A recent study conducted by the Center for Injury Research and Policy of The Research Institute at Nationwide Children's Hospital has found that the number of injuries from weight training has unsurprsingly increased as the activity has become more popular. Almost a million weight training-related injuries were treated in U.S. hospital emergency departments between 1990 and 2007, increasing nearly 50 percent during the 18-year study period.
About two thirds of the recorded injuries were from weights dropping onto a person.
Males (82 percent) and youths aged 13 to 24 years (47 percent) sustained the largest proportion of weight training-related injuries. Injuries to the upper (25 percent) and lower trunk (20 percent) were the most common followed by injuries to the hand (19 percent). The most frequent injury diagnoses were sprains and strains (46 percent) followed by soft tissue injuries (18 percent).
While youths (ages 13-24) had the highest number of injuries, the largest increase in the incidence of injuries occurred among those aged 45 years and older. People aged 55 and older were more likely than their younger counterparts to be injured while using weight-training machines, and to sustain injuries from overexertion and lifting or pulling. On the other hand, youths 12 years and younger were more likely to be injured while using free weights. This age group had a higher proportion of cuts and fractures, and were more likely to sustain injuries as a result of having a weight drop or fall on them than those aged 13 years and older.
"Before beginning a weight training program, it is important that people of all ages consult with a health professional, such as a doctor or athletic trainer, to create a safe training program based on their age and capabilities," said study author Dawn Comstock, PhD, principal investigator in the Center for Injury Research and Policy at Nationwide Children's Hospital. "Getting proper instruction on how to use weight lifting equipment and the proper technique for lifts, as well as providing trained supervision for youths engaging in weight training, will also reduce the risk of injury."
The study also found that while males had the highest number of injuries, there was a larger increase in the incidence of injury among female participants.
"Weight training may still be a male dominated activity," said Dr. Comstock, also a faculty member of The Ohio State University College of Medicine. "However, the increase in incidence among female participants is likely the result of more women weight training as it becomes a more accepted fitness activity for women."
While this study focused on injuries, largely to assess and prevent them, there are decided benefits to weight-lifting. It is an effective means to decrease the incidence of osteoporosis, it has been suggested to help with increasing basal metabolism (your body's ability to burn fat),
it reduces the likelihood and severity of falls in the elderly , improves walking in the elderly, and increases strength and cardivascular health. Exercise plays a key role in our mental health too, as a good way of alleviating stress.
As a chiropractor who's seen a lot of sports injuries, my goal is to assess the nature of the injury, treat it as quickly and effectively as possible, and return the patient to his or her desired activity as soon as safe and reasonable to do so.
I've had the opportunity to treat people with a wide variety of injuries from the gamut of physical activities, from free weights to kettlebells, from fencing to mixed martial arts, from ballet to tapdancing, from yoga and tai chi to competitive boomerang. Removing people's pain and getting them back to the activities they love is absolutely the most gratifying part of my job.
Monday, May 31, 2010
Thursday, May 27, 2010
The effects of spinal manipulation on shoulder pain
This is an interestig study on the immediate effects of thoracic spine and rib manipulation in patients with primary complaints of shoulder pain. 21 subjects with shoulder pain were qualified for the inclusion. Following the physical examination, all subjects received high-velocity thrust manipulative therapy to the upper thoracic spine and/or ribs. The type and number of manipulative techniques performed during the treatment session were based on the presence or absence of specific thoracic and/or rib impairments. Post-treatment effects demonstrated a 51% reduction in shoulder pain and a corresponding increase in shoulder range of motion (30 to 38 degrees). The results from this study suggest that thoracic and rib manipulative therapy is associated with improved shoulder pain and motion in patients with shoulder pain. These interventions support the concept of a regional interdependence between the thoracic spine, upper ribs, and shoulder.
Reference: Strunce JB, Walker MJ, Boyles RE, Young BA. The immediate effects of thoracic spine and rib manipulation on subjects with primary complaints of shoulder pain. J Man Manip Ther. 2009;17(4):230-6.
Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic
www.laurelregionalchiropractic.com
Reference: Strunce JB, Walker MJ, Boyles RE, Young BA. The immediate effects of thoracic spine and rib manipulation on subjects with primary complaints of shoulder pain. J Man Manip Ther. 2009;17(4):230-6.
Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic
www.laurelregionalchiropractic.com
Tuesday, May 25, 2010
A can of soda raises your blood pressure two points.
The average American drinks 2.3 sugar or high fructose corn syrup sweetened drinks per day. Recent research looked at the effects of this on blood pressure. On average, forgoing one sweetened drink was associated with a two point drop in the systolic blood pressure. No effect on blood pressure was noted from caffeine or diet drinks. It should be noted that research on diet drinks suggest that they may be associated with obesity, so switching to artificial sweeteners is not recommended. Additional news on the sugar front regards a comparison of high fructose corn syrup (HCFS) and sugar. Rats fed HFCS were significantly more obese than those fed table sugar, including developing unhealthy belly fat and having bad triglyceride profiles. This is more shocking as the amount of HFCS used was less than half that used in soda. While table sugar is still not good for you, HFCS may be much worse. As HFCS are found in an amazing variety of our food products (40% of all sweeteners used), it's important to read labels and limit the amount until its safety can be determined. Despite it's heavy usage, this is the first long-term study of the effects of high-fructose corn syrup consumption on obesity in lab animals. A similar study has not been done in humans. Further research is seriously needed.
Monday, May 24, 2010
Consumer Reports: Chiropractic is top rated treatment for back pain
-Consumer Reports has recognized that patients are much more satisfied with chiropractic care as the top practitioner when compared to their primary care physician, specialist physician, and physical therapist
April 7 -- In light of a new survey showing that chiropractic spinal manipulation is the top-rated treatment for people suffering with back pain, patients should consider a consultation with a doctor of chiropractic, says the American Chiropractic Association.
The Consumer Reports Health Rating Center released the survey results of more than 14,000 Americans on April 6.
The survey rated doctors of chiropractic as the top practitioner, with survey respondents noting that they were more likely to be "highly satisfied" with the care received from their doctor of chiropractic (59 percent) than their primary care physician (34 percent).
"For the treatment of back pain, few options are better than chiropractic," says ACA President Glenn Manceaux, DC. "As shown in this latest survey, chiropractic spinal manipulation is an evidence-based and effective treatment for low-back pain and other musculoskeletal injuries. Coupled with the high-levels of patient satisfaction, patients should turn to chiropractic as their first choice."
To compare which treatments helped most, Consumer Reports asked its subscribers to rate a comprehensive list of potential remedies along with their satisfaction with the health-care professionals they visited. Most survey respondents had tried five or six different treatments on average, and many found that their back pain interfered with their daily activities, including sleep and their sex life.
Doctors of chiropractic provide drug-free, non-invasive treatment options for many types of pain and inflammation. For example, chronic back pain, neck pain, joint pain and headaches can often be reduced with the appropriate combination of chiropractic manipulation, rehabilitative exercises and lifestyle counseling - all of which are offered by doctors of chiropractic in a patient's personalized treatment plan.
A significant amount of evidence has shown that the use of chiropractic care for certain conditions can be more effective than traditional medical care, with many patients feeling improvement shortly after their first chiropractic visit.
Dr. Paul S. Tetro
Chiropractor
Takoma Park/Silver Spring, MD
April 7 -- In light of a new survey showing that chiropractic spinal manipulation is the top-rated treatment for people suffering with back pain, patients should consider a consultation with a doctor of chiropractic, says the American Chiropractic Association.
The Consumer Reports Health Rating Center released the survey results of more than 14,000 Americans on April 6.
The survey rated doctors of chiropractic as the top practitioner, with survey respondents noting that they were more likely to be "highly satisfied" with the care received from their doctor of chiropractic (59 percent) than their primary care physician (34 percent).
