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Chiropractic Is Safe, Study Shows

Chiropractic care has successfully relieved patients of spinal pain for over a hundred years, and a new study shows that chiropractic is not only effective, it's safe.

Earlier research has examined the safety of chiropractic, but no studies had used sham or placebo interventions to assess the relative safety of chiropractic.

Researchers from Australia sought to fill that gap in knowledge by analyzing the likelihood that patients experienced adverse events after chiropractic care compared to sham interventions. The study involved 183 patients with spinal pain who were randomly selected to receive either real chiropractic care or sham interventions. Patients were then asked to complete questionnaires regarding any side effects they may have experienced immediately after treatment, after 24 hours, and after 2 days or more post-treatment.

The majority of patients did not experience any adverse events, regardless of whether or not they were treated with chiropractic or sham interventions. A minority of patients had mild side effects like muscle stiffness or headache that typically resolved itself within 24 hours post-treatment. The researchers could not detect any major differences in the risk of adverse events between sham and chiropractic treatments. No patients experienced any serious side effects.

The authors pointed out their study was underpowered by 20%, which likely influenced their ability to detect differences between the groups. However, they noted their results were consistent with earlier research showing that any side effects associated with chiropractic are typically mild, temporary, and benign.

This study demonstrates that chiropractic care is a safe, non-invasive way to relieve spinal pain and improve your health. Previous studies have also demonstrated that chiropractic is safe for children, older adults, and pregnant women.

Reference

Walker BF, et al. Outcomes of Usual Chiropractic; Harm (OUCH). A randomised controlled trial. Spine 2013; DOI: 10.1097/BRS.0b013e31829fefe4.

 

Study Finds MRI Overused for Back Pain

A panel of experts recently collaborated in a study which analyzed orders for MRI scans in two large hospitals. They found that more than half the cases in which a lumbar spine MRI scan were done should not have been ordered in the first place. The panel deemed 29% of the MRI referrals inappropriate, and another 27% of "uncertain value".

It was also discovered that family physicians were the biggest culprits in ordering unnecessary low-back MRI scans. Only 34% of family doctors' orders were considered appropriate, compared to 58% of orders by physicians of other specialties.

The research team, lead by Dr. Derek Emery, wrote, "Eliminating inappropriate scans and some uncertain value could reduce the harm that accrues from unneeded investigations and result in significant cost savings."

The use of lumbar spine scans has risen drastically, even though there is a weak correlation between their findings and clinical signs and symptoms. The study noted the possible reasons for their overuse, including patient expectations, doctors' concerns about litigation, and lack of physician accountability in regards to cost. The expert panel recommended strict guidelines for doctors and better patient education.

The only orders where the MRI scans were routinely deemed appropriate was in cases of post-operative leg or back pain. However, these accounted for only 17% of the low back MRI orders.

The findings of the study confirmed what many doctors already understand about MRI overuse. Imaging for low-back pain is one of the top five overused tests and treatments listed by both the American Academy of Family Physicians and the American College of Physicians.

Other studies have pointed out overuse of MRI for other patient conditions, including headache and sciatica.

Reference

Emery D, et al. Overuse of magnetic resonance imaging. JAMA Internal Medicine 2013; online first 25 March: doi 10.1001/jamainternmed.2013.3804.

 

 

Jump Rope Helps Prevent Osteoarthritis

More Than Fun & Games

Jumping rope may be more than a fun recess activity for kids; it could stave off osteoarthritis later in life. Children with diabetes who regularly did jump rope or other weight-bearing activities had improved bone mineral density in a new study. Having a high bone mineral density is believed to be protective against osteoarthritis. The study points to important preventative measures for diabetic and healthy children alike.

Improved Bone Mineral Density

Researchers measured the bone mineral density of 27 children with type 1 diabetes and 3 healthy children. After 9 months, children who participated in two 90 sessions a week of weight-bearing physical activities significantly improved their bone mineral density. These changes weren't observed in children who did not engage in weight-bearing activities.

The study echoes the results of another recent study involving young men participating in loading sports. Young men who performed at least 4 hours a week of basketball, volleyball, soccer or other loading activities had increased volumetric bone density. Participants not involved in loading sports did not experience the same benefits.

Not Just for Kids

You don't have to be young to benefit from weight-bearing activities. Older adults can could also reduce their risk of osteoarthritis with resistance training and loading sports.

