Chiropractic Manipulative therapy and low level laser

Chiropractic Manipulative Therapy and Low-Level Laser Therapy in the Management of Cervical Facet Dysfunction: A Randomized Controlled Study

Chiropractic Manipulative Therapy and Low-Level Laser Therapy in the Management of Cervical Facet Dysfunction: A Randomized Controlled Study

Lindie Saayman, MT (Chiro)a, Caroline Hay, MT (Chiro)b, Heidi Abrahamse, PhDc

Received 7 May 2010; received in revised form 31 January 2011; accepted 10 February 2011.

Abstract

Purpose

The aim of this study was to determine the short-term effect of chiropractic joint manipulation therapy (CMT) and low-level laser therapy (LLLT) on pain and range of motion in the management of cervical facet dysfunction.

Methods

Sixty ambulatory women between the ages of 18 and 40 years with cervical facet joint pain of more than 30-day duration and normal neurologic examination were randomized to receive 1 of 3 treatment options: (1) CMT of the cervical spine, (2) LLLT applied to the cervical facet joints, or (3) a combination of CMT and LLLT. Each participant received 6 treatments in 3 weeks. The main outcome measures were as follows: the Numerical Pain Rating Scale, Neck Disability Index, Cervical Range of Motion Instrument, and Baseline Digital Inclinometer. Measurements were taken during weeks 1 (baseline), 2, 3, and 4.

Results

No differences existed between the 3 groups at baseline. A significant difference was seen between groups 1 (CMT) and 2 (LLLT) for cervical flexion, between groups 1 (CMT) and 3 (CMT + LLLT) for cervical flexion and rotation, and between groups 2 (LLLT) and 3 (CMT + LLLT) for pain disability in everyday life, lateral flexion, and rotation.

Conclusion

All 3 groups showed improvement in the primary and secondary outcomes. A combination of CMT and LLLT was more effective than either of the 2 on their own. Both therapies are indicated as potentially beneficial treatments for cervical facet dysfunction. Further studies are needed to explore optimal treatment procedures for CMT and LLLT and the possible mechanism of interaction between therapies.

Team Lloyd Irvin & Recovery Doc Team Up!

Physio ball for back pain relief

The cause of back pain and the potential treatments for back injury are diverse. Back pain can be the result of a range of conditions that affect muscles, tendons, ligaments, discs, nerves, other soft tissues or joints. Most back pain does not have one simple cause, but may be due to a range of factors, such as poor posture, repetitive activity or trauma. A staple piece of equipment for rehabilitating a back injury is the physio ball.

No matter what the particular cause of back injury, it is well documented that the resulting low back pain inhibits the deep abdominal muscles whose job it is to support the spine. A vicious downward spiral is created where injury causes back pain, which causes the muscles that support the spine to weaken which in turn leaves that back more vulnerable to further injury. It is possible to break free from this cycle and specific lower abdominal stabilization training is a key component to winning the battle. This is where the physio ball comes in, it can also be referred to as an exercise ball, gym ball, stability ball or therapy ball. It is effective in rehabilitation of the back because it helps strengthen and develop the core body muscles that help to stabilize the spine.

It has been shown that the muscle activity required to perform a simple curl-up exercise is almost doubled when using a physio ball compared to the same exercise on a stable surface. Using equipment like the physio ball to perform abdominal exercises changes both the level of muscle activity and the way the muscles work together to stabilize the spine and whole body, this effect is exactly that which is required to counteract the negative effects that back pain has on the muscles.

The physio ball does not simply provide a method to restore the spinal stability that is lost in an episode of back pain. The range of exercises that can be performed when using it allows for expansive program progression, making it suitable for use in very early remedial exercises to end stage functional rehabilitation. It is also possible to perform a range of mobility exercises to promote increased range of motion about the spine as well as improve stability.

The use of a physio ball is an excellent conservative back exercise treatment option for back pain sufferers. It is a readily available, inexpensive and versatile piece of equipment that can be used under the supervision of a health professional and/or as part of an independent management plan for back pain. Not only will its use help to resolve the presenting complaint, it will also help prevent further episodes of low back pain when used as part of a rehabilitation program.