"For the treatment of back pain, few options are better than chiropractic," says ACA President Glenn Manceaux, DC. "As shown in this latest survey, chiropractic spinal manipulation is an evidence-based and effective treatment for low-back pain and other musculoskeletal injuries. Coupled with the high-levels of patient satisfaction, patients should turn to chiropractic as their first choice."
To compare which treatments helped most, Consumer Reports asked its subscribers to rate a comprehensive list of potential remedies along with their satisfaction with the health-care professionals they visited. Most survey respondents had tried five or six different treatments on average, and many found that their back pain interfered with their daily activities, including sleep and their sex life.
Doctors of chiropractic provide drug-free, non-invasive treatment options for many types of pain and inflammation. For example, chronic back pain, neck pain, joint pain and headaches can often be reduced with the appropriate combination of chiropractic manipulation, rehabilitative exercises and lifestyle counseling - all of which are offered by doctors of chiropractic in a patient's personalized treatment plan.
A significant amount of evidence has shown that the use of chiropractic care for certain conditions can be more effective than traditional medical care, with many patients feeling improvement shortly after their first chiropractic visit.
Dr. Paul S. Tetro
Chiropractor
Takoma Park/Silver Spring, MD
Friday, May 21, 2010
Exercise to Reduce Pain
Aerobic Exercise Alters Analgesia and Neurotrophin-3 Synthesis in an Animal Model of Chronic Widespread Painfrom Physical Therapy current issue by Sharma, N. K., Ryals, J. M., Gajewski, B. J., Wright, D. E.
Background
Present literature and clinical practice provide strong support for the use of aerobic exercise in reducing pain and improving function for individuals with chronic musculoskeletal pain syndromes. However, the molecular basis for the positive actions of exercise remains poorly understood. Recent studies suggest that neurotrophin-3 (NT-3) may act in an analgesic fashion in various pain states.
Objective
The purpose of the present study was to examine the effects of moderate-intensity aerobic exercise on pain-like behavior and NT-3 in an animal model of widespread pain.
Design
This was a repeated-measures, observational cross-sectional study.
Methods
Forty female mice were injected with either normal (pH 7.2; n=20) or acidic (pH 4.0; n=20) saline in the gastrocnemius muscle to induce widespread hyperalgesia and exercised for 3 weeks. Cutaneous (von Frey monofilament) and muscular (forceps compression) mechanical sensitivity were assessed. Neurotrophin-3 was quantified in 2 hind-limb skeletal muscles for both messenger RNA (mRNA) and protein levels after exercise training. Data were analyzed with 2-factor analysis of variance for repeated measures (group x time).
Results
Moderate-intensity aerobic exercise reduced cutaneous and deep tissue hyperalgesia induced by acidic saline and stimulated NT-3 synthesis in skeletal muscle. The increase in NT-3 was more pronounced at the protein level compared with mRNA expression. In addition, the increase in NT-3 protein was significant in the gastrocnemius muscle but not in the soleus muscle, suggesting that exercise can preferentially target NT-3 synthesis in specific muscle types.
Limitations
Results are limited to animal models and cannot be generalized to chronic pain syndromes in humans.
Conclusions
This is the first study demonstrating the effect of exercise on deep tissue mechanical hyperalgesia in a rodent model of pain and providing a possible molecular basis for exercise training in reducing muscular pain.
Dr. Joshua Brooks
Chiropractor Fairfax VA 22031
Chiropractor Alexandria VA 22304
Background
Present literature and clinical practice provide strong support for the use of aerobic exercise in reducing pain and improving function for individuals with chronic musculoskeletal pain syndromes. However, the molecular basis for the positive actions of exercise remains poorly understood. Recent studies suggest that neurotrophin-3 (NT-3) may act in an analgesic fashion in various pain states.
Objective
The purpose of the present study was to examine the effects of moderate-intensity aerobic exercise on pain-like behavior and NT-3 in an animal model of widespread pain.
Design
This was a repeated-measures, observational cross-sectional study.
Methods
Forty female mice were injected with either normal (pH 7.2; n=20) or acidic (pH 4.0; n=20) saline in the gastrocnemius muscle to induce widespread hyperalgesia and exercised for 3 weeks. Cutaneous (von Frey monofilament) and muscular (forceps compression) mechanical sensitivity were assessed. Neurotrophin-3 was quantified in 2 hind-limb skeletal muscles for both messenger RNA (mRNA) and protein levels after exercise training. Data were analyzed with 2-factor analysis of variance for repeated measures (group x time).
Results
Moderate-intensity aerobic exercise reduced cutaneous and deep tissue hyperalgesia induced by acidic saline and stimulated NT-3 synthesis in skeletal muscle. The increase in NT-3 was more pronounced at the protein level compared with mRNA expression. In addition, the increase in NT-3 protein was significant in the gastrocnemius muscle but not in the soleus muscle, suggesting that exercise can preferentially target NT-3 synthesis in specific muscle types.
Limitations
Results are limited to animal models and cannot be generalized to chronic pain syndromes in humans.
Conclusions
This is the first study demonstrating the effect of exercise on deep tissue mechanical hyperalgesia in a rodent model of pain and providing a possible molecular basis for exercise training in reducing muscular pain.
Dr. Joshua Brooks
Chiropractor Fairfax VA 22031
Chiropractor Alexandria VA 22304
Iatrogenic Disability and Narcotics Addiction After Lumbar Fusion in a Worker's Compensation Claimant
-This tragic case study is a prime example of some of the dangers that accompany back surgery and routine follow up with narcotic medication. Chiropractic is a drug less, non-surgical healing art that has been shown over decades to help those injured at work and those involved in motor vehicle collisions. All of the worker's compensation and whiplash patients that are seen in my chiropractic clinic in Takoma Park/Silver Spring, MD are closely monitored by top medical doctors if they are taking any form of medication.
-PT
Spine: 20 May 2010 - Volume 35 - Issue 12 - pp E549-E552
Parks, Philip D. MD, MPH, MOccH; Pransky, Glenn S. MD, MOccH; Kales, Stefanos N. MD, MPH
Objective. Describe a case of chronic occupational low back pain with various treatments of questionable efficacy, leading to prolonged disability, iatrogenic narcotic addiction, and opioid-induced hyperalgesia.
Summary of Background Data. Concerns about narcotics and other questionable treatments for chronic low back pain are increasing, especially in those with work-related conditions.
Methods. Medical record review.
Results. The patient had significant, persistent low back symptoms, but good function at work and home. He underwent lumbar fusion to address persistent pain, and subsequently developed failed back surgery syndrome. He was prescribed increasing amounts of opioid analgesics and was recommended for an intrathecal morphine pump, without evaluation of the safety or efficacy of his current regimen. Subsequently, he was hospitalized for opioid detoxification and substance abuse treatment.
Conclusion. Patients with chronic low back pain are at risk for receiving ineffective and potentially harmful treatment. A focus on restoring function instead of complete pain relief may lead to better outcomes in these patients.
Dr. Paul S. Tetro
Chiropractor
Takoma Park/Silver Spring, MD
-PT
Spine: 20 May 2010 - Volume 35 - Issue 12 - pp E549-E552
Parks, Philip D. MD, MPH, MOccH; Pransky, Glenn S. MD, MOccH; Kales, Stefanos N. MD, MPH
Objective. Describe a case of chronic occupational low back pain with various treatments of questionable efficacy, leading to prolonged disability, iatrogenic narcotic addiction, and opioid-induced hyperalgesia.
Summary of Background Data. Concerns about narcotics and other questionable treatments for chronic low back pain are increasing, especially in those with work-related conditions.
Methods. Medical record review.