Taking vitamin D supplements is another way for older adults to improve bone health.

References

Maggio AB, Rizzoli RR, Marchand LM, et al. Physical activity increases bone mineral density in children with type 1 diabetes. Med Sci Sports Exerc 2012;44:1206-1211.

Nilsson M, Ohlsson C, Odén A, Mellström D, and Lorentzon M. Increased physical activity is associated with enhanced development of peak bone mass in men: a five-year longitudinal study. Journal of Bone and Mineral  Research  2012; 27 (5): 1206–1214.

 

Sciatica Pain? Chiropractic Best Option

Chiropractic Speeds Recovery from Sciatica

Most Disabling Low Back Pain

Many people with sciatica find the pain to be so debilitating that they are forced to miss work and social gatherings. Among patients with lower back pain, those with sciatica experience the highest level of disability. According to public health records in Norway, patients with sciatica are disabled for an average of 72 days a year.

Study Finds Chiropractic Speeds Recovery

A recent study offers hope to patients suffering from sciatica pain. The new research suggests that chiropractic treatments may speed sciatica recovery, enabling patients to return to work faster. The researchers evaluated 44 Norwegian workers who had visited the hospital with severe sciatic pain. Most of the participants had been experiencing pain for at least three weeks before visiting the hospital.

Study Method

In the hospital, a chiropractor evaluated each patient's posture, gait, range of motion, and palpation of the lumbar spine. The chiropractor then performed joint adjustments to the spine, in addition to other joints that had been injured as patients compensated for the pain. Soft tissue soreness was relieved with ice treatment. Patients received daily treatments while in the hospital, and then three times a week for a period of two weeks. Some patients also underwent additional follow-up treatments, but most did not receive more than 14 treatments.

91% of patients had returned to work full-time"

Study Results

Within 21 days, 91% of patients had returned to work full-time. An additional 2 patients were back at work part-time. The researchers concluded that the study demonstrates the potential benefit of chiropractic care for sciatica patients.

Reference:

Arana E, Marti-Bonmati L, Vega M, et al. Relationship between low back pain, disability, MR imaging findings and health care provider. Skeletal Radiology 2006;35(9):641-7.

Orlin JR, Didriksen A. Results of chiropractic treatment of lumbopelvic fixation in 44 patients admitted to an orthopedic department. Journal of Manipulative and Physiological Therapeutics 2007;30:135-139.

 

Weight Loss and Back Pain

Weight loss is known to have substantial health benefits. A new study has confirmed that patients who lose weight may experience substantially reduced back pain and sciatica.

Obese patients frequently report lower back pain and sciatica. Research shows that having a higher body mass index (BMI), a measure of obesity, may slow recovery from back pain and increase your risk of common sciatica causes such as lumbar disc degeneration. Decreased space between spinal discs, a potential result of obesity, can cause nerve impingement and sciatica pain.

The new study involved 30 morbidly obese participants who underwent weight-loss surgery. As they lost weight, the space between lumbar spinal discs increased, reducing pressure on the nerves. Patients reported a substantial reduction in lower back pain and radiating leg pain. Weight loss has also been shown to alleviate knee pain.

For patients who are concerned with the risks and costs of bariatric surgery, there are non-invasive weight loss methods available. A new literature review found that exercise and physical therapy may also reduce obese patients' back pain. Chiropractic care can also provide back-pain relief for overweight and obese patients.

References

1. Djurasovic M, Bratcher KR, Glassman S, et a. The Effect of Obesity on Clinical Outcomes After Lumbar Fusion. Spine 2008; 33(16): 1789-1792.

2. Baumgarten K, Walter C, and Watson E. The Effect of Obesity on Orthopaedic Conditions. South Dakota State Medical Association. http://www.sdsma.org/documents/Carlson.pdf.

3. Samartzis D, Karppinen J, Chan D, et al. The association of lumbar intervertebral disc degeneration on magnetic resonance imaging with body mass index in overweight and obese adults: A population-based study. Arthritis and Rheumatism 2012; 64(5): 1488-1496.

4. Lidar Z, Behrbalk E, Regev GJ, et al. Intervertebral Disc Height Changes after Weight Reduction in Morbid Obese Patients, its Effect on Life Quality, Radicular and Low Back Pain. Spine 2012. doi: 10.1097/BRS.0b013e31825fab16.

