The purpose of this study was to compare the short-term effects of a Kinesio Taping application to the cervical spine versus placebo tape application on both neck pain and cervical range of motion in patients with acute whiplash-associated disorders (WADs).
Forty-one patients (21 females) were randomly assigned to 1 of 2 groups: the experimental group received Kinesio Taping to the cervical spine (applied with tension) and the placebo group received a sham Kinesio Taping application (applied without tension). Both neck pain and cervical range-of-motion data were collected at baseline, immediately after the Kinesio Tape application, and at a 24-hour follow-up by an assessor blinded to the treatment allocation of the patients.
The results indicated that patients receiving Kinesio Taping experienced a greater decrease in pain immediately postapplication and at the 24-hour follow-up. Patients in the experimental group obtained a greater improvement in range of motion than those in the control group.
Original article published in J Orthop Sports Phys Ther. 2009;39(7):515-521
Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic
http://www.laurelregionalchiropractic.com/
Friday, January 29, 2010
Monday, January 25, 2010
Chronic pain can add the effect of 20 to 30 years of age.
A study in the Journal of the American Geriatric Society reports that middle aged people with pain develop limits to their ability to function normally associated with people 20 to 30 years older.
The four physical abilities examined were: walking or jogging; stair climbing; ability to perform tasks with the shoulders and arms; and activities of daily living (bathing, dressing, eating etc).
24% of participants had significant pain (often troubled by pain that was moderate or severe most of the time) and across all four physical abilities looked at, participants with pain had much higher rates of functional limitations than subjects without pain. In the mobility function, of subjects aged 50 to 59 without pain, 37% were able to jog 1 mile and 91% were able to walk several blocks without difficulty. In the subjects with pain, only 9% could jog a mile and only 50% were able to walk several blocks.
The lead author of the study, Dr. Kenneth Covinsky of the Division of Geriatrics at University of California, San Francisco: “We found that the abilities of those aged 50 to 59 with pain were far more comparable to subjects aged 80 to 89 without pain, of whom 4% were able to jog 1 mile and 55% were able to walk several blocks, making pain sufferers appear 20 to 30 years older than non-pain sufferers,” surmised Covinsky. “After adjustment for demographic characteristics, socioeconomic status, comorbid conditions, depression, obesity, and health habits, across all four measures, participants with significant pain were at much higher risk for having functional limitations.”
It's not unusual for me in my Silver Spring office to see patients who've been ignoring pain for long periods of time. Sometimes years, sometimes decades. While there are few things as satisfying as removing a decade-old pain, it's always striking how long people will tolerate pain. People often convince themselves that it's normal. Sometimes a past doctor who wasn't effective at removing the pain will convince them it's normal. While I of course can't help everyone, if I can't help you I'll do my best to figure out who can. Pain that effects your quality of life is not normal. You deserve to not have pain. The people in your life will be happier to see the pain free version of yourself. You'll make the lives of those closest to you easier. While it's admirable to be able to function under duress, this paper study suggests that long time pain will eventually wear you down and limit your life. If you've questions on any type of pain, on any treatment feel free to call or email one of us.
ABSTRACT
OBJECTIVES: To examine the relationship between functional limitations and pain across a spectrum of age, ranging from mid life to advanced old age.
DESIGN: Cross-sectional study.
SETTING: The 2004 Health and Retirement Study (HRS), a nationally representative study of community-living persons aged 50 and older.
PARTICIPANTS: Eighteen thousand five hundred thirty-one participants in the 2004 HRS.
MEASUREMENTS: Participants who reported that they were often troubled by pain that was moderate or severe most of the time were defined as having significant pain. For each of four functional domains, subjects were classified according to their degree of functional limitation: mobility (able to jog 1 mile, able to walk several blocks, able to walk one block, unable to walk one block), stair climbing (able to climb several flights, able to climb one flight, not able to climb a flight), upper extremity tasks (able to do 3, 2, 1, or 0), and activity of daily living (ADL) function (able to do without difficulty, had difficulty but able to do without help, need help).
RESULTS: Twenty-four percent of participants had significant pain. Across all four domains, participants with pain had much higher rates of functional limitations than subjects without pain. Participants with pain were similar in terms of their degree of functional limitation to participants 2 to 3 decades older. For example, for mobility, of subjects aged 50 to 59 without pain, 37% were able to jog 1 mile, 91% were able to walk several blocks, and 96% were able to walk one block without difficulty. In contrast, of subjects aged 50 to 59 with pain, 9% were able to jog 1 mile, 50% were able to walk several blocks, and 69% were able to walk one block without difficulty. Subjects aged 50 to 59 with pain were similar in terms of mobility limitations to subjects aged 80 to 89 without pain, of whom 4% were able to jog 1 mile, 55% were able to walk several blocks, and 72% were able to walk one block without difficulty. After adjustment for demographic characteristics, socioeconomic status, comorbid conditions, depression, obesity, and health habits, across all four measures, participants with significant pain were at much higher risk for having functional limitations (adjusted odds ratio (AOR)=2.85, 95% confidence interval (CI)=2.20–3.69, for mobility; AOR=2.84, 95% CI=2.48–3.26, for stair climbing; AOR=3.96, 95% CI=3.43–4.58, for upper extremity tasks; and AOR=4.33; 95% CI=3.71–5.06, for ADL function).
CONCLUSION: Subjects with pain develop the functional limitations classically associated with aging at much earlier ages.
The four physical abilities examined were: walking or jogging; stair climbing; ability to perform tasks with the shoulders and arms; and activities of daily living (bathing, dressing, eating etc).
24% of participants had significant pain (often troubled by pain that was moderate or severe most of the time) and across all four physical abilities looked at, participants with pain had much higher rates of functional limitations than subjects without pain. In the mobility function, of subjects aged 50 to 59 without pain, 37% were able to jog 1 mile and 91% were able to walk several blocks without difficulty. In the subjects with pain, only 9% could jog a mile and only 50% were able to walk several blocks.
The lead author of the study, Dr. Kenneth Covinsky of the Division of Geriatrics at University of California, San Francisco: “We found that the abilities of those aged 50 to 59 with pain were far more comparable to subjects aged 80 to 89 without pain, of whom 4% were able to jog 1 mile and 55% were able to walk several blocks, making pain sufferers appear 20 to 30 years older than non-pain sufferers,” surmised Covinsky. “After adjustment for demographic characteristics, socioeconomic status, comorbid conditions, depression, obesity, and health habits, across all four measures, participants with significant pain were at much higher risk for having functional limitations.”
It's not unusual for me in my Silver Spring office to see patients who've been ignoring pain for long periods of time. Sometimes years, sometimes decades. While there are few things as satisfying as removing a decade-old pain, it's always striking how long people will tolerate pain. People often convince themselves that it's normal. Sometimes a past doctor who wasn't effective at removing the pain will convince them it's normal. While I of course can't help everyone, if I can't help you I'll do my best to figure out who can. Pain that effects your quality of life is not normal. You deserve to not have pain. The people in your life will be happier to see the pain free version of yourself. You'll make the lives of those closest to you easier. While it's admirable to be able to function under duress, this paper study suggests that long time pain will eventually wear you down and limit your life. If you've questions on any type of pain, on any treatment feel free to call or email one of us.
ABSTRACT
OBJECTIVES: To examine the relationship between functional limitations and pain across a spectrum of age, ranging from mid life to advanced old age.
DESIGN: Cross-sectional study.
SETTING: The 2004 Health and Retirement Study (HRS), a nationally representative study of community-living persons aged 50 and older.
PARTICIPANTS: Eighteen thousand five hundred thirty-one participants in the 2004 HRS.
