with some serious side-effects by taking care of your health through diet, exercise, and natural vitamin supplements for a well-rounded lifestyle.

 

The Opioid Crisis’ Latest Victims: Addicted Babies

The Opioid Crisis’ Latest Victims: Addicted Babies

(NU) – And now the nation’s opioid crisis is putting newborn babies at risk.
The use of prescription painkillers like OxyContin by women during pregnancy has resulted in what’s being called “an explosion” of infants as addicted to the drugs as their mothers. Newly published data in JAMA Pediatrics shows the number of cases of neonatal abstinence syndrome (NAS) has risen five-fold in the U.S. from 2000 to 2012 – that’s nearly 22,000 affected inf ants in that last year alone – and the reality behind those stats is heart-wrenching. “The babies, they really suffer,
just like adults do when they withdraw from narcotics,” Dr. Terrie Inder, chair of pediatric new born medicine at Boston’s Brigham and Women’s Hospital, told CBS News. “The babies are very irritable and sometimes have high heart rates, sweating, flushing, diarrhea. They cry a lot.”

Heightening experts’ concern: The crucial early “bonding” between mother and child is disrupted, given the babies’ average hospital stay of 24 days. The mothers, often unaware of the potential collateral damage from the painkillers they’ve been taking, experience what Inder calls “anxiety and guilt.”

Back and neck discomfort is especially common during pregnancy since women’s postural changes can result in spine and pelvic pain.

The open question is whether this latest development, combined with the Centers for Disease Control and Prevention’s call last year for physicians to dramatically curtail prescribing opioids will encourage more women to seek alternatives like drug-free chiropractic care. “All chiropractors are trained to work with women who are pregnant,”, The American Pregnancy Association says, lauding their expertise in “establishing pelvic balance and alignment.”

If you are expecting a baby or know someone who is, Dr. Oblander is well-trained in taking care of women during their pregnancies. Be sure to take good care of yourself and give our office a call if you experience back or hip pain during your pregnancy!

(Article shared from News USA)

Health Update: Close-Up on Adverse Drug Reactions

Health Update: Close-Up on Adverse Drug Reactions

medical theme – doctors desk with documents and stethoscope

You can’t switch on a television these days without seeing a commercial for some new pharmaceutical that will cure whatever may ail you (or cure you from an illness you never knew you had). If you pay attention to it, you will notice that nearly half the ad time is taken up with a long list of possible side effects and adverse reactions that may accompany taking the drug. The possibilities often include everything from slight fatigue to death.

An estimated 4.5 million Americans visit their doctor or the ER each year due to adverse reactions to prescription drugs. These adverse side effects are also suffered by an additional 2 million people each year who are already in the hospital being supervised by medical professionals. The CDC estimates that 82% of Americans are taking at least one drug, and 29% are taking five or more drugs.

The US Food and Drug Administration (FDA) is in charge of approving pharmaceutical drugs for sale in the US. However, their methods for approval are based on the drug companies providing their own scientific studies on the safety of the drug. The FDA does no independent testing. The FDA will usually approve a drug if its benefits are believed to outweigh its dangers. Even assuming the drug companies’ studies have been well-conducted and show that a drug is relatively safe, no drug is completely free from side effects for everyone, even those drugs that are “natural.” A person’s age, weight, gender, overall health and genetic profile have a lot to do with how an individual will respond to a drug.

The most common side effects are gastrointestinal problems, as most drugs are processed via the digestive tract. These problems include nausea, vomiting, constipation and diarrhea. Other common side effects are drowsiness, fatigue and mild skin reactions. Although dizziness may not seem like a dangerous side effect, it can be particularly risky for seniors. According to the Centers for Disease Control and Prevention (CDC), falls among seniors are the leading cause of injury-related death. A quarter of all seniors who fall and break a hip will die within six months of receiving the injury.

Death is of course the most serious side effect of all. Allergic reactions that cause anaphylaxis can be deadly. Some drugs, such as those that treat type 2 diabetes (Actos and Avandia, for example) can cause a stroke or heart attack. Antidepressants can actually increase suicidal thoughts. Some drugs can cause pain and total or partial paralysis, such as the cholesterol-lowering drug Lipitor. Some drugs increase your risk of cancer. Ironically, the drug Tamoxifen, prescribed to treat breast cancer, actually increases the risk of uterine cancer. Memory loss, hallucinations, loss of taste and loss of sight are other common side effects of pharmaceuticals.

