An Open Letter to our Medical friends.

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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.

 

References
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.
4. Joint Commission Online. Revision to Pain Management Standards. http://www.jointcommission.org/assets/1/23/jconline_november_12_14.pdf
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

4 Reasons To Never Skip Your Cool Down.

From: https://www.shape.com/fitness/tips/post-workout-cool-down-benefits-dynamic-stretches

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One of the biggest culprits for skipping your workout? Not having enough time. That not only translates to missed classes and training sessions, but it usually means that when you do manage to get to the gym, you’re more inclined to cut corners (like reps, sets, stretches, warm-ups, and cooldowns) to save some precious time.

But when it comes to your post-workout cooldown, you’re really doing your body a disservice by bypassing it. Coming down from, say, a run or a Tabata circuit by slowing your movements and slowly bringing down your heart rate can help you recover more easily, and increase heart health over time, according to a research published in the Journal of Exercise Physiology Online.

Read on to learn about a few more reasons why you shouldn’t skip your post-workout cooldown.

It controls your post-workout blood flow.

Exercise helps get your blood flowing, so abruptly stopping can actually cause your blood pressure to drop rapidly. When blood pressure drops too quickly, it can cause you to feel light-headed, which is why Heather Henri, M.D., an associate professor of medicine at Stanford University, recommends cooling down for about six minutes after you’ve completed a workout. Fainting is also a risk, as this impact on blood flow could cause blood to pool in your lower extremities, which delays its return to your heart and brain, according to research done by the American Council on Exercise. Cooldowns also reduce the concentration of lactic acid. Using active recovery (here are some active recovery exercise examples) to slowly reduce effort, you can actually increase power and endurance during your next round, too. This is exactly why you shouldn’t totally rest between sets during your workout.

It safely slows down your heart rate.

Your internal body temperature rises during a workout, which means your blood vessels are dilated and your heart is beating faster than normal. It’s important to gradually, and safely bring your heart rate back down after a workout, says Dr. Henri. Skipping the cooldown and dropping the heart rate suddenly can put added stress on your heart, according to research published in the journal Frontiers of Medical and Biological Engineering. Try slowing down your movements from, for example, a faster dance cardio flow to a slower one, a run to a walk, or a plyometric exercise to a movement with both feet on the ground, suggests Deborah Yates, a certified group fitness director for the Bay Club in Silicon Valley.

It prevents injury.

Incorporating a cooldown after your workout can help prevent injuries, and that goes for fitness rookies and seasoned athletes alike. Sprains, strains, and tears in the lower back, hip flexors, knees, hamstrings, and quadriceps are some of the most commonly injuries, says Yates. So, you’ll want to focus on elongating your muscle fibers, which have been under tension during your workout, to achieve your full range of motion. This can be done through hip, lower-back, and spine stretches such as a runner’s lunge or side bend, as well as core-balancing poses such as a standing half lotus and standing bow pose, says Yates.

It increases your flexibility.

The best time to work on your flexibility is when your body is fully warm and you’re breaking a sweat. But instead of hopping off the treadmill and going directly into a toe touch, experts suggest doing some dynamic stretches first. This can decrease your risk of injury, relieve back pain, and improve athletic performance, said Tanja Djelevic, Crunch fitness trainer, in “6 Active Stretches You Should Be Doing.” Taking time for this kind of cooldown can also increase your flexibility and mobility over time, which is thought to help avoid muscle tears, back pain, and joint issues. (Still wondering which is more important, mobility or flexibility? Find out. The answer might surprise you.)

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Headache pain

Did you know that one of the most common causes of headaches are trigger points in the neck muscles. These points can refer pain into the temple, face, skull, and behind the eye. If other methods of treatment have failed to provide relief, trigger point therapy might be the right option for you.

Consider Chiropractic for Neck Pain Treatment

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“Chiropractic is a proven, viable treatment for neck pain. A recent study concluded ‘Mobilization, (Cervical and Thoracic) Manipulation, and Clinical Massage are effective interventions for the management of neck pain.’

If you’re experiencing neck pain, consider an effective, conservative method of treatment, such as chiropractic.”

Reference:

Wong JJ, et al. Are manual therapies, passive physical modalities, or acupuncture e_ective for the management of patients with whiplash associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration. Spine J. 2016 Dec;16(12):1598-1630

Healthy lifestyles (Avoid the Detriments of Sugar)

SUgar Cycle

“Routinely eating products that contain sugar leads to a vicious sugar-craving cycle.

First, sugars are absorbed into our blood and travel to the brain. Then, the sugar in the brain releases a chemical called serotonin that produces a sense of happiness and well- being. Next, as our sugar blood levels fall due to insulin production and sugar absorption, we move from a hyperactive state to more of a tired, irritable and weak state.

This causes concentration levels to fall, and our cells begin to become acidic. Our brain then once again sends a message that we need more sugar, and the cycle repeats itself. Cutting refined sugars out of your diet, or at least decreasing them, will help you avoid this cycle and feeling your best.”

Text Neck Research

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“A new study demonstrated that people who spend long periods of time on an unsupported electronic device (mobile phone) have greater neck pain and loss of neck function. The authors concluded:

“There was a significant correlation between time spent on electronic devices and cervical pain intensity.”

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If you’re experiencing neck pain, check out this video to learn more about what you can do: TXT Neck

Advice for back pain sufferers

“Another study shows the benefit of chiropractic care for back pain sufferers:

A large systematic review of 51 studies examined the efficacy, effectiveness, and safety of various therapies for the treatment of chronic low back pain. The authors concluded:

“There is evidence that manipulation and mobilization are likely to reduce pain and improve function for patients with chronic low back pain; (chiropractic) manipulation appears to produce a larger effect than (physical therapy) mobilization. Both therapies appear safe.”

So if you are someone you know suffers from back pain, call us today. Our doctors have powerful natural tools for treating the source of your problem. Check out this short
video to learn more: Natural Tools For Back Pain

Source:

Coulter ID. et al. Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. 2018 Jan 31. pii: S1529-9430(18)30016-0. Spine Journal. doi: 10.1016/j.spinee.2018.01.013. [Epub ahead of print]”

 

Trigger points in the levator scapula

The levator scapula is a muscle located in your neck. It originates on the transverse processes of C1-C4 vertebrae. It inserts on the superior part of the medial border of the scapula. This muscle acts to elevate the scapula and rotate the glenoid fossa downward. At the cervical attachment it acts to rotate the neck to the same side and assists extension. Trigger points will refer pain into the angle of the neck with spillover into the scapula. When this muscle is tight due to trigger points it will restrict neck rotation causing the classic stiff neck. With a forward head position this muscle often becomes stretched and over worked.