Results. The patient had significant, persistent low back symptoms, but good function at work and home. He underwent lumbar fusion to address persistent pain, and subsequently developed failed back surgery syndrome. He was prescribed increasing amounts of opioid analgesics and was recommended for an intrathecal morphine pump, without evaluation of the safety or efficacy of his current regimen. Subsequently, he was hospitalized for opioid detoxification and substance abuse treatment.
Conclusion. Patients with chronic low back pain are at risk for receiving ineffective and potentially harmful treatment. A focus on restoring function instead of complete pain relief may lead to better outcomes in these patients.
Dr. Paul S. Tetro
Chiropractor
Takoma Park/Silver Spring, MD
Changes in Head and Neck Posture Using an Office Chair With and Without Lumbar Roll Support
-This is a nice study that illustrates once again how interconnected different areas of the spine are. Following a whiplash injury, many patients must return to their offices and immediately begin a full schedule. The authors' conclusions support the notion that by supporting the lumbar spine, favorable changes can be made in the cervical spine. In my chiropractic clinic in Greenbelt, MD we stress the spine, and ultimately the body as a whole.
-LC
Spine: 20 May 2010 - Volume 35 - Issue 12 - pp E542-E548
Horton, Stuart J. MPhty, DipMDT; Johnson, Gillian M. PhD; Skinner, Margot A. PhD
Objective. To investigate change in sagittal alignment of head and neck posture in response to adjustments of an office chair with and without a lumbar roll in situ.
Summary of Background Data. Forward head posture has been identified as a risk factor for neck pain, and there is evidence to show that ergonomic correction in sitting may reduce the incidence of pain. The effect placement of a lumbar roll has on cervical spine posture has not been previously investigated experimentally but rather, is assumed to have a positive influence on head and neck posture.
Methods. Thirty healthy male participants (18-30 years) were photographed while registered in the natural head resting position in each of 4 sitting positions with and without a lumbar roll in situ. Two positions incorporated adjustments to the back rest and 1 to the seat pan of the office chair. The craniovertebral (CV) angle, as a determinant of head and neck posture was measured from the set of digitized photographs obtained for each participant. Comparisons between the CV angle in all postural registrations were made using a mixed model analysis adjusted for multiple comparisons.
Results. Of the positions examined, significant differences in the mean CV angles were found with the backrest of the chair at 100° and at 110° (P < id="SPELLING_ERROR_6" class="blsp-spelling-error">situ and the backrest position at 110°, there was a significant increase in the mean CV compared with the angle without the lumbar roll in situ (2.32°, 95% confidence interval:
1.31-3.33; P < 0.001).
Conclusion. The degree of angulation of the backrest support of an office chair plus the addition of lumbar roll support are the 2 most important factors to be taken into account when considering seating factors likely to favorably change head and neck postural alignment, at least in asymptomatic subjects.
Dr. Louis S. Crivelli II
Chiropractor
Greenbelt, MD
-LC
Spine: 20 May 2010 - Volume 35 - Issue 12 - pp E542-E548
Horton, Stuart J. MPhty, DipMDT; Johnson, Gillian M. PhD; Skinner, Margot A. PhD
Objective. To investigate change in sagittal alignment of head and neck posture in response to adjustments of an office chair with and without a lumbar roll in situ.
Summary of Background Data. Forward head posture has been identified as a risk factor for neck pain, and there is evidence to show that ergonomic correction in sitting may reduce the incidence of pain. The effect placement of a lumbar roll has on cervical spine posture has not been previously investigated experimentally but rather, is assumed to have a positive influence on head and neck posture.
Methods. Thirty healthy male participants (18-30 years) were photographed while registered in the natural head resting position in each of 4 sitting positions with and without a lumbar roll in situ. Two positions incorporated adjustments to the back rest and 1 to the seat pan of the office chair. The craniovertebral (CV) angle, as a determinant of head and neck posture was measured from the set of digitized photographs obtained for each participant. Comparisons between the CV angle in all postural registrations were made using a mixed model analysis adjusted for multiple comparisons.
Results. Of the positions examined, significant differences in the mean CV angles were found with the backrest of the chair at 100° and at 110° (P < id="SPELLING_ERROR_6" class="blsp-spelling-error">situ and the backrest position at 110°, there was a significant increase in the mean CV compared with the angle without the lumbar roll in situ (2.32°, 95% confidence interval:
1.31-3.33; P < 0.001).
Conclusion. The degree of angulation of the backrest support of an office chair plus the addition of lumbar roll support are the 2 most important factors to be taken into account when considering seating factors likely to favorably change head and neck postural alignment, at least in asymptomatic subjects.
Dr. Louis S. Crivelli II
Chiropractor
Greenbelt, MD
The Effects of Precompetition Massage on the Kinematic Parameters of 20-m Sprint Performance
The Effects of Precompetition Massage on the Kinematic Parameters of 20-m Sprint Performance
The effects of precompetition massage on the kinematic parameters of 20-m sprint performance. J Strength Cond Res 24(5): 1179-1183, 2010-The purpose of this study was to investigate what effect precompetition massage has on short-term sprint performance. Twenty male collegiate games players, with a minimum training/playing background of 3 sessions per week, were assigned to a randomized, counter-balanced, repeated-measures designed experiment used to analyze 20-m sprints performance. Three discrete warm-up modalities, consisting of precompetition massage, a traditional warm-up, and a precompetition massage combined with a traditional warm-up were used. Massage consisted of fast, superficial techniques designed to stimulate the main muscle groups associated with sprint running. Twenty-meter sprint performance and core temperature were assessed post warm-up interventions. Kinematic differences between sprints were assessed through a 2-dimensional computerized motion analysis system (alpha level p <= 0.05). Results indicated that sprint times in the warm-up and massage combined with warm-up conditions were significantly faster than massage alone. Also, step rate and mean knee velocity were found to be significantly greater in the warm-up and massage combined with warm-up modalities when compared to massage alone. No significant differences were demonstrated in any measures when the warm-up and massage and warm-up combined conditions were compared. Massage as a preperformance preparation strategy seems to decrease 20-m sprint performance when compared to a traditional warm-up, although its combination with a normal active warm-up seems to have no greater benefit then active warm-up alone. Therefore, massage use prior to competition is questionable because it appears to have no effective role in improving sprint performance. (C) 2010 National Strength and Conditioning Association
Alexandria, VA 22304
703-750-1177
HYPERCHOLESTEROLEMIA, HYPERTRIGLYCERIDEMIA - Nuts, Total Cholesterol, LDL Cholesterol, HDL Cholesterol, Triglycerides
| Nut Consumption May Improve Blood Lipid Profiles | |
| Keywords: | HYPERCHOLESTEROLEMIA, HYPERTRIGLYCERIDEMIA - Nuts, Total Cholesterol, LDL Cholesterol, HDL Cholesterol, Triglycerides |
| Reference: | "Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials," Sabate J, Ros E, et al, Arch Intern Med, 2010; 170(9): 821-7. (Address: Department of Nutrition, Loma Linda University, Nichol Hall Room 1102, Loma Linda, CA 92350, USA. E-mail: jsabate@llu.edu ). |
| Summary: | In a pooled analysis of 25 nut consumption studies involving 583 men and women with normolipidemia and hypercholesterolemia who were not taking lipid-lowering medications, results indicate that nut consumption may improve lipid profiles in a dose-dependent manner. A mean daily consumption of 67 g of nuts was associated with a 5.1% mean reduction in total cholesterol concentration, a 7.4% mean reduction in low-density lipoprotein cholesterol concentration (LDL-C), and a 5.6% mean reduction in ratio of LDL-C to high-density lipoprotein cholesterol concentration (HDL-C). Additionally, subjects with blood triglyceride levels of at least 150 mg/dL showed a 10.2% mean decrease in blood triglyceride levels. Lastly, the lipid-lowering effects of nut consumption was found to be strongest in subjects with high baseline LDL-C and subjects with low BMI (body mass index). Thus, the authors of this study conclude, "Nut consumption improves blood lipid levels in a dose-related mann er, particularly among subjects with higher LDL-C or with lower BMI." |
4269 Branch ave
Temple Hills, MD 20748
301 316-2111
Thursday, May 20, 2010
Recent reseach suggests drugs provide limited benefit against diabetes and heart disease
Below are links to four recent articles suggesting that the pathway to a lower risk of diabetes and heart disease does not lie in medications. Changes in lifestyle are proving to be a more effective strategy. The best part is, even for those that are diagnosed as being at risk for diabetes or heart disease, it is never too late to benefit from a more active lifestyle.
