Chronic Low Back Pain: Which Treatment Is More Effective?

3 Oct

For patients with chronic low back pain (cLBP), treatment guidelines recommend a non-surgical approach as the FIRST-LINE treatment. Ideally, the goal would be to avoid an initial surgery unless it’s absolutely indicated. That means, unless there is loss of bowel or bladder control or retention (which represents a medical emergency) or if there is progressive neurological motor and sensory loss, one can safely avoid surgery and conservatively manage the condition.

Interestingly enough, a systematic review of the results from three randomized controlled studies carried out in Norway and the United Kingdom found the outcomes or results between the surgical fusion vs. non-surgical treatment of patients with cLBP showed NO DIFFERENCE at an 11-year follow-up!

Studies have shown chiropractic to be highly beneficial for acute and chronic low back pain cases. In one study, researchers reviewed data on 72,326 cLBP patients in the Medicare system who received one of four possible treatment combinations between 2006 and 2012: 1) chiropractic only; 2) chiropractic followed by conventional medical care (CMC); 3) CMC followed by chiropractic; 4) CMC alone.

The research team found that chiropractic care alone (group 1) resulted in the lowest costs, and these patients had lower rates of back surgery and shorter episodes of care.

The group receiving CMC alone (group 4) had the highest costs, with the second and third groups being similar—both costing less and being more effective than CMC alone.

The conclusion of the study reads, “These findings support initial CMT [chiropractic manipulative therapy] use in the treatment of, and possibly broader chiropractic management of, older multiply-comorbid cLBP patients.”

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

 

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Meditation and Chiropractic

22 Sep

With growing evidence that meditation has significant health benefits, a 2016 study by a team of researchers from the United States, Spain, and France sought to explain how and why meditation actually works.

The study investigated the difference between “mindful meditation” in a group of experienced meditators vs. “quiet non-meditative activity” in a group of untrained control subjects. After eight hours of mindfulness practice, the meditation group showed a range of genetic and molecular differences, which in turn correlated with faster physical recovery from a stressful situation.

According to researchers, this is the first time a study has documented a rapid alteration in gene expression within meditating subjects. Interestingly, the researchers observed these changes in the SAME genes that anti-inflammatory and pain-killing drugs target! Thus, they speculate that mindful-based training may benefit patients with inflammatory conditions! This and prior studies have prompted the American Heart Association to endorse meditation as an effective cardiac preventative intervention.

Meditation has been found to be helpful for many conditions including stress management, lowering high blood pressure, heart disease, and depression. You can incorporate meditation into your life with three simple meditation exercises! The initial advice is “…go slow and be compassionate and gentle with yourself.” Your mind will try to wander (called our “default mode”) which consumes about half of our day, so try to focus (called “focus mode”)!

  1. WALKING MEDITATION: At a slow to medium pace, focus on your feet. Notice how your heel hits the ground and then feel the roll of your foot followed by the big toe pushing off prior to the swing phase. Feel for stones under the foot and other interesting sensations. If your mind starts to wander (default mode), gently bring your attention back to your foot (focus mode). You WILL get better with practice, and you’ll soon find it much easier to “focus” during stressful situations!
  2. NOVEL EXPERIENCES: It’s much easier to lose focus on the people you see everyday vs. those seen only one time a month. The next time you arrive home from work, pretend you haven’t seen your spouse/friend in 30 days. Give them your undivided attention. Then, try this on co-workers and other people you see every day. Believe me, they WILL notice a difference!
  3. GRATITUDE EXERCISES: When you’re not in their presence, focus on a person’s face and send them a “silent gratitude” for being in your life. Try this on family members, friends, co-workers, and others!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care, we would be honored to render our services.

  YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Low Speed Collisions – Where Does All That Energy Go?

20 Sep

You may have heard the comment, “If there’s no damage to the car, then there’s no injury.” Unfortunately, that does not always seem to be the case.

There are MANY factors that affect the dynamics of a collision and whether or not injury occurs. A short list includes: vehicle type and design, speed, angle of collision, momentum, acceleration factors, friction, kinetic and potential energy, height, weight, muscle mass, seat back angle and spring, head position upon impact, etc.

Consider Sir Isaac Newton’s Third Law of Motion: “For every action there is an equal and opposite reaction.” This law applies to a car accident at any speed. Using the analogy of hitting a pool ball into the corner pocket straight on, when the cue ball stops, its momentum is transferred to the target ball which accelerates at the same speed…hopefully into the corner pocket!