MEASUREMENTS: Participants who reported that they were often troubled by pain that was moderate or severe most of the time were defined as having significant pain. For each of four functional domains, subjects were classified according to their degree of functional limitation: mobility (able to jog 1 mile, able to walk several blocks, able to walk one block, unable to walk one block), stair climbing (able to climb several flights, able to climb one flight, not able to climb a flight), upper extremity tasks (able to do 3, 2, 1, or 0), and activity of daily living (ADL) function (able to do without difficulty, had difficulty but able to do without help, need help).
RESULTS: Twenty-four percent of participants had significant pain. Across all four domains, participants with pain had much higher rates of functional limitations than subjects without pain. Participants with pain were similar in terms of their degree of functional limitation to participants 2 to 3 decades older. For example, for mobility, of subjects aged 50 to 59 without pain, 37% were able to jog 1 mile, 91% were able to walk several blocks, and 96% were able to walk one block without difficulty. In contrast, of subjects aged 50 to 59 with pain, 9% were able to jog 1 mile, 50% were able to walk several blocks, and 69% were able to walk one block without difficulty. Subjects aged 50 to 59 with pain were similar in terms of mobility limitations to subjects aged 80 to 89 without pain, of whom 4% were able to jog 1 mile, 55% were able to walk several blocks, and 72% were able to walk one block without difficulty. After adjustment for demographic characteristics, socioeconomic status, comorbid conditions, depression, obesity, and health habits, across all four measures, participants with significant pain were at much higher risk for having functional limitations (adjusted odds ratio (AOR)=2.85, 95% confidence interval (CI)=2.20–3.69, for mobility; AOR=2.84, 95% CI=2.48–3.26, for stair climbing; AOR=3.96, 95% CI=3.43–4.58, for upper extremity tasks; and AOR=4.33; 95% CI=3.71–5.06, for ADL function).
CONCLUSION: Subjects with pain develop the functional limitations classically associated with aging at much earlier ages.
Sunday, January 24, 2010
Treatment for Sciatica in Fairfax, VA
Featured article from the ACA...
Sciatica
Sciatica describes persistent pain felt along the sciatic nerve, which runs from the lower back, down through the buttock, and into the lower leg. The sciatic nerve is the longest and widest nerve in the body, running from the lower back through the buttocks and down the back of each leg. It controls the muscles of the lower leg and provides sensation to the thighs, legs, and the soles of the feet.
Although sciatica is a relatively common form of low-back and leg pain, the true meaning of the term is often misunderstood. Sciatica is actually a set of symptoms—not a diagnosis for what is irritating the nerve root and causing the pain.
Sciatica occurs most frequently in people between the ages of 30 and 50 years old. Most often, it tends to develop as a result of general wear and tear on the structures of the lower spine, not as a result of injury.
What are the symptoms of sciatica?
The most common symptom associated with sciatica is pain that radiates along the path of the sciatic nerve, from the lower back and down one leg; however, symptoms can vary widely depending on where the sciatic nerve is affected. Some may experience a mild tingling, a dull ache, or even a burning sensation, typically on one side of the body.
Some patients also report:
• A pins-and-needles sensation, most often in the toes or foot
• Numbness or muscle weakness in the affected leg or foot
Pain from sciatica often begins slowly, gradually intensifying over time. In addition, the pain can worsen after prolonged sitting, sneezing, coughing, bending, or other sudden movements.
How is sciatica diagnosed?
Your doctor of chiropractic will begin by taking a complete patient history. You’ll be asked to describe your pain and to explain when the pain began, and what activities lessen or intensify the pain. Forming a diagnosis will also require a physical and neurological exam, in which the doctor will pay special attention to your spine and legs. You may be asked to perform some basic activities that will test your sensory and muscle strength, as well as your reflexes. For example, you may be asked to lie on an examination table and lift your legs straight in the air, one at a time.
In some cases, your doctor of chiropractic may recommend diagnostic imaging, such as x-ray, MRI, or CT scan. Diagnostic imaging may be used to rule out a more serious condition, such as a tumor or infection, and can be used when patients with severe symptoms fail to respond to six to eight weeks of conservative treatment.
What are my treatment options?
For most people, sciatica responds very well to conservative care, including chiropractic. Keeping in mind that sciatica is a symptom and not a stand-alone medical condition, treatment plans will often vary depending on the underlying cause of the problem.
Chiropractic offers a non-invasive (non-surgical), drug-free treatment option. The goal of chiropractic care is to restore spinal movement, thereby improving function while decreasing pain and inflammation. Depending on the cause of the sciatica, a chiropractic treatment plan may cover several different treatment methods, including but not limited to spinal adjustments, ice/heat therapy, ultrasound, TENS, and rehabilitative exercises.
An Ounce of Prevention Is Worth a Pound of Cure
While it’s not always possible to prevent sciatica, consider these suggestions to help protect your back and improve your spinal health.
• Maintain a healthy diet and weight
• Exercise regularly
• Maintain proper posture
• Avoid prolonged inactivity or bed rest
• If you smoke, seek help to quit
•Use good body mechanics when lifting
Chiropractor Fairfax, VA 22031
Sciatica
Sciatica describes persistent pain felt along the sciatic nerve, which runs from the lower back, down through the buttock, and into the lower leg. The sciatic nerve is the longest and widest nerve in the body, running from the lower back through the buttocks and down the back of each leg. It controls the muscles of the lower leg and provides sensation to the thighs, legs, and the soles of the feet.
Although sciatica is a relatively common form of low-back and leg pain, the true meaning of the term is often misunderstood. Sciatica is actually a set of symptoms—not a diagnosis for what is irritating the nerve root and causing the pain.
Sciatica occurs most frequently in people between the ages of 30 and 50 years old. Most often, it tends to develop as a result of general wear and tear on the structures of the lower spine, not as a result of injury.
What are the symptoms of sciatica?
The most common symptom associated with sciatica is pain that radiates along the path of the sciatic nerve, from the lower back and down one leg; however, symptoms can vary widely depending on where the sciatic nerve is affected. Some may experience a mild tingling, a dull ache, or even a burning sensation, typically on one side of the body.
Some patients also report:
• A pins-and-needles sensation, most often in the toes or foot
• Numbness or muscle weakness in the affected leg or foot
Pain from sciatica often begins slowly, gradually intensifying over time. In addition, the pain can worsen after prolonged sitting, sneezing, coughing, bending, or other sudden movements.
How is sciatica diagnosed?
Your doctor of chiropractic will begin by taking a complete patient history. You’ll be asked to describe your pain and to explain when the pain began, and what activities lessen or intensify the pain. Forming a diagnosis will also require a physical and neurological exam, in which the doctor will pay special attention to your spine and legs. You may be asked to perform some basic activities that will test your sensory and muscle strength, as well as your reflexes. For example, you may be asked to lie on an examination table and lift your legs straight in the air, one at a time.
In some cases, your doctor of chiropractic may recommend diagnostic imaging, such as x-ray, MRI, or CT scan. Diagnostic imaging may be used to rule out a more serious condition, such as a tumor or infection, and can be used when patients with severe symptoms fail to respond to six to eight weeks of conservative treatment.
What are my treatment options?
For most people, sciatica responds very well to conservative care, including chiropractic. Keeping in mind that sciatica is a symptom and not a stand-alone medical condition, treatment plans will often vary depending on the underlying cause of the problem.