Dr. Brian Lancaster
Chiropractor, Frederick, MD
Exercise at work to prevent low back pain
More jobs now require prolonged sitting which has been associated with loss of the lumbar lordosis, intervertebral disc (IVD) compression, and height loss, possibly increasing the risk of lower back pain. There are numerous studies suggest that exercise can play an important role in preventing occupational and non-occupational low back pain. An innovative approach was published in the April issue of The Spine Journal that used an office chair exercise that is performed while seated. The exercise provides a brief decompression of the lumbar spine by moving forward on the chair seat, placing the hands on the seat of the chair, pressing downward with the arms to take pressure off the lumbar spine, and arching the back and shoulders backward at the same time. This decompression maneuver held for 5 seconds followed by 3 seconds of reloading (sitting normally) and was repeated 4 times. Sequential MRI demonstrated a marked increase in vertical height of the lumbar spine using this decompression strategy. The authors concluded that “Seated upright MRI and stadiometry, as performed in this study, appear to be feasible methods for detecting compressive and decompressive spinal changes associated with normal sitting and, alternately, seated unloading exercises. Larger studies are encouraged to determine normative values of our study measurements and to determine if morphological changes induced by seated unloading predict treatment response and/or reductions in the incidence of sitting-related LBP.”
There are numerous quality evidence that post-treatment exercise programs can prevent recurrences of back pain. There have been many studies published this past decade that support the value of exercise in primary, secondary as well as tertiary prevention of low back pain. These studies have been conducted with multiple age groups and multiple settings including sports venues and the workplace.
Source:
http://www.chiroaccess.com/Articles/Exercise-and-the-Prevention-of-Low-Back-Pain.aspx?id=0000162
Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic
There are numerous quality evidence that post-treatment exercise programs can prevent recurrences of back pain. There have been many studies published this past decade that support the value of exercise in primary, secondary as well as tertiary prevention of low back pain. These studies have been conducted with multiple age groups and multiple settings including sports venues and the workplace.
Source:
http://www.chiroaccess.com/Articles/Exercise-and-the-Prevention-of-Low-Back-Pain.aspx?id=0000162
Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic
TRIGGER POINTS
TRIGGER POINTS
These muscle knots are “exquisitely tender points” that produce pain, either in the direct muscle area, or sometimes referred to another spot. As well as being extremely interesting when pressed, they are a very common phenomenon among athletes.
Should anyone worry about them? Well, yes, because exquisite pain is not their only characteristic. An active trigger point can also cause:
- loss of range of movement of soft tissue
- a change in muscle function, including weakness, loss of co-ordination and
decreased work tolerance
- subsequent changes in joint mechanics and overall movement patterns
- neural tension signs (reduced mobility of the nervous system)
And it’s worth noting that not all trigger points manifest pain – those that don’t are known as “latent” trigger points – but they nevertheless cause the same range of problems.
It is best to see a chiropractor trained in trigger point therapy for problems related to these nasty spots. All the doctors of ABC CLINICS are specifically trained to seek and destroy these points of pain.
Dr. John Rosa
Rosa Chiropractic and Physical Therapy Center
Rockville/Gaithersburg, MD
These muscle knots are “exquisitely tender points” that produce pain, either in the direct muscle area, or sometimes referred to another spot. As well as being extremely interesting when pressed, they are a very common phenomenon among athletes.
Should anyone worry about them? Well, yes, because exquisite pain is not their only characteristic. An active trigger point can also cause:
- loss of range of movement of soft tissue
- a change in muscle function, including weakness, loss of co-ordination and
decreased work tolerance
- subsequent changes in joint mechanics and overall movement patterns
- neural tension signs (reduced mobility of the nervous system)
And it’s worth noting that not all trigger points manifest pain – those that don’t are known as “latent” trigger points – but they nevertheless cause the same range of problems.
It is best to see a chiropractor trained in trigger point therapy for problems related to these nasty spots. All the doctors of ABC CLINICS are specifically trained to seek and destroy these points of pain.
Dr. John Rosa
Rosa Chiropractic and Physical Therapy Center
Rockville/Gaithersburg, MD
Monday, May 17, 2010
Headaches are effectively treated by addressing neck issues.
It is very common when talking to patients for them to separate out neck pain and headaches as two unrelated problems. Before I became a chiropractor, my thinking was that a headache represented some imbalance in the brain. Since the brain has no pain receptors itself, we understood that something outside the brain is the most likely cause. Common causes are muscle spasm or joint problems. When I first started ten years ago, my patients and myself were often both surprised when I treated their necks and their headaches vanished. A recent study found that spinal surgery was effective in relieving headaches in a great number of patients. While surgery has improved, it is unfortunately not the least risky approach to dealing with headaches. A 2007 study on these procedures noted a 1 out of a 1000 risk of death. An earlier meta-analysis identified spinal manipulation as an effective intervention for headaches, comparable in some studies to the relief from pain medication. The risk of death from chiropractic based on most up to date research is considered to be less than 1 in 5 million, this risk is much less than the risk from pain medication.
I would like to point our that I do not talk about the risks to dissuade people from seeking conventional help for headaches, as I firmly believe that all options should be available. I think it's wonderful that the people in the surgical study lost their headaches. In the interest of "first do no harm", chiropractic is a safe option that is often not tried. My colleagues and myself find nothing is quite so fun as taking someone's headache away.
I would like to point our that I do not talk about the risks to dissuade people from seeking conventional help for headaches, as I firmly believe that all options should be available. I think it's wonderful that the people in the surgical study lost their headaches. In the interest of "first do no harm", chiropractic is a safe option that is often not tried. My colleagues and myself find nothing is quite so fun as taking someone's headache away.
Friday, May 14, 2010
Chronic Whiplash Pain Caused by Spinal Facet Injury
In an article published in late 2007 in the Journal of the American Academy of Orthopedic Surgeons revealed that a significant number of people suffering acute neck pain following a motor vehicle collision develop chronic pain that last for years. The most common source of the chronic pain is damage to the spinal facet joints, followed by disc pain. The authors reviewed the medical literature and published data concerning chronic whiplash pain. The review reveals that 15% to 40% of patients with acute neck pain following a motor vehicle collision develop chronic pain, and that 5% to 7% become permanently partially or totally disabled. The most common source of chronic whiplash neck pain: the facet joint (49% to 54%).
In the treatment of chronic neck pain, exercise is recommended as helpful to strengthening the weak muscle groups but exercise alone is rarely curative. Many studies have shown that spinal manipulation is one of the most effective treatments for whiplash injury. Early manipulation to the cervical spine will restore motion, decrease pain, and increase the speed of recovery. The early manipulation will also decrease the buildup of scar tissue and future chronic pain syndromes.