Although there is no doubt that some pharmaceuticals are far more useful than they are dangerous (antibiotics, for example), if you want to avoid the harmful side-effects that many drugs may produce, try to keep as healthy as possible. Eat right, get regular exercise and visit your Billings Chiropractor Dr. Greg Oblander to keep your body in top condition.

 

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What’s Inside the Average American Medicine Cabinet? And What Should Be.

What’s Inside the Average American Medicine Cabinet? And What Should Be.

What’s Inside the Average American Medicine Cabinet?  And What Should Be.Take a look inside the average American’s medicine cabinet and you are likely to find out-of-date prescription medications, half-used bottles of lotion, some painkillers and a box of Band-Aids. Some of these are useful, and some should have been disposed of long ago. Along with the annual maintenance that you perform on your smoke detector, your medicine cabinet should have a thorough evaluation and clean-out once a year as well.

Many minor health issues can be treated at home, saving you and your doctor unnecessary time and expense. The key is to be sure that what you have on hand is effective for treating your problem. Medicines lose their effectiveness over time, so any medicine that is beyond its expiration date should be discarded. Do not flush medicines down the toilet or dispose of them in the trash, as they can make their way into the water system, which is becoming an increasing problem for water treatment facilities. Instead, drop off expired medicines at your local pharmacy, where they will dispose of them safely.

Experts advise that the following items should be staples in any medicine cabinet:

Painkillers – It is useful to have a few different types on hand, to treat different types of pain. Aspirin is best for general pain relief and to reduce fever, acetaminophen is easier on the stomach and good for children (who should not take aspirin due to the danger of Reye’s syndrome), and ibuprofen is an anti-inflammatory useful for treating muscle cramps, sprains and arthritis pain. None of these should be taken in large amounts, as they can harm the liver.

Antihistamine/Decongestant – For itching, sneezing and congestion due to colds and allergies.

Cold and flu remedies – To reduce the aches, pain and fever of a cold or flu.

Cough medicine – Can be either a suppressant (to reduce coughing) or an expectorant (to loosen phlegm and make coughing more productive). However, FDA pediatricians warn that cough medicine should not be given to children under 6 years of age because of the potential for severe harmful side effects. Studies have found that honey is actually more effective than most cough medicines in reducing coughing. Honey, however, should not be given to children under one year of age because of the risk of infant botulism.

Gastrointestinal remedies – To treat indigestion, heartburn, diarrhea and nausea. Pepto-Bismol and some type of antacid are useful items to have on hand.

First aid kit – To treat minor injuries, a basic first aid kit should contain Band-Aids, sterile dressing, medical tape, tweezers, eyewash, antiseptic cream, an ace bandage and a thermometer.

Your bathroom is not the best place to keep medications, as the heat and moisture from the shower can speed their deterioration. A better choice is to keep them in a cool, dark, dry place such as in a linen closet. By keeping your medicine cabinet well-stocked and up-to-date, you may be able to save yourself a trip to the doctor.

Remember, that in addition to basic medical supplies, one of the best ways to stay healthy is to get a regular adjustment from Dr. Oblander!

Spotlight on Drug Interactions: What You should Know

Spotlight on Drug Interactions: What You should Know

drug-interactions
drug-interactions

Medications—prescription, over-the-counter, and herbal/nutritional­—are used every day by millions of Americans to treat illnesses and to help them stay healthy.  There is no question that these medications have improved our lives: Just try to imagine a world without antibiotics or without the tens of thousands of other medications that we rely on to save lives and prevent serious diseases.

At the same time, because Americans take so many medications—often simultaneously—a growing health risk has emerged in the form of drug interactions. Drug interactions are the negative side effects that can occur when we combine medications with other medications or with certain types of food or drinks that we also consume. For example, you have probably received a prescription at some point and been told by your doctor or pharmacist not to drink alcohol while taking it, because that could cause negative drug interactions. But did you know that a simple thing like grapefruit juice could also cause negative interactions? In a review published in the Canadian Medical Association Journal, researchers identified 85 different medications that interact negatively with grapefruit or grapefruit juice. Of these medications, 43 pose a risk of serious side effects, including severe symptoms like respiratory failure, kidney failure, intestinal bleeding, and even sudden death.