Chiropractic offers a non-invasive (non-surgical), drug-free treatment option. The goal of chiropractic care is to restore spinal movement, thereby improving function while decreasing pain and inflammation. Depending on the cause of the sciatica, a chiropractic treatment plan may cover several different treatment methods, including but not limited to spinal adjustments, ice/heat therapy, ultrasound, TENS, and rehabilitative exercises.
An Ounce of Prevention Is Worth a Pound of Cure
While it’s not always possible to prevent sciatica, consider these suggestions to help protect your back and improve your spinal health.
• Maintain a healthy diet and weight
• Exercise regularly
• Maintain proper posture
• Avoid prolonged inactivity or bed rest
• If you smoke, seek help to quit
•Use good body mechanics when lifting
Chiropractor Fairfax, VA 22031
Thursday, January 21, 2010
Athletes Enhance Physical Performance With Chiropractic Care
What do Barry Bonds, Tiger Woods, Andy Roddick, and Lance Armstrong have in common? They are incredibly accomplished athletes that have used chiropractic care as a key ingredient to their success.
The fact is that more professional athletes are under chiropractic care than ever before. Even more revealing is the increased use of regular chiropractic care for the entire professional teams. In fact, Chiropractic Economics reported that over 95% of teams in the NFL use chiropractors as a regular part of player care.
Some professional athletes pay personal chiropractors to give treatment before, during, or after a game. Barry Bonds, one of the best all time baseball players, has a personal chiropractor who travels to games. Barry Bonds has incorporated chiropractic into his lifestyle. He reportedly said, “I think it should be mandatory to see a chiropractor and massage therapist.”
Professional athletes get three main benefits with chiropractic care: to prevent injury, manage injury, and to enhance physical performance.
A research study conducted by Drs. Anthony Lauro and Brian Mouch, published in the Journal of Chiropractic research and Clinical Investigation in 1991, indicated chiropractic care might improve athletic performance by as much as 16.7% over a two week period. The report also concluded that subluxation-free athletes react faster, coordinate better, execute fine movements with improved accuracy and precision, amounting to an overall better athlete. Another study in the Journal of Vertebral Subluxation Research in 1997 revealed that chiropractic care increases an athlete’s capillary count. This means increased blood flow and more oxygen to the body.
It is strongly recommended that both professional and amateur athletes look into chiropractic and to see how it can help them perform to their potential.
Dr. David P. Chen
Chiropractor at Laurel Regional Chiropractic
Laurel, Maryland
The fact is that more professional athletes are under chiropractic care than ever before. Even more revealing is the increased use of regular chiropractic care for the entire professional teams. In fact, Chiropractic Economics reported that over 95% of teams in the NFL use chiropractors as a regular part of player care.
Some professional athletes pay personal chiropractors to give treatment before, during, or after a game. Barry Bonds, one of the best all time baseball players, has a personal chiropractor who travels to games. Barry Bonds has incorporated chiropractic into his lifestyle. He reportedly said, “I think it should be mandatory to see a chiropractor and massage therapist.”
Professional athletes get three main benefits with chiropractic care: to prevent injury, manage injury, and to enhance physical performance.
A research study conducted by Drs. Anthony Lauro and Brian Mouch, published in the Journal of Chiropractic research and Clinical Investigation in 1991, indicated chiropractic care might improve athletic performance by as much as 16.7% over a two week period. The report also concluded that subluxation-free athletes react faster, coordinate better, execute fine movements with improved accuracy and precision, amounting to an overall better athlete. Another study in the Journal of Vertebral Subluxation Research in 1997 revealed that chiropractic care increases an athlete’s capillary count. This means increased blood flow and more oxygen to the body.
It is strongly recommended that both professional and amateur athletes look into chiropractic and to see how it can help them perform to their potential.
Dr. David P. Chen
Chiropractor at Laurel Regional Chiropractic
Laurel, Maryland
Tuesday, January 19, 2010
Vitamin D Deficiency (Part 2)
In part one of the vitamin D discussion, I reviewed how highly prevalent a vitamin D deficiency is, even in southern areas in the country with warmer climates. I mentioned that the current recommended dosage appears to be significantly lower that evidence suggests would be a necessary minimum dosage, and concluded that the best way to determine the necessary dosage is to be tested.
Currently, the two lab tests are 1,25(OH)D, and 25(OH)D. The later, which is also referred to as 25-hydroxyvitamin D, appears to indicate a true deficiency with more accuracy. The range of normal levels in the test is 20-56 ng/ml. However, even the low end of the normal range is probably too low. A more appropriate normal range appears to be at the high end, closer to the 56 ng/ml.
So what happens when you are low? First of all, join the club. So many of us, myself included, have tested deficient. The obvious solution is to get more sun exposure when possible. However, in some climates that is easier said than done. This is where oral supplementation comes in. Two possible supplements exist. One is cholecalciferol, otherwise known as D3, and ergocalciferol, known as D2. Research indicates that D3 is the better option, since the body is able to use it more effectively. Once supplementation begins, lab results should be monitored closed, every 4-6 months at first, until the optimal dosage becomes clear.
The good news is that this is a problem that, when properly identified and managed, is fairly easy to treat and control. A little vitamin D can go a long way to helping you live a longer, healthier life.
Brian Lancaster, D.C.
Valley Chiropractic in Frederick, MD
Friday, January 15, 2010
Complementary and alternative medicine use among US Navy and Marine Corps personnel
Throughout the years in Greenbelt, MD I have seen many military and government service personnel. Recently, chiropractic care has been fully integrated into the United States Armed Services and the Veterans Health Care Administration. I say it's about time that our best and bravest get the care they so much deserve.
-LC
-LC
Background
Recently, numerous studies have revealed an increase in complementary and alternative medicine (CAM) use in US civilian populations. In contrast, few studies have examined CAM use within military populations, which have ready access to conventional medicine. Currently, the prevalence and impact of CAM use in US military populations remains unknown.
Methods
To investigate CAM use in US Navy and Marine Corps personnel, the authors surveyed a stratified random sample of 5,000 active duty and Reserve/National Guard members between December 2000 and July 2002. Chi-square tests and multivariable logistic regression were used to assess univariate associations and adjusted odds of CAM use in this population.
Results and discussion
Of 3,683 service members contacted, 1,446 (39.3%) returned a questionnaire and 1,305 gave complete demographic and survey data suitable for study. Among respondents, more than 37% reported using at least one CAM therapy during the past year. Herbal therapies were among the most commonly reported (15.9%). Most respondents (69.8%) reported their health as being very good or excellent. Modeling revealed that CAM use was most common among personnel who were women, white, and officers. Higher levels of recent physical pain and lower levels of satisfaction with conventional medical care were significantly associated with increased odds of reporting CAM use.
Conclusion
These data suggest that CAM use is prevalent in the US military and consistent with patterns in other US civilian populations. Because there is much to be learned about CAM use along with allopathic therapy, US military medical professionals should record CAM therapies when collecting medical history data.
-Dr. Louis S. Crivelli II
Chiropractor
Greenbelt, MD
Good art decreases pain. Bad art, not so much.
A recent study from Consciousness and Cognition found that people looking at art they considered beautiful allowed them to distract themselves from a painful stimuli. They used a laser (not to be confused with the pain-relieving cold laser therapy available at most of our offices) and then directly measured brain waves activated when pain is occurring as well as the subjects opinion on the pain. Neutral or ugly art neither increased or decreased pain on average. Favorites as beautiful were "Starry Night" by Vincent Van Gogh and Botticellis "Birth of Venus", Picasso's work was often chosen as ugly. In
terestingly, a few labelled Edward Munch's "The Scream" as beautiful, and noticed pain lessened while looking at it. As doctors focused on relieving pain, we are focused on any reasonable means of reducing pain, and there's certainly no harm in enjoying the art. In addition to encouraging people with pain to use art as a way of feeling better, it has other applications too. Men who are asked their opinion of china patterns, fabric swatches or paint samples could offer concrete evidence that they have absolutely no aesthetic preference. I would personally find this less painful than traditional alternatives. Art critics who claim an uncoventional art is beautiful could have their brain waves measured to see if they're telling the truth, or just being pretentious. If you've got a question on therapy for pain; conventional, unconventional or completely outside the box, feel free to ask any of our doctors.