As you may know, Tiger Woods announced on his blog on Wednesday that an MRI determined he has inflammation in the facet joint of his neck which causes pain in the area along with headaches and difficulty rotating the head. Even though he denied that his neck injury is related to the Nov. 27 car accident, but it is possible that Tiger may not have been aware of the damage immediately. As the damage sometimes doesn't manifest itself until a physical activity that puts strain on the neck - things like lifting boxes or hitting golf balls in Tiger’s case.
Reference: Schofferman J, Bogduk N, and Slosar P. Chronic whiplash and whiplash-associated disorders: An evidence-based approach. J Am Acad Orthop Surg. 2007 Oct;15(10):596-606.
Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic
www.laurelregionalchiropractic.com
In the treatment of chronic neck pain, exercise is recommended as helpful to strengthening the weak muscle groups but exercise alone is rarely curative. Many studies have shown that spinal manipulation is one of the most effective treatments for whiplash injury. Early manipulation to the cervical spine will restore motion, decrease pain, and increase the speed of recovery. The early manipulation will also decrease the buildup of scar tissue and future chronic pain syndromes.
As you may know, Tiger Woods announced on his blog on Wednesday that an MRI determined he has inflammation in the facet joint of his neck which causes pain in the area along with headaches and difficulty rotating the head. Even though he denied that his neck injury is related to the Nov. 27 car accident, but it is possible that Tiger may not have been aware of the damage immediately. As the damage sometimes doesn't manifest itself until a physical activity that puts strain on the neck - things like lifting boxes or hitting golf balls in Tiger’s case.
Reference: Schofferman J, Bogduk N, and Slosar P. Chronic whiplash and whiplash-associated disorders: An evidence-based approach. J Am Acad Orthop Surg. 2007 Oct;15(10):596-606.
Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic
www.laurelregionalchiropractic.com
Knee Osteoarthritis
Moving to Maintain Function in Knee Osteoarthritis:
Evidence From the Osteoarthritis Initiative from Archives of Physical Medicine and Rehabilitation by Dorothy D. Dunlop, Pamela Semanik, Jing Song, Leena Sharma, Michael Nevitt, Rebecca Jackson, Jerry Mysiw, Rowland W. Chang, Osteoarthritis Initiative Investigators
Abstract: Dunlop DD, Semanik P, Song J, Sharma L, Nevitt M, Mysiw J, Chang RW, for the Osteoarthritis Initiative Investigators. Moving to maintain function in knee osteoarthritis: evidence from the Osteoarthritis Initiative.
Objectives: To investigate the association between baseline physical activity and 1-year functional performance in adults with knee osteoarthritis (OA).Design: Prospective cohort study of knee OA development and progression with 1-year follow-up.
Setting: Community.Participants: Osteoarthritis Initiative public data on adults with knee OA (n=2274; age, 45–79y) who participated in functional performance assessments (timed 20-m walk and chair stand test) at baseline and 1-year follow-up.Interventions: Not applicable.Main Outcome Measure: A good 1-year performance outcome (separately defined for walk time and chair stand measures) was improvement from baseline quintile or maintenance in the best quintile.
Results: Almost 2 in 5 persons with radiographic knee OA improved or maintained high performance at 1 year. Physical activity measured by the Physical Activity Scale for the Elderly (PASE) was significantly associated with good walk rate and chair stand outcomes (odds ratio per 40 units PASE [95% confidence interval]=1.13 [1.13, 1.17] and 1.10 [1.05, 1.15], respectively), as were participation in sports/recreational activities (1.45 [1.23, 1.71] and 1.29 [1.09, 1.51], respectively) and lifestyle activities (1.11 [1.06, 1.16] and 1.09 [1.04, 1.14], respectively). An independent protective relationship for these physical activity measures approached significance after adjusting for sociodemographic and health factors. Older adults reported the least baseline physical activity and least frequent good 1-year outcomes.
Conclusions: These findings support public health recommendations to be physically active in order to preserve function for persons with knee OA. Physical activity messages should specifically target older adults whose low activity levels may jeopardize their ability to maintain functional performance.
Chiropractor Fairfax VA 22031
Evidence From the Osteoarthritis Initiative from Archives of Physical Medicine and Rehabilitation by Dorothy D. Dunlop, Pamela Semanik, Jing Song, Leena Sharma, Michael Nevitt, Rebecca Jackson, Jerry Mysiw, Rowland W. Chang, Osteoarthritis Initiative Investigators
Abstract: Dunlop DD, Semanik P, Song J, Sharma L, Nevitt M, Mysiw J, Chang RW, for the Osteoarthritis Initiative Investigators. Moving to maintain function in knee osteoarthritis: evidence from the Osteoarthritis Initiative.
Objectives: To investigate the association between baseline physical activity and 1-year functional performance in adults with knee osteoarthritis (OA).Design: Prospective cohort study of knee OA development and progression with 1-year follow-up.
Setting: Community.Participants: Osteoarthritis Initiative public data on adults with knee OA (n=2274; age, 45–79y) who participated in functional performance assessments (timed 20-m walk and chair stand test) at baseline and 1-year follow-up.Interventions: Not applicable.Main Outcome Measure: A good 1-year performance outcome (separately defined for walk time and chair stand measures) was improvement from baseline quintile or maintenance in the best quintile.
Results: Almost 2 in 5 persons with radiographic knee OA improved or maintained high performance at 1 year. Physical activity measured by the Physical Activity Scale for the Elderly (PASE) was significantly associated with good walk rate and chair stand outcomes (odds ratio per 40 units PASE [95% confidence interval]=1.13 [1.13, 1.17] and 1.10 [1.05, 1.15], respectively), as were participation in sports/recreational activities (1.45 [1.23, 1.71] and 1.29 [1.09, 1.51], respectively) and lifestyle activities (1.11 [1.06, 1.16] and 1.09 [1.04, 1.14], respectively). An independent protective relationship for these physical activity measures approached significance after adjusting for sociodemographic and health factors. Older adults reported the least baseline physical activity and least frequent good 1-year outcomes.
Conclusions: These findings support public health recommendations to be physically active in order to preserve function for persons with knee OA. Physical activity messages should specifically target older adults whose low activity levels may jeopardize their ability to maintain functional performance.
Chiropractor Fairfax VA 22031
Friday, May 7, 2010
Here is another article to read when considering the current health care debate:
Health, life insurers hold $1.88 billion in fast-food stocks: AJPH article
Harvard researchers say insurers put profits over health
EMBARGOED until:
April 15, 2010, 5 p.m. Eastern time
Contact:
Arun Mohan, M.D., M.B.A.
J. Wesley Boyd, M.D., Ph.D.
Steffie Woolhandler, M.D., M.P.H.
Mark Almberg, PNHP, (312) 782-6006, mark@pnhp.org
Just weeks after the passage of a health bill that will dramatically increase the number of Americans covered by private health insurers, Harvard researchers have detailed the extent to which life and health insurance companies are major investors in the fast-food industry.
Although fast food can be consumed responsibly, research has shown that fast-food consumption is linked to obesity and cardiovascular disease, two leading causes of death, and contributes to the poor health of children. The evidence is so compelling that as part of the new law more than 200,000 fast-food and other chain restaurants will be required to include calorie counts on their menus, including their drive-through menus.
A new article on insurance company holdings, published online in today's [Thursday, April 15] American Journal of Public Health, shows that U.S., Canadian and European-based insurance firms hold at least $1.88 billion of investments in fast-food companies.
"These data raise questions about the opening of vast new markets for private insurers at public expense, as is poised to happen throughout the United States as a result of the recent health care overhaul," says lead author Dr. Arun Mohan.
Among the largest owners of fast-food stock are U.S.-based Prudential Financial, Northwestern Mutual and Massachusetts Mutual Life Insurance Company, and European-based ING.