The growing possibility of serious—and even deadly—drug interactions places an increasing burden on physicians, pharmacists, and the public to become more aware of this problem and to take steps to prevent it. The risks of negative drug-to-drug and drug-to-food reactions are numerous and can be affected by factors such as the age and gender of the patient as well as his or her medical history, general health, body composition, and the number of medications used.

It is virtually impossible for a layman to be aware of all of the possible negative drug-to-drug and drug-to-food interactions, so the most important piece of advice to take to heart is to never leave your doctor’s office after having been prescribed a drug without asking when to take it, how much of it to take, and whether there is anything it should not be taken with.

This should be considered a basic health safety procedure, and you should practice it with scrupulousness. For example, if you are meeting with your doctor and are about to be prescribed medication, be sure to tell him or her if you are using any other medications, nutritional supplements or herbal products. Your doctor needs this information to safely prescribe the medications you need. Even “small” things that you think may not matter might actually matter a great deal! Remember our grapefruit example? If you normally eat a lot of grapefruit or drink a lot of grapefruit juice, you should mention this. Why? Because one of the chemical compounds found in grapefruit increases the absorption of many drugs. This can enhance their effects and make them more powerful, sometimes dangerously so.

This does not mean, of course, that you need to provide every detail of your diet and lifestyle to your doctor—focus on the aspects that you think may be relevant. You can learn a lot about possible negative drug interactions by reading publications such as this document on common drug interactions, “Drug Interactions: What You Should Know,” available from the U.S. Food and Drug Administration.

Also, if you want to be proactive, you can consult the online Interactive Drug Checker at WebMD, which allows you to enter the name of a prescription, over-the-counter, or herbal medication and then enter additional medications and find possible negative interactions between them.

Another all-important piece of advice is to always read the label that comes with the medication or supplement. It will contain information about the medication as well as other drugs, supplements, and foods that should not be taken at the same time.

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

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

???????????????????????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.

 

What’s the Difference Between an MD and a DC?

What’s the Difference Between an MD and a DC?

md-or-dc-200-300It’s important to know the basic differences between an MD (Medical Doctor) and a DC (Doctor of Chiropractic) so that you understand the unique role that each type of medical professional plays in helping you to maintain or regain your health.

MDs and DCs are both licensed healthcare providers. They examine, diagnose and treat patients. However, most MDs have more hours of training in physiology, whereas DCs typically have more hours of anatomy training. Their methods of practice may help explain this difference in emphasis. DCs are experts in musculoskeletal health and general wellness. Like an MD, a DC will use diagnostic imaging, lab tests, clinical exams and questionnaires to determine a diagnosis, but the course of treatment will be different. MDs tend to prescribe pharmaceuticals and surgery to treat patients, whereas DCs use a more holistic approach involving a variety of hands-on treatments as well as advice on diet and exercise.

Office visits are also often quite different experiences. On a typical visit to an MD, you will likely be asked by a nurse or assistant to fill out paperwork and provide information about your condition. Then the MD will visit you, look at the information, perhaps perform a brief clinical examination, and quickly prescribe a treatment. In the course of doing this, most doctors will take only a small amount of time to understand your overall health picture. And treatment will usually involve drugs and/or medical procedures.

It is not uncommon for patients to have a more personal relationship with their DC than with their MD. Visits to a DC also tend to be more involved. The chiropractor will speak with you at length about not only your physical symptoms, but your lifestyle habits as well. He or she will examine you, perform any necessary tests, discuss possible treatment options, and provide appropriate manual therapies. Together, these treatment methods are sometimes referred to as “physical medicine”.  These may include targeted spinal adjustments, therapeutic massage, disc decompression, laser therapy, electrical stimulation and hot and cold treatments as well as structured exercise and stretching programs. In addition, the chiropractor may also make specific suggestions about your nutrition, day-to-day environment and physical activity.

 
In general, musculoskeletal problems (particularly those related to back, neck and joint pain) are better treated by a DC. However, many chiropractors have also developed specialized expertise in other areas as well. DCs will refer you to an MD if they believe that diagnosing and treating your specific condition is beyond their scope of practice.