Reference: Exercises on a "swiss ball" for chronic low back pain. Stankovic, A, Lazovic, M and Kocic, M. 2008, Proceedings of the 7th Mediterranean congress of physical an rehabilitation medicine, pp. 58-60.

Dr. David P. Chen
Chiropractor in Laurel, MD 20708

Recovery and Sports

Most of you that follow my blog know that I am passionate about recovery and feel that it's the secret to increased performance in elite level athletics. I recently found Restwise when a professional athlete I know suggested them to me. When I did some research and called the company I could not believe they were on the same page as I was in terms of implementing aspects of recovery.

"Restwise takes the science of recovery out of the lab and puts it into your hands. Answer a brief series of research-based questions on the Restwise website every day and the resulting Recovery Score will, for the first time ever, quantify your body's state of recovery. "

I will be teaming up with Restwise to sponsor a group of varied athletes in different sports, called "Team-Recovery Doc." I will be combining Restwise data and apply them to my five pillars of recovery in addition to all of the modalities at my disposal....

Dartfish Motion Analysis

Class IV Lasers

Diagnostic Muskuloskelteal Ultrasound

RecoveyDoc Movement Assements evaluation

Nutrition.......................etc etc.

We are going to change the way RECOVERY is done.

Check back soon to see who the newest members will be!!!!!

Chiropractic care is the key to optimum perfomance

Green Bay Packers quarterback Aaron Rodgers and fitness pioneer Jack Lalanne are huge advocates for chiropractic care. Actually, Aaron Rodgers' father is a chiropractor in Chico, California and Jack Lalanne was a Doctor of Chiropractic himself.

Aaron Rodgers is not the only NFL player or athlete who believes in the benefit of chiropractic care. New Orleans Saints 2006 first round pick, Reggie Bush, has been receiving regular chiropractic care since playing football in high school and his collegiate years. "I look at Chiropractic care as important to keeping me healthy and at the top of my game." 2010 Hall Of Fame inductee Jerry Rice, who is a spokesperson for the Foundation for Chiropractic Progress, a non-profit organization dedicated to educating the public of the many benefits associated with chiropractic care. "I did a lot of things to stay in the game, but regular visits to my chiropractor made all of the difference", Jerry Rice says. Some of the elite athletes, Lance Armstrong, Tiger Woods, Emmitt Smith, Tom Brady, and Michael Jordan just to name a few, have all benefited from chiropractic care to help them to stay on top of their game. All 32 teams in the NFL have either one or several chiropractors on staff. The need for chiropractic care in the NFL has been driven by the players' desire for optimum performance, and not just for treating injuries.

The good news is that you don't have to be a professional athlete to receive chiropractic care, but you do have to want to make an investment in your health and want to create a healthier lifestyle. It doesn't matter if you have extreme pain or no pain at all, chiropractic allows you to live life to the fullest.

Dr. David P. Chen
Chiropractor in Laurel, MD 20708

Spinal Manipulation Therapy for Acute Low Back Pain

The October 2010 issue of The Spine Journal includes a new review of the scientific evidence supporting spinal manipulative therapy (SMT) for low back pain (LBP). The results were quite favorable and reflect a growing body of evidence supporting SMT over medications and other conservative options. SMT research demonstrates “equivalent or superior improvement in pain and function when compared with other commonly used interventions, such as physical modalities, medication, education, or exercise, for short, intermediate, and long-term follow-up.” The authors conclude by recommending that other health care providers consider SMT as a viable option if self care or education fails to provide pain relief.

METHODS: Literature was identified by searching MEDLINE using indexed and free text terms. Studies were included if they were randomized controlled trials (RCTs) published in English, and SMT was administered to a group of patients with LBP of less than 3 months. RCTs included in two previous SRs were also screened, as were reference lists of included studies. Combined search results were screened for relevance by two reviewers. Data related to methods, risk of bias, harms, and results were abstracted independently by two reviewers.