5. Atchison J and Vincent H. Obesity and low back pain: relationships and treatment. Pain Management 2012; 2(1): 79-86/(doi: 10.2217/pmt.11.64)

 

Study Finds Chiropractic Beneficial for Fibromyalgia

A new study from Egypt reports that chiropractic care can be an effective treatment strategy for fibromyalgia.

The study involved 120 people between the ages of 40 and 65 who had suffered with severe fibromyalgia for four years or more. Each person rated their pain as a 4 or higher on a pain scale and also had limited movement in their cervical (neck area) spine, specifically in their C1-C2 area.

All of the individuals participating in this study engaged in 12 weeks of therapy which included:

  • An education program (one two-hour session per week) designed to provide the participant with more information about fibromyalgia and available treatment options;
  • Cognitive behavioral therapy (one two-hour session per week) which involved discussion regarding pain management via relaxation exercises, challenging treatment-prohibitive beliefs about fibromyalgia, and positive reinforcement about what types of actions can be taken to ease fibromyalgia symptoms; and
  • An exercise program (three one-hour sessions per week plus 20-minute session twice daily at home) which included relaxation techniques, as well as active and passive stretches.

One-half of the individuals were also randomly assigned to a treatment group, which meant that they also engaged in upper cervical chiropractic adjustments. This involved a high-velocity, low-amplitude thrust to the C1-2 motion segment three times per week for the first month. This was then reduced to once a week sessions for the remaining eight weeks.

At the beginning of the study, the conclusion of the study, and at one year post-study, each participant was asked to complete various questionnaires to help the researchers determine what effect, if any, the chiropractic had on easing fibromyalgia symptoms and reducing its impact on their lifestyle. Specifically, questions were asked regarding physical function abilities, work days missed due to fibromyalgia symptoms, sleep disturbances, level of pain, fatigue, depression, and anxiety.

The individuals who participated in the cervical chiropractic care group showed more improvement and better results than the control group who had no chiropractic intervention. This was validated by questionnaire scores that improved by 15 or more percent. The researchers concluded that adding chiropractic to your current fibromyalgia treatment regimen may offer even more benefits when it comes to getting to the root off the problem.

Reference:

Moustafa IM, Diab AA. The addition of upper cervical manipulative therapy in the treatment of patients with fibromyalgia: a randomized controlled trial. Rheumatology International 2015;35(7):1163-1174.

 

Is one type of spinal pain more debilitating than the next?

Two Is Not Better Than One

Suffering from a combination of neck pain and sciatica may prove more debilitating than back pain alone.

Although previous research has examined the economic impact of back and neck pain on employees, most studies have evaluated each condition separately.
To assess the combined impact of multi-site spinal pain, Finnish researchers surveyed 6, 934 municipal employees. 15% of women and 23% of men suffered from low-back pain, sciatica, or neck pain.

While having at least one type of pain increased participants' risk of sick leave, suffering from multiple types of spinal pain exacerbated that risk. Over the course of three years, participants with both neck pain and sciatica had the highest number of medically-certified sick days. Compared to women without pain, those with sciatica and neck pain were twice as likely to have medically-certified sick days.

Researchers suggested that employee health care address the multiple site of spinal pain to prevent decreased work ability.

Kääriä S, Laaksonen M, et al. Scan J Public Health 2012; 40: doi  10.1177/1403494811435490.

 

Chiropractic vs. Drugs for Pregnant Women with Migraine

An estimated 30-40% of women with migraine feel their symptoms worsen during pregnancy, likely because of hormonal changes. These women often wonder whether it's safe to continue their current migraine medications, or if they should seek conservative treatments like chiropractic care.

At least one migraine drug should be avoided during pregnancy, according to new FDA warnings, because the drug (valoprate) was tied to lower IQ scores in children. The FDA warnings are based on a new study that children whose mothers took valoprate drugs during pregnancy had lower I.Q. scores at age six compared to children exposed to other antiepileptics.

Valoprate products already had labels warning of fetal risks and birth defects. In 2011, the FDA announced interim results from the Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) study that demonstrated that children exposed to valoprate had cognitive deficits at age three. Many of these children continued to have lower IQ scores at age six, prompting the FDA to strengthen its existing warning labels.