U.S.-based Northwestern Mutual and Massachusetts Mutual Life Insurance Company both offer life insurance as well as disability and long-term care insurance. Northwestern Mutual owns $422.2 million of fast-food stock, with $318.1 million of McDonald's. Mass Mutual owns $366.5 million of fast-food stock, including $267.2 in McDonald's.
Holland-based ING, an investment firm that also offers life and disability insurance, has total fast-food holdings of $406.1 million, including $12.3 million in Jack in the Box, $311 million in McDonald's, and $82.1 million in Yum! Brands (owner of Pizza Hut, KFC and Taco Bell) stock.
New Jersey-based Prudential Financial Inc. sells life insurance and long-term disability coverage. With total fast-food holdings of $355.5 million, Prudential Financial owns $197.2 of stock in McDonald's and also has significant stakes in Burger King, Jack-in-the-Box, and Yum! Brands.
The researchers also itemize the fast-food holdings of London-based Prudential Plc, U.K.-based Standard Life, U.S.-based New York Life, Scotland-based Guardian Life, Canada-based Manulife and Canada-based Sun Life. (See table; all data current as of June 11, 2009.)
"Our data illustrate the extent to which the insurance industry seeks to turn a profit above all else," says Dr. Wesley Boyd, senior author of the study. "Safeguarding people's health and well-being take a back seat to making money."
Mohan, Boyd and their co-authors, Drs. Danny McCormick, Steffie Woolhandler and David Himmelstein, all at the Cambridge Health Alliance and Harvard Medical School, culled their data from Icarus, a proprietary database of industrial, banking and insurance companies. Icarus draws upon Securities and Exchange Commission filings and news reports from providers like Dow Jones and Reuters. In addition, the authors obtained market capitalization data from Yahoo! Finance.
The authors write, "The health bill just enacted in the Washington will likely expand the reach of the insurance industry. Canada and Britain are also considering further privatization of health insurance. Our article highlights the tension between profit maximization and the public good these countries face in expanding the role of private health insurers. If insurers are to play a greater part in the health care delivery system they ought to be held to a higher standard of corporate responsibility."
Several of these same researchers, all of whom are affiliated with Physicians for a National Health Program, have previously published data about the extent to which the insurance industry is invested in tobacco. They say that because private, for-profit insurers have repeatedly put their own financial gain over the public's health, readers in the United States, Canada and Europe should be wary about insurance firms' participation in care.
Insurance industry holdings in fast-food companies (in millions of U.S. dollars) as of June 11, 2009.
| Insurance Company | Jack in the Box | McDonald's | Burger King | Yum! Brands | Wendy's/ Arby's Group | Total |
| Prudential plc | 80.5 | 80.5 | ||||
| Prudential Financial | 34.1 | 197.2 | 43.7 | 80.5 | 355.5 | |
| Mass Mutual | 23.1 | 267.2 | 58.8 | 17.4 | 366.5 | |
| New York Life | 2.4 | 2.4 | ||||
| Northwestern Mutual | 40.9 | 318.1 | 63.2 | 422.2 | ||
| Sun Life | 26.8 | 26.8 | ||||
| Standard Life | 63.0 | 63.0 | ||||
| ING | 12.3 | 311.7 | 82.1 | 406.1 | ||
| Manulife | 89.1 | 53.7 | 3.3 | 146.1 | ||
| Guardian Life | 7.2 | 9.5 | 16.7 | |||
| MetLife | 2.2 | 2.2 | ||||
| Total | 120.0 | 1,183.3 | 165.5 | 404.2 | 15.0 | 1,888.0 |
"Life and Health Insurance Industry Investments in Fast Food," Arun V. Mohan, M.D., M.B.A.; Steffie Woolhandler, M.D., M.P.H.; David U. Himmelstein, M.D.; and J. Wesley Boyd, M.D., Ph.D. American Journal of Public Health, April 15, 2010.
Dr Brian Lancaster
Valley Chiropractic in Frederick, MD
Rehab Study for Low Back Pain
Rehabilitation of a Patient with Functional Instability Associated with Failed Back Surgery,
The Journal of the American Chiropractic Association, Dec 2004 by Adams, Vincent
123456Next ..Abstract
Objective: A report of a case of a low-tech non-dynamometric functional exercise program in the rehabilitation of a functionally unstable lower back, associated with failed back surgery.
Clinical Features: A 41-year-old female presented to a chiropractic office with severe lower-back pain, with radiation down the left leg to the calf. Seven months prior, she had an L5-S1 discectomy. Two months after the surgery, her pain in the lower back and leg returned. An MRI 6 months after the surgery showed no evidence of a recurrent disc herniation, but revealed a small image enhancement along the, posterior annulus adjacent to the right S1 nerve root, consistent with post-operative change. Plain film radiography was unremarkable.
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Intervention and Outcome: The home-based therapeutic techniques used in this case were based on the patient's weaknesses demonstrated on a functional evaluation. This evaluation consisted of 4 functional tests, including the repetitive squat, Sorenson static back endurance, repetitive sit-up, and the repetitive arch-up tests. The exercises were performed over a 6-week period, and resulted in a decrease in both pain and functional disability based on visual analog scale, pain diagrams, and the Oswestry low-back pain questionnaire.
Conclusion: A home-based exercise program proved very effective in decreasing this patient's functional disability level, but was ineffective in reducing pain levels. Further investigation of chiropractic management of such cases is warranted.
Key Words or Phrases: functional instability, rehabilitation, failed back surgery
Dr. Joshua Brooks
Chiropractor Fairfax, VA
The Journal of the American Chiropractic Association, Dec 2004 by Adams, Vincent
123456Next ..Abstract
Objective: A report of a case of a low-tech non-dynamometric functional exercise program in the rehabilitation of a functionally unstable lower back, associated with failed back surgery.
Clinical Features: A 41-year-old female presented to a chiropractic office with severe lower-back pain, with radiation down the left leg to the calf. Seven months prior, she had an L5-S1 discectomy. Two months after the surgery, her pain in the lower back and leg returned. An MRI 6 months after the surgery showed no evidence of a recurrent disc herniation, but revealed a small image enhancement along the, posterior annulus adjacent to the right S1 nerve root, consistent with post-operative change. Plain film radiography was unremarkable.
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Intervention and Outcome: The home-based therapeutic techniques used in this case were based on the patient's weaknesses demonstrated on a functional evaluation. This evaluation consisted of 4 functional tests, including the repetitive squat, Sorenson static back endurance, repetitive sit-up, and the repetitive arch-up tests. The exercises were performed over a 6-week period, and resulted in a decrease in both pain and functional disability based on visual analog scale, pain diagrams, and the Oswestry low-back pain questionnaire.
Conclusion: A home-based exercise program proved very effective in decreasing this patient's functional disability level, but was ineffective in reducing pain levels. Further investigation of chiropractic management of such cases is warranted.
Key Words or Phrases: functional instability, rehabilitation, failed back surgery
Dr. Joshua Brooks
Chiropractor Fairfax, VA
Chiropractic management of fibromyalgia syndrome: a systematic review of the literature.
This study concludes that chiropractic can be an effective treatment for fibromyalgia. In my chiropractic office in Takoma Park/Silver Spring, MD I see a fair amount of patients with fibromyalgia developing as the result of whiplash associated disorders.
-Dr. Tetro
Schneider M, Vernon H, Ko G, Lawson G, Perera J.
OBJECTIVE: Fibromyalgia syndrome (FMS) is one of the most commonly diagnosed nonarticular soft tissue conditions in all fields of musculoskeletal medicine, including chiropractic. The purpose of this study was to perform a comprehensive review of the literature for the most commonly used treatment procedures in chiropractic for FMS and to provide evidence ratings for these procedures. The emphasis of this literature review was on conservative and nonpharmaceutical therapies.
