In the past year, many trusted medical establishments including the FDA (1), CDC (2), Joint Commission (3,4), JAMA (5), and The American College of Physicians/ Annals of Internal Medicine (6) have encouraged medical providers to prescribe spinal manipulation as a first line treatment for acute, subacute, and chronic low back pain.
Most recently, The Lancet echoed that endorsement, and provided a unique perspective:
The reduced emphasis on pharmacological care recommends nonpharmacological care as the first treatment option and reserves pharmacological care for patients for whom nonpharmacological care has not worked. These guidelines endorse the use of exercise and a range of other non- pharmacological therapies, including massage, spinal manipulation, and acupuncture.
Gaps between evidence and practice exist, with limited use of recommended first- line treatments and inappropriately high use of imaging, rest, opioids, spinal injections, and surgery. Doing more of the same will not reduce back-related disability or its long-term consequences. The advances with the greatest potential are arguably those that align practice with the evidence. (7)
Unfortunately, personal experience skews our perception of each other’s merit, i.e., we primarily see each other’s failures since the successes don’t need to seek additional care. Regardless of our professional degree, we all have failed cases mixed into our many clinical successes. We must not lose sight of the evidence supporting each other’s overwhelming proven value for a given diagnosis. If we judge each other by our successes rather than our failures, we will work toward an integrated model where the patient wins. Together, we will help more patients than either working alone.
We are honored for the opportunity to co-manage your patients.
1. FDA Education Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain. May 2017. Accessed on May 12, 2017
2. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain- United States, 2016. MMWR Recomm Rep 2016;65(No. RR-1):1–49.
3. The Official Newsletter of The Joint Commission. Joint Commission Enhances Pain Assessment and Management Requirements for Accredited Hospitals. July 2017 Volume 37 Number 7. Ahead of print in 2018 Comprehensive Accreditation Manual for Hospitals.
5. Paige NM, Miake-Lye IM, Booth MS, et al. Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain; Systematic Review and Meta-analysis. JAMA. 2017;317(14):1451-1460.
6. Qaseem A, et al. for the Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166(7):514-530.
7. Foster, Nadine EBuchbinder, Rachelle et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet, Published Online March 21, 2018 http://dx.doi.org/10.1016/ S0140-6736(18)30489-6
New research suggests that a diet low in red meat and rich in whole grains may reduce the risk of developing a chronic lung disease known as chronic obstructive pulmonary disease (COPD). Researchers tracked over 120,000 individuals and found that healthy eaters were one-third less likely to develop COPD when compared with regular consumers of red meat, refined grains, sugary drinks, and alcohol. The findings reveal that good eating habits appear to lower COPD risk for both smokers and nonsmokers alike.
One of the most common causes of a stiff neck are trigger points in the levator scapulae muscle. This muscle runs up the side of the neck from the top of the shoulder blade. It helps to shrug the shoulders and move and stabilize the neck. When trigger points form in this muscle they will produce pain and stiffness in the neck. Deep tissue trigger point massage applied to these knots is an effective treatment method.
Waking up with a headache or consistently getting one by the end of work each day is not fun (or normal). Headaches can be caused by a variety of factors, none of which are a shortage of medication in your body! As a matter of fact, if you have been relying on drugs to find relief day after day, there is a variety of new research that encourages you to reconsider.
Why it Matters:
Relying on medications to find relief each and every day places an enormous amount of strain on your liver and other internal organs. What’s more, researchers have found that a common “side” effect of many popular headache mediations is…more headaches! And if that wasn’t enough to encourage you to think differently about how to treat your headaches, new research has found an increased risk of heart attacks in people who had taken NSAIDs (or non-steroidal anti-inflammatory drugs). It’s easy to see why our firm belief is that the best way for most people to find relief from their headaches is through natural healthcare such as combination of Chiropractic and light stress-relieving exercise like yoga.
Headache medications often have dangerous side effects.
Research has shown little to no evidence that such drugs are effective at treating headaches.
In a recent study, over 30% of participants saw a 100% improvement in the frequency and severity of their headaches after receiving Chiropractic care.
Our workshop on finding natural solutions and relief from headaches is coming up soon! We’ll help you discover the causes of many common types of headaches, share tips on reducing their impact in your life, and review the steps you can take to ensure that you don’t have to suffer from them in the future. Share this with a friend and be sure to let us know how many people will be attending the workshop with you!
Dose-Response and Efficacy of Spinal Manipulation for Chronic Cervicogenic Headache: A Pilot Randomized Controlled Trial. The Spine Journal. 2010
Chiropractic spinal manipulative therapy for cervicogenic headache: a single-blinded, placebo, randomized controlled trial. BioMed Central. 2017
Cardiovascular and general, overall health are well established factors to general wellbeing and mental health. Likewise, improving your overall health and specifically cardiovascular health will lead to improvements in your mental health and overall outlook.
Chiropractic: Resolution of Shoulder Pain Following Chiropractic Care.
A new case study sheds light on the benefits of chiropractic care for shoulder pain. A 73-year-old woman with a one-year history of shoulder pain presented for chiropractic care. Her working diagnosis included brachial neuritis, cervicalgia, arthritis, and cervical spinal joint fixations. She reported resolution of pain, and improvements in both function and quality of life following just eleven chiropractic treatments over the course of ten weeks.