“Valproate medications should never be used in pregnant women for the prevention of migraine headaches because we have even more data now that show the risks to the children outweigh any treatment benefits for this use,” explained Russell Katz, MD, who directs the FDA's research on neurology products. The FDA recommended that women consult with their health-care provider before stopping any medications.

Case Study of Chiropractic for Migraine in Pregnancy

The findings from the NEAD study are enough to make many women wary of relying on migraine medications during pregnancy. Instead of risking the potential effects of drugs, women often opt for natural treatments in pregnancy such as chiropractic care.

One case study demonstrates how chiropractic can safely ease headache in pregnancy. A 24-year old women who had suffered from migraines her whole life had noticed her symptoms worsening during pregnancy. In addition to her headaches, she suffered from nausea and sensitivity to light and noise. She tried a host of conservative and medical treatments to no avail, and decided to see a chiropractor while 32 weeks pregnant.

The patient was treated with a multimodal treatment plan that included chiropractic spinal adjustments, trigger point therapy, massage therapy, and lifestyle changes. The women felt her symptoms improve within one week of treatment. The case study suggests that chiropractic can offer a safe alternative for women searching for effective migraine relief in pregnancy.

Reference

Alcantara J and Cossette M. Intractable migraine headaches during pregnancy under chiropractic care. Complementary Therapies in Clinical Practice 2009; 15:192-7.

 

Chiropractic More Effective Than Drugs for Back Pain, Study Shows

​Got an achy back? You're better off  going to a chiropractor than popping another pain pill, suggests the results of a new study.

The study, published in the medical journal Spine, shows that that chiropractic adjustments are more effective than a drug for easing back pain.

To compare the efficacy of drugs and chiropractic, researchers tested the effects of spinal adjustments and a non-steroidal anti-inflammatory drug called diclofenac. They divided 38 patients with acute back pain into three treatment groups. One group received spinal adjustments and a placebo drug; the second group received sham adjustments and real diclofenac; and the control group received sham adjustments and a placebo drug.

While both the active treatment groups improved, patients receiving spinal adjustments were significantly better off than patients taking diclofenac. They experienced greater improvements in physical disability, function, time off work, and rescue medication.

This led researchers to conclude that "spinal manipulation was significantly better than non-steroidal anti-inflammatory drug diclofenac and clinically superior to placebo."

These findings add to the growing body of research showing that chiropractic is more effective than drugs for back pain and sciatica. And it's easy to see why. While drugs temporarily dull the pain, they do little to treat the root of the problem. Instead, chiropractic can relieve symptoms while addressing the underlying cause of pain.

Reference

von Heymann, et al. Spinal high-velocity low amplitude manipulation in acute nonspecific low back pain: a double-blinded randomized controlled trial in comparision with diclofenac and placebo. Spine 2013; 38 (7): 540-48. doi: 10.1097/BRS.0b013e318275d09c.

 

Chiropractic Best Option for Sacroiliac Joint Pain

Dysfunction in the sacroiliac joint (SIJ), located in the pelvis, is thought to be a possible cause of sciatica, resulting in back pain that radiates down the leg and below the knee.

Scientists have questioned what the best treatment option is for patients with SIJ-related leg pain. In a recent study, researchers compared three treatment options: physical therapy, chiropractic manual therapy, and intra-articular injections of corticosteroids. Patients included 51 adults with leg pain associated with the sacroiliac joint. Researchers analyzed the effectiveness of each method after 6 weeks of selected treatments, and again after 12 weeks. The results for each patient was categorized as either a success or failure, based on relief or worsening of symptoms and average pain scores.

The study's findings revealed that manual therapy is the superior choice for treating leg pain associated with the SIJ. The success rate for chiropractic manual therapy was 72%, compared to just 20% for physiotherapy and 50% for corticosteroid injections. Researchers also found that neither physical therapy nor injections resulted in significant pain relief, whereas manual therapy resulted in a significant improvement on pain scores.

Due to the success rate and pain reduction of manual therapy, the study authors concluded that chiropractic should be the first treatment of choice in patients with SIJ-related leg pain. They hoped that their findings would be confirmed by further research with a larger sample size.

Additional research has highlighted the efficacy of chiropractic for sciatica, even after surgery has failed.

Reference

Visser L, Woudenberg N, et al. Treatment of the sacroiliac joint in patients with leg pain: a randomized-controlled trial. European Spine Journal 2013 [online]. doi: 10.1007/s00586-013-2833-2.