Thursday, January 14, 2010
Effects of Biofreeze and chiropractic adjustments on acute low back pain: a pilot study.
Objective
The specific aims of the study were to study the effectiveness of Biofreeze combined with chiropractic adjustments on acute low back pain (LBP) compared with chiropractic care only. The hypothesis was that Biofreeze enhances the effect of chiropractic adjustments on acute LBP.
Methods
The data were collected at the baseline, 2 weeks after treatment, and 4 weeks after treatment for final analyses. Diversified manual adjustments were provided by licensed chiropractors twice a week for 4 weeks to both control and experimental groups. Biofreeze was applied to the lower back area 3 times a day for 4 weeks in the experimental group. For at-home care, subjects were instructed to apply Biofreeze 3 times a day as follows: Using a 5-g sample pack, subjects were instructed to apply Biofreeze to the low back once in the morning and 2 times in the afternoon. For evening application, subjects were instructed to apply once in the late afternoon, once in the evening, and once at bedtime. Outcome assessments included visual analog scale, Roland Morris Disability Questionnaire, heart rate variability for stress, and electromyography for low back muscle activity.
Results
A total of 36 subjects were recruited in the study (25 male). The average age was 34 years. Significant pain reduction was found after each week of treatment in the experimental group (P < .05). The Roland Morris Disability Questionnaire did not show significant changes in both groups. There were no significant differences for pain reduction in the control group. Heart rate variability analysis showed no significant change (P > .05) in the experimental group after 4 weeks of Biofreeze and chiropractic adjustments. There were no statistically significant changes in the electromyography readings between the 2 groups.
Conclusion
Biofreeze combined with chiropractic adjustment showed significant reduction in LBP. Biofreeze cooling gel gives rise to the cooling sensation without lower skin temperature because of the unique characteristic of menthol, which is one of the main ingredients. It is clear that the cooling effect of Biofreeze is different from the application of cold. It is possible that menthol stimulates the peripheral sensory receptors to inhibit pain through the gate control mechanisms.
Original article by: Zhang J, Enix D, Snyder B, Giggey K, Tepe R. J Chiropr Med. 2008 Jun;7(2):59-65.
Dr. David P. Chen
Chiropractor at Laurel Regional Chiropractic
Laurel, Maryland
The specific aims of the study were to study the effectiveness of Biofreeze combined with chiropractic adjustments on acute low back pain (LBP) compared with chiropractic care only. The hypothesis was that Biofreeze enhances the effect of chiropractic adjustments on acute LBP.
Methods
The data were collected at the baseline, 2 weeks after treatment, and 4 weeks after treatment for final analyses. Diversified manual adjustments were provided by licensed chiropractors twice a week for 4 weeks to both control and experimental groups. Biofreeze was applied to the lower back area 3 times a day for 4 weeks in the experimental group. For at-home care, subjects were instructed to apply Biofreeze 3 times a day as follows: Using a 5-g sample pack, subjects were instructed to apply Biofreeze to the low back once in the morning and 2 times in the afternoon. For evening application, subjects were instructed to apply once in the late afternoon, once in the evening, and once at bedtime. Outcome assessments included visual analog scale, Roland Morris Disability Questionnaire, heart rate variability for stress, and electromyography for low back muscle activity.
Results
A total of 36 subjects were recruited in the study (25 male). The average age was 34 years. Significant pain reduction was found after each week of treatment in the experimental group (P < .05). The Roland Morris Disability Questionnaire did not show significant changes in both groups. There were no significant differences for pain reduction in the control group. Heart rate variability analysis showed no significant change (P > .05) in the experimental group after 4 weeks of Biofreeze and chiropractic adjustments. There were no statistically significant changes in the electromyography readings between the 2 groups.
Conclusion
Biofreeze combined with chiropractic adjustment showed significant reduction in LBP. Biofreeze cooling gel gives rise to the cooling sensation without lower skin temperature because of the unique characteristic of menthol, which is one of the main ingredients. It is clear that the cooling effect of Biofreeze is different from the application of cold. It is possible that menthol stimulates the peripheral sensory receptors to inhibit pain through the gate control mechanisms.
Original article by: Zhang J, Enix D, Snyder B, Giggey K, Tepe R. J Chiropr Med. 2008 Jun;7(2):59-65.
Dr. David P. Chen
Chiropractor at Laurel Regional Chiropractic
Laurel, Maryland
Wednesday, January 13, 2010
Vitamin D deficiency (Part 1)
As we learn more about the growing problem of Vitamin D deficiency, we are finding that the current recommendations for intake are insufficient. Currently 400 IU of Vitamin D is recommended in order to prevent pathology resulting from a deficiency. However, many studies are finding that a daily intake of over 10 times that amount is needed to affect other, seemingly unrelated diseases, such as breast cancer, colon cancer, osteoporosis, diabetes, and hypertension.
The difficulty with making recommendations in the past is that it can vary widely since the body can produce Vitamin D from sunlight. This has led many to assume that his or her individual exposure is adequate. Research is showing otherwise*. An alarmingly large number of patients are showing deficiency in labwork.
I say this as a person that has tested deficient recently. Like everyone else, I suffer from the belief that eating, sleeping, and exercising adequately should suffice. The results show that I was wrong.
Based off preliminary findings, it is safe to assume that many people need a daily intake in excess of 4,000 IU of Vitamin D. The only way to truly know what the correct intake needed is to be tested.
Stay tuned for more information on laboratory tests, and how to proceed when a deficiency is noted.
* http://ods.od.nih.gov/factsheets/vitamind.asp
Dr. Brian Lancaster
Valley Chiropractic in Frederick, MD
Tuesday, January 12, 2010
Alpha-Lipoic Acid and Gamma Linolenic Acid Supplementation plus Physical Rehab Improves Neuropathic Symptoms in Patients with Radicular Neuropathy More Effectively Than Rehab Alone
Keywords:BACK PAIN, RADICULAR NEUROPATHY, CHRONIC PAIN, NEUROPATHIC PAIN, NERVE ROOT COMPRESSION, INTERVERTEBRAL DISC INJURY - Alpha-Lipoic Acid, Gamma Linolenic Acid, Physical Rehabilitation
Reference:“The use of alpha-lipoic acid (ALA), gamma linolenic acid (GLA) and rehabilitation in the treatment of back pain: effect on health-related quality of life,” Ranieri M, Sciuscio M, et al, Int J Immunopathol Pharmacol, 2009; 22(3 Suppl): 45-50. (Address: Physical Medicine and Rehabilitation Unit, Neurological and Psychiatric Sciences Department, Aldo Moro University, Bari 70124, Italy. E-mail: ranieri@neurol.uniba.it ).