RESULTS: The MEDLINE search returned 699 studies, of which six were included; an additional eight studies were identified from two previous SRs. There were 2,027 participants in the 14 included RCTs, which combined SMT with education (n=5), mobilization (MOB) (n=4), exercise (n=3), modalities (n=3), or medication (n=2). The groups that received SMT were most commonly compared with those receiving physical modalities (n=7), education (n=6), medication (n=5), exercise (n=5), MOB (n=3), or sham SMT (n=2). Most studies (n=6) administered 5 to 10 sessions of SMT over 2 to 4 weeks for acute LBP. Outcomes measured included pain (n=10), function (n=10), health-care utilization (n=6), and global effect (n=5). Studies had a follow-up of less than 1 month (n=7), 3 months (n=1), 6 months (n=3), 1 year (n=2), or 2 years (n=1). When compared with various control groups, results for improvement in pain in the SMT groups were superior in three RCTs and equivalent in three RCTs in the short term, equivalent in four RCTs in the intermediate term, and equivalent in two RCTs in the long term. For improvement in function, results from the SMT groups were superior in one RCT and equivalent in four RCTs in the short term, superior in one RCT and equivalent in one RCT in the intermediate term, and equivalent in one RCT and inferior in one RCT in the long term. No harms related to SMT were reported in these RCTs.

CONCLUSIONS: Several RCTs have been conducted to assess the efficacy of SMT for acute LBP using various methods. Results from most studies suggest that 5 to 10 sessions of SMT administered over 2 to 4 weeks achieve equivalent or superior improvement in pain and function when compared with other commonly used interventions, such as physical modalities, medication, education, or exercise, for short, intermediate, and long-term follow-up.

Reference: Dagenais, S; Gay, RE; Tricco, AC; Freeman, MD; Mayer, JM (2010). "NASS Contemporary Concepts in Spine Care: spinal manipulation therapy for acute low back pain.". The spine journal. 10 (10): 918–40.

Dr. David P. Chen
Chiropractor in Laurel, MD 20708

4 "Snow Day" Treadmill Tricks

4 "Snow Day" Treadmill Tricks

The 'mill is a fine tool for staying fit when the mercury drops. But it's important to have a plan of action when you hit the machine. Not only will it make the time pass more quickly, but you'll get a greater fitness boost than you would if you did the same type of run every time you went inside. Here are four TM workouts to do on the days you'd rather not risk black ice—or blue toes.

How to avoid packing on pounds this off-season.

The "Fast 15"

Do this workout when you're pressed for time. Jog for three minutes. Then increase the speed to a faster pace and hold it for two minutes (it's okay if you're huffing and puffing a bit by the end). Walk for 30 seconds. Repeat the sequence. Next, extend the run portion to three minutes. Walk for 30 seconds. Repeat. Cool down with a short walk.

The Pace Booster

Warm up for six minutes by alternating 30 seconds jogging with 30 seconds walking. Then increase your speed slightly and run for 30 seconds. Walk for 30 seconds. Continue this 30/30 ratio. Increase your speed slightly with each successive run segment. Do as many cycles as you comfortably can.

Treadmill workouts that keep you focused—and fit.

The Distance Run

Increase your speed until you're running comfortably. Run for two minutes, then walk for one minute. Repeat this 2:1 ratio three times. Bump up the ratio: Run for three minutes, then walk for one minute. Repeat three times. End the workout by running two 2:1 segments, followed by two 1:1 segments.

Winter got you down? How to outrun the blues during the season of plunging temps and zero motivation.

The Hill Climb

Gradually increase your speed until you're at easy-run pace. Run for three minutes. Raise the incline to 2 percent for one minute, then to 4 for one minute. Lower the incline and rest for one minute. Raise to 4 percent and run for two minutes. Alternate running two minutes at an incline/jogging one minute on the flat for as long as you can.

Run stronger, longer, and faster with the latest science.