METHODS: The Scientific Commission of the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) was charged with developing literature syntheses, organized by anatomical region, to evaluate and report on the evidence base for chiropractic care. This article is the outcome of this charge. As part of the CCGPP process, preliminary drafts of these articles were posted on the CCGPP Web site www.ccgpp.org (2006-8) to allow for an open process and the broadest possible mechanism for stakeholder input. Online comprehensive literature searches were performed of the following databases: Cochrane Database of Systematic Reviews; National Guidelines Clearinghouse; Cochrane Central Register of Controlled Trials; Manual, Alternative, and Natural Therapy Index System; Index to Chiropractic Literature, Cumulative Index to Nursing and Allied Health Literature; Allied and Complementary Medicine; and PubMed up to June 2006.
RESULTS: Our search yielded the following results: 8 systematic reviews, 3 meta-analyses, 5 published guidelines, and 1 consensus document. Our direct search of the databases for additional randomized trials did not find any chiropractic randomized clinical trials that were not already included in one or more of the systematic reviews/guidelines. The review of the Manual, Alternative, and Natural Therapy Index System and Index to Chiropractic Literature databases yielded an additional 38 articles regarding various nonpharmacologic therapies such as chiropractic, acupuncture, nutritional/herbal supplements, massage, etc. Review of these articles resulted in the following recommendations regarding nonpharmaceutical treatments of FMS. Strong evidence supports aerobic exercise and cognitive behavioral therapy. Moderate evidence supports massage, muscle strength training, acupuncture, and spa therapy (balneotherapy). Limited evidence supports spinal manipulation, movement/body awareness, vitamins, herbs, and dietary modification.
CONCLUSIONS: Several nonpharmacologic treatments and manual-type therapies have acceptable evidentiary support in the treatment of FMS.
Dr. Paul S. Tetro
Chiropractor
Takoma Park/Silver Spring, MD
-Dr. Tetro
Schneider M, Vernon H, Ko G, Lawson G, Perera J.
OBJECTIVE: Fibromyalgia syndrome (FMS) is one of the most commonly diagnosed nonarticular soft tissue conditions in all fields of musculoskeletal medicine, including chiropractic. The purpose of this study was to perform a comprehensive review of the literature for the most commonly used treatment procedures in chiropractic for FMS and to provide evidence ratings for these procedures. The emphasis of this literature review was on conservative and nonpharmaceutical therapies.
METHODS: The Scientific Commission of the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) was charged with developing literature syntheses, organized by anatomical region, to evaluate and report on the evidence base for chiropractic care. This article is the outcome of this charge. As part of the CCGPP process, preliminary drafts of these articles were posted on the CCGPP Web site www.ccgpp.org (2006-8) to allow for an open process and the broadest possible mechanism for stakeholder input. Online comprehensive literature searches were performed of the following databases: Cochrane Database of Systematic Reviews; National Guidelines Clearinghouse; Cochrane Central Register of Controlled Trials; Manual, Alternative, and Natural Therapy Index System; Index to Chiropractic Literature, Cumulative Index to Nursing and Allied Health Literature; Allied and Complementary Medicine; and PubMed up to June 2006.
RESULTS: Our search yielded the following results: 8 systematic reviews, 3 meta-analyses, 5 published guidelines, and 1 consensus document. Our direct search of the databases for additional randomized trials did not find any chiropractic randomized clinical trials that were not already included in one or more of the systematic reviews/guidelines. The review of the Manual, Alternative, and Natural Therapy Index System and Index to Chiropractic Literature databases yielded an additional 38 articles regarding various nonpharmacologic therapies such as chiropractic, acupuncture, nutritional/herbal supplements, massage, etc. Review of these articles resulted in the following recommendations regarding nonpharmaceutical treatments of FMS. Strong evidence supports aerobic exercise and cognitive behavioral therapy. Moderate evidence supports massage, muscle strength training, acupuncture, and spa therapy (balneotherapy). Limited evidence supports spinal manipulation, movement/body awareness, vitamins, herbs, and dietary modification.
CONCLUSIONS: Several nonpharmacologic treatments and manual-type therapies have acceptable evidentiary support in the treatment of FMS.
Dr. Paul S. Tetro
Chiropractor
Takoma Park/Silver Spring, MD
Study recommends conservative management of lumbar disc herniation before surgical discectomy
A recent article appeared in the Spine Journal examines the cost of previous conservative care for patients that ultimately elect to have spinal surgery. The study consisted of 30,709 patients. The average cost of conservative care in the 90 days period before surgery was $3,445 each. Magnetic resonance imaging and other diagnostic procedures represented a little over half of the total pre-surgery costs. Of the treatment costs, 16% were for injections, 5.7% physical therapy, and 1.2% chiropractic care. Despite the fact that these expenses were for failed back conservative care, the authors recognize the overall benefits of conservative care and recognize that many patients are able to avoid surgery. They conclude that “Although a large number of patients will ultimately require surgical intervention, given that many patients will improve with nonoperative therapy, a trial of conservative management is appropriate”.
Previous studies have examined conservative versus surgical treatment related to several common causes of low back pain. For spinal stenosis, “Among patients with lumbar spinal stenosis completing 8- to 10-year follow-up, low back pain relief, predominant symptom improvement, and satisfaction with the current state were similar in patients initially treated surgically or nonsurgically.” Another study of patients with disc herniation reported, “…with moderate or severe sciatica, surgical treatment was associated with greater improvement than nonsurgical treatment at 5 years. However, patients treated surgically were as likely to be receiving disability compensation, and the relative benefit of surgery decreased over time.”
Sources:
Daffner SD, Hymanson HJ, Wang JC. Cost and use of conservative management of lumbar disc herniation before surgical discectomy. Spine J. 2010 Mar 31.
http://www.chiroaccess.com/Articles/Studies-Recommend-Conservative-Care-for-Low-Back-Pain-before-Surgery.aspx?id=0000148
Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic
Previous studies have examined conservative versus surgical treatment related to several common causes of low back pain. For spinal stenosis, “Among patients with lumbar spinal stenosis completing 8- to 10-year follow-up, low back pain relief, predominant symptom improvement, and satisfaction with the current state were similar in patients initially treated surgically or nonsurgically.” Another study of patients with disc herniation reported, “…with moderate or severe sciatica, surgical treatment was associated with greater improvement than nonsurgical treatment at 5 years. However, patients treated surgically were as likely to be receiving disability compensation, and the relative benefit of surgery decreased over time.”
Sources:
Daffner SD, Hymanson HJ, Wang JC. Cost and use of conservative management of lumbar disc herniation before surgical discectomy. Spine J. 2010 Mar 31.
http://www.chiroaccess.com/Articles/Studies-Recommend-Conservative-Care-for-Low-Back-Pain-before-Surgery.aspx?id=0000148
Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic
-This very interesting Sweedish study illustrates that the effects of whiplash can sometimes occur in body areas or systems that seem uncommon to most patients. In my chiropractic clinic in Greenbelt, MD, we focus on the body as a whole, not just the symptoms. As a specialist in whiplash related disorders, I strive to help patients overcome all aspects of this growing epidemic.
-Dr. C
Cardiovascular and muscle activity during chewing in whiplash-associated disorders (WAD).
Kalezic N, Noborisaka Y, Nakata M, Crenshaw AG, Karlsson S, Lyskov E, Eriksson PO.
Centre for Musculoskeletal Research, University of Gavle, Sweden; Sports Medicine Unit, Umea University, Sweden.
OBJECTIVE: The present study aimed to elucidate possible physiological mechanisms behind impaired endurance during chewing as previously reported in WAD. We tested the hypothesis of a stronger autonomic reaction in WAD than in healthy subjects in response to dynamic loading of the jaw-neck motor system.