Summary:In a study involving 203 patients with back pain including compressive radiculopathy syndrome from disc-nerve root conflict, supplementation with alpha-lipoic acid (600 mg/d) and gamma-linolenic acid (360 mg), along with participating in a physical rehabilitation program for a period of 6 weeks was found to be more effective than patients who were treated with the physical rehabilitation program alone. Specifically, those who received the ALA + GLA were found to have significantly greater improvements in paresthesias, stabbing and burning pain, Oswestry Low Back Pain Disability Questionnaire, Aberdeen Low Back Pain Scale, and improvements in quality of life, assessed via the SF-36, Revised Leeds Disability Questionnaire, and the Roland and Morris disability questionnaire. The authors conclude, “Oral treatment with alpha-lipoic acid (ALA) and gamma-linolenic acid (GLA) for six weeks in synergy with rehabilitation therapy improved neuropathic symptoms and deficits in pa tients with radicular neuropathy.”
Reference:“The use of alpha-lipoic acid (ALA), gamma linolenic acid (GLA) and rehabilitation in the treatment of back pain: effect on health-related quality of life,” Ranieri M, Sciuscio M, et al, Int J Immunopathol Pharmacol, 2009; 22(3 Suppl): 45-50. (Address: Physical Medicine and Rehabilitation Unit, Neurological and Psychiatric Sciences Department, Aldo Moro University, Bari 70124, Italy. E-mail: ranieri@neurol.uniba.it ).
Summary:In a study involving 203 patients with back pain including compressive radiculopathy syndrome from disc-nerve root conflict, supplementation with alpha-lipoic acid (600 mg/d) and gamma-linolenic acid (360 mg), along with participating in a physical rehabilitation program for a period of 6 weeks was found to be more effective than patients who were treated with the physical rehabilitation program alone. Specifically, those who received the ALA + GLA were found to have significantly greater improvements in paresthesias, stabbing and burning pain, Oswestry Low Back Pain Disability Questionnaire, Aberdeen Low Back Pain Scale, and improvements in quality of life, assessed via the SF-36, Revised Leeds Disability Questionnaire, and the Roland and Morris disability questionnaire. The authors conclude, “Oral treatment with alpha-lipoic acid (ALA) and gamma-linolenic acid (GLA) for six weeks in synergy with rehabilitation therapy improved neuropathic symptoms and deficits in pa tients with radicular neuropathy.”
Friday, January 8, 2010
Vitamin D Deficiency May Contribute to Musculoskeletal Pain
Almost on a daily basis at my office in Germantown, MD, I see patients who commonly present with idiopathic musculoskeletal pain, or in plain english, physical pain of an unknown origin. Despite the high incidence and potential consequences of such pain, precise diagnosis and effective treatment are not always easily attained.
Additionally, extremely low levels of vitamin D, known as hypovitaminosis D, may be a cause of nonspecific musculoskeletal pain that goes undetected, leading to more severe consequences, such as softening of the bones, which occurs in osteomalacia.
In a study designed to evaluate the prevalence of hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain, researchers screened 150 consecutive patients (ages 10-65) who presented to a primary care clinic between February 2000 and June 2002 with complaints of idiopathic musculoskeletal pain. Patients had no known health condition that would decrease production or absorption of vitamin D, and none had fibromyalgia, temporomandibular disorder or complex regional pain syndrome that could account for their musculoskeletal pain.
Rates of vitamin D deficiency were "unexpectedly high," according to the authors, "particularly in this population of nonelderly, nonhousebound, primary care outpatients." Overall, 28% of patients had severely deficient vitamin D levels; 55% of those individuals were younger than age 55. These deficiencies were similar for men and women, and season was not a significant variable in determining vitamin D levels.
Conclusion: "All patients with persistent, nonspecific musculoskeletal pain are at high risk for the consequences of unrecognized and untreated severe hypovitaminosis D," state the authors. "Because osteomalacia is a known cause of persistent, nonspecific non-musculoskeletal pain, screening all outpatients with such pain for hypovitaminosis D should be standard practice in clinical care."
Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clinic Proceedings 2003;78:1463-70.
Dr. Michael Cramer
Cramer Chiropractic & Rehabilitation
Germantown, MD
Thursday, January 7, 2010
4 WAYS TO SHED BELLY FAT
1. Exercise- You can't exercise to spot reduce, but it will help you shed excess pounds -- and often, the fat your body sheds first comes from your belly. Abdominal crunches can help tone muscles to make your stomach look flatter, but to truly get rid of fat, you have to burn it off through aerobic activity.
2. Be a mindful eater- Researchers are currently investigating whether really paying attention to what you eat can help redistribute body fat from your waist to your hips. Plenty of studies, though, have shown that mindful eating can help with weight loss efforts.
3. Get adequate amounts of sleep- Too little sleep (less than six hours) or too much (more than eight hours) results in an excess production of the stress hormone cortisol. This hormone promotes the storage of fat in the belly.
4. Reduce stress- Penciling in 15 minutes a day for relaxation can also lower your cortisol levels, helping you shed belly fat. Deep breathing, a stroll outdoors under the blossoming trees, or a bubble bath can help you leave the world behind.
Dr. John Rosa
Chiropractor
Rockville, MD
2. Be a mindful eater- Researchers are currently investigating whether really paying attention to what you eat can help redistribute body fat from your waist to your hips. Plenty of studies, though, have shown that mindful eating can help with weight loss efforts.
3. Get adequate amounts of sleep- Too little sleep (less than six hours) or too much (more than eight hours) results in an excess production of the stress hormone cortisol. This hormone promotes the storage of fat in the belly.
4. Reduce stress- Penciling in 15 minutes a day for relaxation can also lower your cortisol levels, helping you shed belly fat. Deep breathing, a stroll outdoors under the blossoming trees, or a bubble bath can help you leave the world behind.
Dr. John Rosa
Chiropractor
Rockville, MD
Wednesday, January 6, 2010
A Comparison Between Chiropractic Management and Pain Clinic Management for Chronic Low-back Pain in a National Health Service Outpatient Clinic
OBJECTIVE: To compare outcomes in perception of pain and disability for a group of patients suffering with chronic low-back pain (CLBP) when managed in a hospital by either a regional pain clinic or a chiropractor. DESIGN: The study was a pragmatic, randomized, controlled trial.
SETTING: The trial was performed at a National Health Service (NHS) hospital outpatient clinic (pain clinic) in the United Kingdom.
SUBJECTS AND INTERVENTIONS: Patients with CLBP (i.e., symptom duration of >12 weeks) referred to a regional pain clinic (outpatient hospital clinic) were assessed and randomized to either chiropractic or pain-clinic management for a period of 8 weeks. The study was pragmatic, allowing for normal treatment protocols to be used. Treatment was administered in an NHS hospital setting.
OUTCOME MEASURES: The Roland-Morris Disability Questionnaire (RMDQ) and Numerical Rating Scale were used to assess changes in perceived disability and pain. Mean values at weeks 0, 2, 4, 6, and 8 were calculated. The mean differences between week 0 and week 8 were compared across the two treatment groups using Student's t-tests. Ninety-five percent (95%) confidence intervals (CIs) for the differences between groups were calculated.
RESULTS: Randomization placed 12 patients in the pain clinic and 18 in the chiropractic group, of which 11 and 16, respectively, completed the trial. At 8 weeks, the mean improvement in RMDQ was 5.5 points greater for the chiropractic group (decrease in disability by 5.9) than for the pain-clinic group (0.36) (95% CI 2.0 points to 9.0 points; p = 0.004). Reduction in mean pain intensity at week 8 was 1.8 points greater for the chiropractic group than for the pain-clinic group (p = 0.023).
CONCLUSIONS: This study suggests that chiropractic management administered in an NHS setting may be effective for reducing levels of disability and perceived pain during the period of treatment for a subpopulation of patients with chronic low-back pain.
Original article published by: Wilkey A, Gregory M, Byfield D, McCarthy PW. J Altern Complement Med. Jun 2008; 14(5): 465-473.