Annals of Vertebral Subluxation Research, February 2015
Knee osteoarthritis is a condition that can cause stiffness that limits joint range of motion. Over time, the knee’s flexion and extension movements become limited, generally causing pain and an alteration of the normal biomechanics. Your thigh muscles also have to work harder during movement, generating a feeling of muscle tension.To date, the exact causes of osteoarthritis have not been fully identified. It is completely normal to have a mild level of osteoarthritis with age. However, the more advanced stages of osteoarthritis can affect the ability to carry out daily activities and sports. An exacerbation of symptoms usually occurs during a period when the level of physical activity has been drastically increased. Direct trauma to the knee can increase the symptoms of osteoarthritis.
In the knee, the joint affected by osteoarthritis is the t ibiofemoral joint, formed by the femur bone and the tibia bone. It is mainly cartilage damage combined with the presence, in some cases, of slight bone spurs in the joint that appear to be responsible for the restriction of movement. Over time, certain muscles in the thigh area may compensate for the joint restriction and become more tense.1
Signs & Symptoms that you may experience
Each person will react differently to osteoarthritis and management will depend on its stage. Knee osteoarthritis can produce, but is not limited to, local pain in the knee, localized edema and stiffness in certain knee movements. Repetitive movements of the knee during walking or other sports activities and a squatting position with direct pressure can cause pain.
Knee osteoarthritis is a progressive condition that cannot be cured, which means that the range of motion may decrease over time. An active lifestyle and a rehabilitation plan may however slow the progression of this condition and make it easier to manage the symptoms.
Relative rest is a good way to prevent your symptoms from getting worse after a painful episode. A few days of rest while reducing activities that cause significant pain m ay be necessary, but it is very important to avoid deconditioning. A quick return to your daily activities, light cardiovascular exercises that do not cause an increase in pain, joint mobilization exercises and knee and hip muscles strengthening exercises will allow for better recovery.
Follow your therapist’s advice. This will help you manage the various stages of the healing process and increase the odds of success. Your therapist will accompany you during your rehabilitation program in order to improve range of motion of your knee’s joint, regain flexibility, muscle strength and endurance, and functional state.
According to the principles of knee osteoarthritis rehabilitation, improving joint range of motion should be an integral part of the treatment plan. A program to improve joint range of motion and flexibility, as well as specific muscle strengthening is common to control the symptoms of knee osteoarthritis.
▶ WHAT TO AVOID
Do not rely solely on a passive treatment approach. Each phase of the rehabilitation process is important. Patients who actively participate in their treatment plan tend to recover more quickly. Keep in mind that pain is not always a good indicator of joint or tissue damage. A significant level of pain does not necessarily imply a more advanced stage of osteoarthritis. As soon as you feel better and the pain is well under control, introduce, in collaboration with your therapist, light mobility and strengthening exercises based on your tolerance. Remember that exercise is an excellent way to manage pain associated with osteoarthritis.
Have you ever been excited to start a new exercise program, shed a few pounds, and get in shape? It’s incredible, until about 2-3 weeks in when you suffer an injury, take a few days off and then never quite get back on track. Does this story sound familiar? You’re not alone. It happens all the time. So let’s take a look at how you can get active, reach your goals, and avoid those pesky injuries during those first few weeks.
Why it Matters:
While it’s impossible to avoid every potential injury, a balance of spinal strength and flexibility can help dramatically reduce your likelihood of getting injured. Rome wasn’t built in a day, and neither was your body. Long term strength is built through repetition. While there is a time and place for loading with max weight, if you are just getting started in a workout routine, it’s usually best to start slow by using lighter weights and working towards increasing your repetitions. Flexibility is the second key to staying injury free. Whether you are stretching during long work hours at the computer, practicing yoga on the weekends, or using Chiropractic care to improve your spinal (and extremity) range of motion, it’s essential to view flexibility as a journey rather than a destination. Every day that you take a proactive step with your strength and flexibility, you are reducing the chance of an injury, making progress towards your goals, and living a healthier life.
Stretching can improve your flexibility and decrease your risk of injury.
Dynamic (or movement-based) warm-ups have been shown to potentially enhance performance.
Strength training can increase your resilience and prepare your body for activity.
We understand that everyone has unique health goals. If you have a specific question about injury prevention based on the activities you love, ask! We believe that by taking a proactive approach with your health and wellness, you can have a more inspired and fulfilling life, and we’ll be here for you every step of the way.
Mayo Clinic: Stretching: Focus on Flexibility. 2017
Exercise: Muscle Weakness Affects 1 in 5 Older Americans. Twenty percent of Americans 80 years of age and older have weak muscle strength, according to experts at the Centers for Disease Control and Prevention (CDC). Prior studies have linked fading muscle strength to slower walking speed and an increased risk of death. The CDC recommends that seniors should strive to maintain optimal physical conditioning through good overall preventive care, nutrition, and exercise.
Centers for Disease Control and Prevention, January 2015
When exercising, it is important to make your routine enjoyable and fun to help ensure that you keep exercising. The American Heart Association suggests the following: wear shoes that are comfortable and fit properly, wear clothing that is appropriate for weather conditions, start slow, stick to a consistent workout time, make expectations reasonable for your health and abilities, include fun activities with family and friends, track you progress, and reward yourself for success. American Heart Association, February 2015