DESIGN: Cardiovascular reactivity, muscle fatigue indicies of EMG, and perceptions of fatigue, exhaustion and pain were assessed during standardised chewing. Twenty-one WAD subjects and a gender/age matched control group participated. Baseline recordings were followed by two sessions of alternating unilateral chewing of a bolus of gum with each session followed by a rest period.
RESULTS: More than half of the WAD subjects terminated the test prematurely due to exhaustion and pain. In line with our hypothesis the chewing evoked an increased autonomic response in WAD exhibited as a higher increase in heart rate as compared to controls. Furthermore, we saw consistently higher values of arterial blood pressure for WAD than for controls across all stages of the experiment. Masseter EMG did not indicate muscle fatigue nor were there group differences in amplitude and mean power frequency. Pain in the WAD group increased during the first session and remained increased, whereas no pain was reported for the controls.
CONCLUSION: More intense response to chewing in WAD might indicate pronounced vulnerability to dynamic loading of the jaw-neck motor system with increased autonomic reactivity to the test. Premature termination and autonomic involvement without EMG signs of muscle fatigue may indicate central mechanisms behind insufficient endurance during chewing.
Dr. Louis S. Crivelli II
Chiropractor
Greenbelt, MD
-Dr. C
Cardiovascular and muscle activity during chewing in whiplash-associated disorders (WAD).
Kalezic N, Noborisaka Y, Nakata M, Crenshaw AG, Karlsson S, Lyskov E, Eriksson PO.
Centre for Musculoskeletal Research, University of Gavle, Sweden; Sports Medicine Unit, Umea University, Sweden.
OBJECTIVE: The present study aimed to elucidate possible physiological mechanisms behind impaired endurance during chewing as previously reported in WAD. We tested the hypothesis of a stronger autonomic reaction in WAD than in healthy subjects in response to dynamic loading of the jaw-neck motor system.
DESIGN: Cardiovascular reactivity, muscle fatigue indicies of EMG, and perceptions of fatigue, exhaustion and pain were assessed during standardised chewing. Twenty-one WAD subjects and a gender/age matched control group participated. Baseline recordings were followed by two sessions of alternating unilateral chewing of a bolus of gum with each session followed by a rest period.
RESULTS: More than half of the WAD subjects terminated the test prematurely due to exhaustion and pain. In line with our hypothesis the chewing evoked an increased autonomic response in WAD exhibited as a higher increase in heart rate as compared to controls. Furthermore, we saw consistently higher values of arterial blood pressure for WAD than for controls across all stages of the experiment. Masseter EMG did not indicate muscle fatigue nor were there group differences in amplitude and mean power frequency. Pain in the WAD group increased during the first session and remained increased, whereas no pain was reported for the controls.
CONCLUSION: More intense response to chewing in WAD might indicate pronounced vulnerability to dynamic loading of the jaw-neck motor system with increased autonomic reactivity to the test. Premature termination and autonomic involvement without EMG signs of muscle fatigue may indicate central mechanisms behind insufficient endurance during chewing.
Dr. Louis S. Crivelli II
Chiropractor
Greenbelt, MD
Foot Orthotics and Chiropractic care in Temple Hills, MD
For decades, Foot Levelers has enthusiastically
supported and promoted chiropractic research.
Twenty-two years ago in our Success Express
magazine, we announced the commitment of a
quarter of a million dollars to fund the Greenawalt
Chair for Research at Northwestern College of
Chiropractic (now Northwestern Health Sciences
University).1 By that time Foot Levelers was
already an established financial backer of the
Foundation for Chiropractic Education and
Research (FCER), and we encouraged the readers
of our magazine—as well as other chiropractic
suppliers—to join us in giving to the profession’s
“primary source of financial support for chiropractic
research and postdoctoral research training of
doctors of chiropractic.”2-4
In the late 1990s, Foot Levelers teamed up with
New York Chiropractic College to establish “the
nation’s first gait research center in a chiropractic
setting” at NYCC’s Seneca Falls campus.5
Heeding Dr. Reed Phillips’ call to “be supportive
of chiropractic research in any way possible,”6
the partnership between Foot Levelers and NYCC
“sparked research that may reveal how the body’s
gait can disrupt chiropractic adjustments, which
could lead to the identification of ways an
adjustment can best be preserved, such as
through the use of orthotics.”7
This research booklet
is proof that “Foot Levelers’ products are a
beneficial adjunct to chiropractic care.”8 Here is
peer-reviewed research by some of the finest
academicians in the chiropractic profession,
including work done at NYCC’s Biomechanics/
Gait Research Laboratory in Seneca Falls.
The future of chiropractic research is limited only
by the support it receives from those who form
the chiropractic community of professionals,
staff, and suppliers. Foot Levelers pledges to
continue sponsoring and promoting chiropractic
research, and to share the benefits of that
research with our Partners In Progress.
References
1. [No author]. Chair for research announced. Success Express 1985; 9(2):59.
2. Rossman E. FCER’s role in chiropractic research. Success Express 1985;
9(3):57-61.
3. [No author]. Are your suppliers supporting chiropractic research? Success
Express 1985; 9(4):55-59.
4. [No author]. Chiropractic research…key to the future. Success Express
1988;12(1):45-47.
5. [No author]. NYCC and Foot Levelers team up to establish gait research
program. Success Express 1998; 18(3):28.
6. Phillips RB. A lesson in history: the need for research. Success Express
1988; 12(1):25-29.
7. [No author]. Foot Levelers gait research program is helping advance field
of chiropractic. Success Express 2000; 20(2):11.
8. [No author]. ACC conference highlights orthotics research. Success
Express 2004; 24(3):5.
Aekta Erry, D.C.
Chiroprator, Temple Hills, MD
Chiropractic management of patients post-disc arthroplasty: eight case reports
Background: When conservative therapies for low back pain (LBP) are not effective, elective surgery may be proposed to these patients. Over the last 20 years, a new technology, disc replacement, has become increasingly popular because it is believed to maintain or restore the integrity of spinal movement and minimize the side-effects compared to fusion. Although disc replacement may relieve a patient from pain and related disability, soreness and stiffness of the lumbopelvic region seem to be common aftermaths of the surgery. This prospective case series was undertaken to identify and describe potential adverse events of lumbar spinal manipulation, a common therapy for low back pain, in a group of patients with symptoms after disc prostheses.Cases presentationEight patients who underwent lumbar spine total disc replacement were referred by an orthopaedic surgeon for chiropractic treatments.
These patients had 1 or 2 total lumbar disc replacements and were considered stable according to the surgical protocol but presented persistent, post-surgical, non-specific LBP or pelvic pain. They were treated with lumbar spine side posture manipulations only and received 8 to 10 chiropractic treatments based on the clinical evolution and the chiropractor's judgment. Outcome measures included benign, self-limiting, and serious adverse events after low back spinal manipulative therapy. The Oswestry Disability Index, a pain scale and the fear avoidance belief questionnaire were administered to respectively assess disability, pain and fear avoidance belief about work and physical activity. This prospective case series comprised 8 patients who all had at least 1 total disc replacement at the L4/L5 or L5/S1 level and described persistent post-surgical LBP interfering with their daily activities. Commonly-reported side-effects of a benign nature included increased pain and/or stiffness of short duration in nearly half of the chiropractic treatment period. No major or irreversible complication was noted. Conclusions: During the short treatment period, no major complication was encountered by the patients. Moreover, the benign side-effects reported after lumbar spine manipulation were similar in nature and duration to those frequently experienced by the general population.
Chiropractic management of patients post-disc arthroplasty: eight case reports
Julie O'Shaughnessy1 
1 Département de chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
2 Private practice, Québec City, Canada
3 Centre Hospitalier Universitaire de Québec, Hôpital St-François d'Assise, Québec, Québec, Canada
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