Dr. David P. Chen
Chiropractor at Laurel Regional Chiropractic
Laurel, Maryland
OBJECTIVE: To compare outcomes in perception of pain and disability for a group of patients suffering with chronic low-back pain (CLBP) when managed in a hospital by either a regional pain clinic or a chiropractor. DESIGN: The study was a pragmatic, randomized, controlled trial.
SETTING: The trial was performed at a National Health Service (NHS) hospital outpatient clinic (pain clinic) in the United Kingdom.
SUBJECTS AND INTERVENTIONS: Patients with CLBP (i.e., symptom duration of >12 weeks) referred to a regional pain clinic (outpatient hospital clinic) were assessed and randomized to either chiropractic or pain-clinic management for a period of 8 weeks. The study was pragmatic, allowing for normal treatment protocols to be used. Treatment was administered in an NHS hospital setting.
OUTCOME MEASURES: The Roland-Morris Disability Questionnaire (RMDQ) and Numerical Rating Scale were used to assess changes in perceived disability and pain. Mean values at weeks 0, 2, 4, 6, and 8 were calculated. The mean differences between week 0 and week 8 were compared across the two treatment groups using Student's t-tests. Ninety-five percent (95%) confidence intervals (CIs) for the differences between groups were calculated.
RESULTS: Randomization placed 12 patients in the pain clinic and 18 in the chiropractic group, of which 11 and 16, respectively, completed the trial. At 8 weeks, the mean improvement in RMDQ was 5.5 points greater for the chiropractic group (decrease in disability by 5.9) than for the pain-clinic group (0.36) (95% CI 2.0 points to 9.0 points; p = 0.004). Reduction in mean pain intensity at week 8 was 1.8 points greater for the chiropractic group than for the pain-clinic group (p = 0.023).
CONCLUSIONS: This study suggests that chiropractic management administered in an NHS setting may be effective for reducing levels of disability and perceived pain during the period of treatment for a subpopulation of patients with chronic low-back pain.
Original article published by: Wilkey A, Gregory M, Byfield D, McCarthy PW. J Altern Complement Med. Jun 2008; 14(5): 465-473.
Dr. David P. Chen
Chiropractor at Laurel Regional Chiropractic
Laurel, Maryland
Barefoot running may be better
Years ago, a friend from karate showed me a magazine ad for a shoe designed to be worn for karate. "But we're all barefoot! Everyone runs, jumps, breaks boards and (outside of when we kick trees) no one's needed them in the history of the art before. Grandmaster's been stomping around for 50 some years barefoot, and he doesn't need any shoes. Why would someone need them now?" My answer is that it wasn't driven by anyone's need for shoes, but by someone's desire to sell shoes. Recent research bears me out. It has been suggested that for running, conventional "neutral" running shoes may cause some of the knee/leg/ankle/hip problems that some runners see. This article in the American Academy of Physical Medicine and Rehabilitation suggests that barefoot runners may have less torque, suggesting less damage, to critical areas in the ankle, knee and hip. The article recommended that future design be closer to barefoot than current conventional running shoe design. In my practice, my goal for patients who exercise is always to find a way for them to keep exercising the way they wish to. I'm grateful that advancing research keeps giving insight into how to make this possible.
Enhancement of in vitro interleukin-2 production in normal subjects following a single spinal manipulative treatment
This wonderful study demonstrates that the immune system can be positively effected with an adjustment. Empirical evidence has suggested this for years, but it's nice to see some objective studies starting to back it up. In Takoma Park, MD I make sure to tell my patients to get adjusted when they feel a cold "coming on".
-PTBackground
Increasing evidence supports somato-visceral effects of manual therapies. We have previously demonstrated that a single spinal manipulative treatment (SMT) accompanied by audible release has an inhibitory effect on the production of proinflammatory cytokines in asymptomatic subjects. The purpose of this study is to report on SMT-related changes in the production of the immunoregulatory cytokine interleukin 2 (IL-2) and to investigate whether such changes might differ with respect to the treatment approach related to the presence or absence of an audible release (joint cavitation).
Methods
Of 76 asymptomatic subjects, 29 received SMT with cavitation (SMT-C), 23 were treated with SMT without cavitation (SMT-NC) and 24 comprised the venipuncture control (VC) group. The SMT-C and SMT-NC subjects received a single, similar force high velocity low amplitude manipulation, in the upper thoracic spine. However, in SMT-NC subjects, positioning and line of drive were not conducive to cavitation. Blood and serum samples were obtained before and then at 20 and 120 min post-intervention. The production of IL-2 in peripheral blood mononuclear cell cultures was induced by activation for 48 hr with Staphylococcal protein A (SPA) and, in parallel preparations, with the combination of phorbol ester (TPA) and calcium ionophore. The levels of IL-2 in culture supernatants and serum were assessed by specific immunoassays.
Results
Compared with VC and their respective baselines, SPA-induced secretion of IL-2 increased significantly in cultures established from both SMT-C and SMT-NC subjects at 20 min post-intervention. At 2 hr post-treatment, significant elevation of IL-2 synthesis was still apparent in preparations from SMT-treated groups though it became somewhat attenuated in SMT-NC subjects. Conversely, IL-2 synthesis induced by TPA and calcium ionophore was unaltered by either type of SMT and was comparable to that in VC group at all time points. No significant alterations in serum-associated IL-2 levels were observed in any of the study groups.
Conclusion
The present study demonstrates that, the in vitro T lymphocyte response to a conventional mitogen (SPA), as measured by IL-2 synthesis, can become enhanced following SMT. Furthermore, within a period of time following the manipulative intervention, this effect may be independent of joint cavitation. Thus the results of this study suggest that, under certain physiological conditions, SMT might influence IL-2-regulated biological responses.
-Dr. Paul Tetro
Chiropractor
Takoma Park, MD
Tuesday, January 5, 2010
Professional Athletes Utilize Chiropractic Care
NFL Game Day Morning recently included on the show how Jacksonville Jaguar running back Maurice Jones-Drew utilizes chiropractic care to help him heal and perform better. Although the coverage was great, this is nothing new when it comes to professional athletes incorporating chiropractic.
In the recent past, chiropractic care has been utilized by many professional athletes, including Muhammad Ali, Nolan Ryan, Kareem Abdul-Jabbar, Carl Lewis, Barry Bonds, Emmitt Smith, and Joe Montana. Jerry Rice once stated that "chiropractic care has been instrumental in my life, both on and off the field. . ."
As someone that races mountain bikes on a non-professional level, even I have been quite grateful to have immediate chiropractic care after a race. The jarring during a long ride or race can often cause my upper neck to tighten, leading to a headache. Having someone help correct the damage I know I am inflicting on myself with the sport I enjoy is certainly helpful!
But the question is why everyone, regardless of sport activity level, doesn't utilize chiropractic care. I'm not just referring to reducing symptoms, but providing a boost in performance. We may not all get to play for the Jacksonville Jaguars, but we all have people that depend on us.
Brian Lancaster, D.C.
Valley Chiropractic
Frederick, MD
Kinesio Tape in Alexandria VA
What is K
inesio Tape?
For over 25 years, Kinesio has provided comfort and stability to our loyal users. Kinesio Tape offers patients a more gentle approach to rehabilitation than those provided by conventional athletic tape. On the heels of our unprecedented publicity and positive feedback from the 2008 Olympic Games in Beijing, we here at Kinesio would like to invite you to experience what athletes and medical practitioners around the world are calling the rehabilitative and enhancement tool. I have worked with Kinesio tape for over 10 Years and am a certified Kinesio taping practitioner.