Dr. Joshua Brooks
Chiropractic - Physiotherapy, Fairfax, Va

Chiropractic Maintenance Care for Chronic Lower Back Pain

A new single blinded placebo controlled study conducted by the faculty of medicine at Mansoura University, conclusively demonstrates that chiropractic maintenance care provides significant benefits for those with chronic low back pain.

BACKGROUND: Spinal adjustments is a common treatment option for low back pain (LBP). Numerous clinical trials have attempted to evaluate its effectiveness for different subgroups of acute and chronic LBP previously, but the efficacy of maintenance adjustments in chronic non-specific LBP has never been studied.

In this study, 60 patients with chronic, nonspecific LBP lasting at leas 6 months were randomized into 3 groups:

1. One third of them received 12 treatments of sham adjustments over a one-month.
2. One third of them received 12 treatments of adjustments during a one-month period, with no follow-up care during the next nine months.
3. One third of them received 12 Chiropractic adjustments during the first month, followed by “maintenance” adjustments every two weeks, for the next nine months.

To determine any difference among these 3 care groups, researchers measured pain and disability scores, generic health status, and back-specific patient satisfaction at baseline, and at 1-month, 4-months, 7-months, and at 10-months.

RESULTS: Patients in groups (groups 2 & 3) experienced significantly lower pain and disability scores than the sham group at the end of the first 1-month period.

At the 10-month follow-up, only the maintenance group maintained improvements in pain and disability, while the group that only received 1-months care had reverted to their pretreatment pain and disability levels.

CONCLUSIONS: This is the first medically managed trial that clearly demonstrates that maintenance chiropractic care provides significant benefits to those who suffer from chronic low back pain.

SOURCE: "Does Maintained Spinal Manipulation Therapy for Chronic Non-specific Low Back Pain Result in Better Long Term Outcome?" Spine (Phila Pa 1976). 2011 Jan 17.

Dr. David P. Chen
Chiropractor in Laurel, Maryland
Laurel Regional Chiropractic

One more reason to take breaks from sitting: a smaller waistline

Always wanted a smaller waist? Scientists have discovered that the answer could be something as simple as taking frequent small breaks from sitting.

A U.S. National Health and Nutrition Examination Survey published in the European Society of Cardiology’s European Heart Journal revealed that participants who took more small breaks from sitting had smaller waistlines than those who did not. This was true even for those who were spent up to 21.2 hours a day sedentary. For the 25% of participants who took the most breaks from sitting, the survey found that waistlines were on average 1.61 inches or 4.1 centimeters smaller than the 25% of participants who took the fewest breaks. The survey, led by University of Queensland researcher followed 4,757 people, all aged 20 and older. The survey lasted for seven days, during which participants wore an accelerometer on their right hips when they were awake. These accelerometers measured the intensity of the participants’ physical activity. Low levels of intensity were equated with sedentary periods.

Having a small waistline indicates less abdominal fat, which in turn is an indicator for better heart health. Larger waists, on the other hand, are linked to cardiovascular disease and high blood pressure as well as higher risk for type 2 diabetes. Another study published in the journal, Obesity, links increases in waistlines to increased chance of premature death.

Participants who took more frequent breaks from sitting also had lower levels of C-reactive protein (CRP). CRPs are produced by the liver. Production is correlated with the level of inflammation in the body. The study also found that taking breaks had a significant effect on lowering HDL-cholesterol, particularly in non-Hispanic whites. Conversely, those who were had higher sedentary times tended to have larger waists, higher HDL-cholesterol, CRPs, triglycerides and insulin.

The benefits of frequent breaks from sitting is linked to muscle activity in the legs and back. When sitting or reclining, these large muscles are largely inactive. However when standing, these muscles are forced to continually contract in order to maintain posture. This increased activity helps to clear plasma triglycerides, which is a risk factor for cardiovascular disease.

Still not convinced? By taking frequent breaks and doing some stretches while sitting at work will also save you from frequent neck and back pain.

Source: http://www.msnbc.msn.com/id/41028986/ns/health-diet_and_nutrition/

Dr. David P. Chen
Chiropractor in Laurel, MD 20708
Laurel Regional Chiropractic