Kinesio Tape is a Latex free, non-medicated, thin, porous cotton fabric with a medical grade acrylic adhesive. The tape is comprised of elastic qualities which are designed for a 30-40% longitudinal only stretch when applied. Our bodies were designed to move and the Kinesio Taping Technique promotes movement and motion. With Kinesio Tape, we are not only limited to supporting and stabilizing musculature, but allowed to provide rehabilitation while encouraging movement!
How it Works:
The technique relies heavily on insertions and origins of muscles. The built-in stretch of the tape can help stabilize injured muscles, support fatigued, weakened and/or strained muscles, and can also help facilitate a stretch for those muscles in spasm.
In addition to muscle support, Kinesio Tape can lift the skin to increase the space between the skin and muscle. This reduced localized pressure in the affected area helps promote circulation, lymphatic drainage, and lessen the irritation on the subcutaneous neural pain receptors. As an end result, the Kinesio Taping Technique reduces pain and inflammation.
Since the introduction of Kinesio Tape in the United States, medical practitioners such as PTs, ATCs, OTs, DCs, MTs and MDs have recognized and embraced this effective, safe and best of all, easy-to-use modality. The method and tape allow the individual to receive the therapeutic benefits 24 hours a day with both comfort and ease because it can be worn for several days per application. Currently, Kinesio Tape is being used in hospitals, clinics, high schools, colleges, professional sports teams, and even at the Olympic level
Alexandria, VA
Monday, January 4, 2010
Arthritis Treatment
Another great article from ACA today...
Don't Take Arthritis Lying Down
Years ago, doctors hardly ever told rheumatoid arthritis patients to "go take a hike" or "go for a swim." Arthritis was considered an inherent part of the aging process and a signal to a patient that it's time to slow down. But not so anymore. Recent research and clinical findings show that there is much more to life for arthritis patients than the traditional recommendation of bed rest and drug therapy.
What Is Rheumatoid Arthritis?
The word "arthritis" means "joint inflammation" and is often used in reference to rheumatic diseases. Rheumatic diseases include more than 100 conditions, including gout, fibromyalgia, osteoarthritis, psoriatic arthritis, and many more. Rheumatoid arthritis is also a rheumatic diseases, affecting about 1 percent of the U.S. population (about 2.1 million people.)1 Although rheumatoid arthritis often begins in middle age and is more frequent in the older generation, it can also start at a young age.
Rheumatoid arthritis causes pain, swelling, stiffness, and loss of function in the joints. Several features distinguish it from other kinds of arthritis:
-Tender, warm, and swollen joints.
-Fatigue, sometimes fever, and a general sense of not feeling well.
-Pain and stiffness lasts for more than 30 minutes after a long rest.
-The condition is symmetrical. If one hand is affected, the other one is, too.
-The wrist and finger joints closest to the hand are most frequently affected. Neck, shoulder, elbow, hip, knee, ankle, and feet joints can also be affected.
-The disease can last for years and can affect other parts of the body, not only the joints.2
-Rheumatoid arthritis is highly individual. Some people suffer from mild arthritis that lasts from a few months to a few years and then goes away. Mild or moderate arthritis have periods of worsening symptoms (flares) and periods of remissions, when the patient feels better. People with severe arthritis feel pain most of the time. The pain lasts for many years and can cause serious joint damage and disability.
Should Arthritis Patients Exercise?
Exercise is critical in successful arthritis management. It helps maintain healthy and strong muscles, joint mobility, flexibility, endurance, and helps control weight. Rest, on the other hand, helps to decrease active joint inflammation, pain, and fatigue. For best results, arthritis patients need a good balance between the two: more rest during the active phase of arthritis, and more exercise during remission.2 During acute systematic flares or local joint flares, patients should put joints gently through their full range of motion once a day, with periods of rest. To see how much rest is best during flares, patients should talk to their health care providers.3
The following exercises are most frequently recommended for patients with arthritis:*
Type of Exercise Benefits Frequency of Exercise
Range-of-motion exercises, e.g. stretching and dance Help maintain normal joint movement and increase joint flexibility. Can be done daily and should be done at least every other day.
Strengthening exercises, e.g. weight lifting Help improve muscle strength, which is important to support and protect joints affected by arthritis. Should be done every other day, unless pain and swelling are severe.
Aerobic or endurance exercises, e.g. walking, bicycle riding, and swimming Help improve the cardiovascular system and muscle tone and control weight. Swimming is especially valuable because of its minimal risk of stress injuries and low impact on the body. Should be done for 20 to 30 minutes three times a week unless pain and swelling are severe.
Range-of-motion exercises, e.g. stretching and dance Help maintain normal joint movement and increase joint flexibility. Can be done daily and should be done at least every other day. Strengthening exercises, e.g. weight lifting Help improve muscle strength, which is important to support and protect joints affected by arthritis. Should be done every other day, unless pain and swelling are severe. Aerobic or endurance exercises, e.g. walking, bicycle riding, and swimming Help improve the cardiovascular system and muscle tone and control weight. Swimming is especially valuable because of its minimal risk of stress injuries and low impact on the body. Should be done for 20 to 30 minutes three times a week unless pain and swelling are severe.
* Adapted from Questions and Answers about Arthritis and Exercise.3
If patients experience
Unusual or persistent fatigue,
Increased weakness,
Decreased range of motion,
Increased joint swelling, or
Pain that lasts more than one hour after exercising,
they need to talk to their health care provider.3 Doctors of chiropractic will help arthritis patients develop or adjust their exercise programs to achieve maximum health benefits with minimal discomfort and will identify the activities that are off limits for this particular arthritis patient.
Nutrition for the Rheumatoid Arthritis Patient
Arthritis medications help suppress the immune system and slow the progression of the disease. But for those who prefer an alternative approach, nutrition may provide complementary support. Some evidence shows that nutrition can play a role in controlling the inflammation, and possibly also in slowing the progression of rheumatoid arthritis.
Some foods and nutritional supplements can be helpful in managing arthritis:
Fatty-acid supplements: eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and gamma linolenic acid (GLA). Several studies point to the effectiveness of these fatty acid supplements in reducing joint pain and swelling, and lessening reliance on corticosteroids.4,5
Deep-sea fish, such as salmon, tuna, herring, and halibut, are sources of EPA and DHA. GLA is found in very few food sources, such as black currants and borage seed.
Turmeric, a spice that's used to make curry dishes, may also be helpful. A 95 percent curcuminoid extract has been shown to significantly inhibit the inflammatory cascade and provide relief of joint inflammation and pain.
Ginger extract has been shown to be beneficial in terms of inflammation.
Nettle leaf extract may inhibit some inflammatory pathways.
A vegetarian or low-allergen diet can help with the management of rheumatoid arthritis as well.
The benefits and risks of most of these agents are being researched. Before taking any dietary supplement, especially if you are using medication to control your condition, consult with your health care provider.
What Can Your Doctor of Chiropractic Do?
If you suffer from rheumatoid arthritis, your doctor of chiropractic can help you plan an individualized exercise program that will:
Help you restore the lost range of motion to your joints.
Improve your flexibility and endurance.
Increase your muscle tone and strength.
Doctors of chiropractic can also give you nutrition and supplementation advice that can be helpful in controlling and reducing joint inflammation.
Chiropractor Fairfax, VA 22031
Don't Take Arthritis Lying Down
Years ago, doctors hardly ever told rheumatoid arthritis patients to "go take a hike" or "go for a swim." Arthritis was considered an inherent part of the aging process and a signal to a patient that it's time to slow down. But not so anymore. Recent research and clinical findings show that there is much more to life for arthritis patients than the traditional recommendation of bed rest and drug therapy.
What Is Rheumatoid Arthritis?
The word "arthritis" means "joint inflammation" and is often used in reference to rheumatic diseases. Rheumatic diseases include more than 100 conditions, including gout, fibromyalgia, osteoarthritis, psoriatic arthritis, and many more. Rheumatoid arthritis is also a rheumatic diseases, affecting about 1 percent of the U.S. population (about 2.1 million people.)1 Although rheumatoid arthritis often begins in middle age and is more frequent in the older generation, it can also start at a young age.
Rheumatoid arthritis causes pain, swelling, stiffness, and loss of function in the joints. Several features distinguish it from other kinds of arthritis:
-Tender, warm, and swollen joints.
-Fatigue, sometimes fever, and a general sense of not feeling well.
-Pain and stiffness lasts for more than 30 minutes after a long rest.
-The condition is symmetrical. If one hand is affected, the other one is, too.
-The wrist and finger joints closest to the hand are most frequently affected. Neck, shoulder, elbow, hip, knee, ankle, and feet joints can also be affected.
-The disease can last for years and can affect other parts of the body, not only the joints.2
-Rheumatoid arthritis is highly individual. Some people suffer from mild arthritis that lasts from a few months to a few years and then goes away. Mild or moderate arthritis have periods of worsening symptoms (flares) and periods of remissions, when the patient feels better. People with severe arthritis feel pain most of the time. The pain lasts for many years and can cause serious joint damage and disability.
Should Arthritis Patients Exercise?
Exercise is critical in successful arthritis management. It helps maintain healthy and strong muscles, joint mobility, flexibility, endurance, and helps control weight. Rest, on the other hand, helps to decrease active joint inflammation, pain, and fatigue. For best results, arthritis patients need a good balance between the two: more rest during the active phase of arthritis, and more exercise during remission.2 During acute systematic flares or local joint flares, patients should put joints gently through their full range of motion once a day, with periods of rest. To see how much rest is best during flares, patients should talk to their health care providers.3
The following exercises are most frequently recommended for patients with arthritis:*
Type of Exercise Benefits Frequency of Exercise
Range-of-motion exercises, e.g. stretching and dance Help maintain normal joint movement and increase joint flexibility. Can be done daily and should be done at least every other day.
Strengthening exercises, e.g. weight lifting Help improve muscle strength, which is important to support and protect joints affected by arthritis. Should be done every other day, unless pain and swelling are severe.
Aerobic or endurance exercises, e.g. walking, bicycle riding, and swimming Help improve the cardiovascular system and muscle tone and control weight. Swimming is especially valuable because of its minimal risk of stress injuries and low impact on the body. Should be done for 20 to 30 minutes three times a week unless pain and swelling are severe.
Range-of-motion exercises, e.g. stretching and dance Help maintain normal joint movement and increase joint flexibility. Can be done daily and should be done at least every other day. Strengthening exercises, e.g. weight lifting Help improve muscle strength, which is important to support and protect joints affected by arthritis. Should be done every other day, unless pain and swelling are severe. Aerobic or endurance exercises, e.g. walking, bicycle riding, and swimming Help improve the cardiovascular system and muscle tone and control weight. Swimming is especially valuable because of its minimal risk of stress injuries and low impact on the body. Should be done for 20 to 30 minutes three times a week unless pain and swelling are severe.
* Adapted from Questions and Answers about Arthritis and Exercise.3
If patients experience
Unusual or persistent fatigue,
Increased weakness,
Decreased range of motion,
Increased joint swelling, or
Pain that lasts more than one hour after exercising,
they need to talk to their health care provider.3 Doctors of chiropractic will help arthritis patients develop or adjust their exercise programs to achieve maximum health benefits with minimal discomfort and will identify the activities that are off limits for this particular arthritis patient.
Nutrition for the Rheumatoid Arthritis Patient
Arthritis medications help suppress the immune system and slow the progression of the disease. But for those who prefer an alternative approach, nutrition may provide complementary support. Some evidence shows that nutrition can play a role in controlling the inflammation, and possibly also in slowing the progression of rheumatoid arthritis.
Some foods and nutritional supplements can be helpful in managing arthritis:
Fatty-acid supplements: eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and gamma linolenic acid (GLA). Several studies point to the effectiveness of these fatty acid supplements in reducing joint pain and swelling, and lessening reliance on corticosteroids.4,5
Deep-sea fish, such as salmon, tuna, herring, and halibut, are sources of EPA and DHA. GLA is found in very few food sources, such as black currants and borage seed.
Turmeric, a spice that's used to make curry dishes, may also be helpful. A 95 percent curcuminoid extract has been shown to significantly inhibit the inflammatory cascade and provide relief of joint inflammation and pain.
Ginger extract has been shown to be beneficial in terms of inflammation.
Nettle leaf extract may inhibit some inflammatory pathways.
A vegetarian or low-allergen diet can help with the management of rheumatoid arthritis as well.
The benefits and risks of most of these agents are being researched. Before taking any dietary supplement, especially if you are using medication to control your condition, consult with your health care provider.
What Can Your Doctor of Chiropractic Do?
If you suffer from rheumatoid arthritis, your doctor of chiropractic can help you plan an individualized exercise program that will:
Help you restore the lost range of motion to your joints.
Improve your flexibility and endurance.
Increase your muscle tone and strength.
Doctors of chiropractic can also give you nutrition and supplementation advice that can be helpful in controlling and reducing joint inflammation.
Chiropractor Fairfax, VA 22031
Prediction of Treatment Outcome in Patients with Low Back Pain Treated by Chiropractors - does the psychological profile matter?
It is generally thought that a patient's psychological status can serve as a boost or a hindrance to their recovery. In this interesting Swedish study, the investigators found no link between psychological status and the outcome of their chiropractic care. In Greenbelt, MD we find that by boosting patient morale, we achieve better, longer lasting results.
Background
It is clinically important to be able to select patients suitable for treatment and to be able to predict with some certainty the outcome for patients treated for low back pain (LBP). It is not known to what degree outcome among chiropractic patients is affected by psychological factors. Objectives: To investigate if some demographic, psychological, and clinical variables can predict outcome with chiropractic care in patients with LBP.
Method
A prospective multi-center practice-based study was carried out, in which demographic, clinical and psychological information was collected at base-line. Outcome was established at the 4th visit and after three months. The predictive value was studied for all base-line variables, individually and in a multivariable analysis.
Results
In all, 55 of 99 invited chiropractors collected information on 731 patients. At the 4th visit data were available on 626 patients and on 464 patients after 3 months. Fee subsidization (OR 3.2; 95% CI 1.9-5.5), total duration of pain in the past year (OR 1.5; 95% CI 1.0-2.2), and general health (OR 1.2; 95% CI 1.1-1.4) remained in the final model as predictors of treatment outcome at the 4th visit. The sensitivity was low (12%), whereas the specificity was high (97%). At the three months follow-up, duration of pain in the past year (OR 2.1; 95% CI 1.4-3.1), and pain in other parts of the spine in the past year (OR1.6; 1.1-2.5) were independently associated with outcome. However, both the sensitivity and specificity were relatively low (60% and 50%). The addition of the psychological variables did not improve the models and none of the psychological variables remained significant in the final analyses. There was a positive gradient in relation to the number of positive predictor variables and outcome, both at the 4th visit and after 3 months.
Conclusion
Psychological factors were not found to be relevant in the prediction of treatment outcome in Swedish chiropractic patients with LBP.
-Dr. Louis S. Crivelli II
Chiropractor
Greenbelt, MD
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