This example is not quite the same as an automobile collision because the energy transfer is very efficient due in part to the two pool balls not deforming (crushing or breaking) on impact with one another. If either ball did deform, more energy absorption would occur and the acceleration of the second ball would be lower.

In fact, in the United States, vehicle bumpers are tested at 2.5 mph with impact equipment of similar mass with the test vehicle’s brakes disengaged and the transmission in neutral. National Highway Transportation Highway Safety Administration (NHTSA) vehicle safety standards demand that no damage should occur to the car in this scenario.

However, energy transfer occurs very quickly and with a greater amount of force when there is no vehicle deformation (damage). As a result, a greater amount of energy (described as G-force) is directly transferred to the occupants inside the vehicle—increasing the risk of injury. A 1997 Society of Automobile Engineers article provided an example in which the same 25 mph (12 m/s) collision resulted in a five-times greater force on the occupants of the vehicle when the crush distance of the impact fell from 1 meter to .2 meters.

So be aware that even low-speed impacts can still place quite a bit of force on your body, even if the bumper of your car doesn’t have a scratch on it.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for Whiplash, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR WHIPLASH! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Hip Pain or Low Back Pain – Which One Is It?

19 Sep

Technically, the hip is the ball-and-socket joint between the long bone of the thigh and the pelvis; but more often than not, many people will point to a number of different places on their back or pelvis and say, “My hip is killing me” when it’s not really “the hip” at all!

Hip pain can be located in the front (groin area), the side, the back, or in the buttocks. The “classic sign” of hip pain is reproduced most consistently when you try to cross your legs—put your ankle on the far end of the thigh and then push down on your knee. This may feel tight and cause pain in the groin area. For many people, hip pain is also reproduced when they cross their legs and then pull their knee towards the opposite shoulder.

The hip is a VERY strong joint due to the deep receiving cup of the pelvis and the round ball that fits nicely into it. Because it’s a freely moving joint, there is a joint capsule. The capsule is lined with tissue that produces an oily substance that lubricates the joint (called synovial fluid), and when hip pain occurs, this can be caused by a capsulitis (inflammation of the capsule) with a buildup of synovial fluid (called synovitis).

When the smooth, shiny surface of the ball starts to wear thin (which can eventually wear away down to the bone), that’s a condition called “osteoarthritis.” This occurs over time for many and may eventually result in the need for a hip replacement. This usually isn’t needed until an individual is in their late 60s or older (if at all), but for those who injure a hip earlier in life, the “wearing out” process may accelerate and a hip replacement may be needed well before old age.

There are many studies that report low back and hip arthritis often occur together, and differentiating between the two can sometimes be a challenge. For example, pain can radiate from the hip to the knee, which many doctors will diagnose as “sciatic nerve.” But hip pain can present exactly the same, making it hard to determine if it’s low back-generated pain or hip-generated pain.

This is why it’s SO IMPORTANT that your doctor of chiropractic conduct a careful history and examination. There are specific tests that he or she will perform that help determine which of the two is causing the pain. There are times when they may find BOTH problems co-existing together, making it necessary to manage two problems, rather than just one.

There are many mobilization, manipulation, soft tissue therapies, modalities, and exercises available to patients with both hip and low back pain. So if you’re not sure what is bothering you and you don’t know what to do, visit your doctor of chiropractic and he or she will help you through this.

If you, a friend or family member requires care for hip pain, we sincerely appreciate the trust and confidence shown by choosing our services!

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR HIP PAIN! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

 

A Deeper Look into Headaches

14 Sep

Headaches are REALLY common! In fact, two out of three children will have a headache by the time they are fifteen years old, and more than 90% of adults will experience a headache at some point in their life. It appears safe to say that almost ALL of us will have firsthand knowledge of what a headache is like sooner or later!

Certain types of headaches run in families (due to genetics), and headaches can occur during different stages of life. Some have a consistent pattern, while others do not. To make this even more complicated, it’s not uncommon to have more than one type of headache at the same time!

Headaches can vary in frequency and intensity, as some people can have several headaches in one day that come and go, while others have multiple headaches per month or maybe only one or two a year. Headaches may be continuous and last for days or weeks and may or may not fluctuate in intensity.

For some, lying down in a dark, quiet room is a must. For others, life can continue on like normal. Headaches are a major reason for missed work or school days as well as for doctor visits. The “cost” of headaches is enormous—running into the billions of dollars per year in the United States (US) in both direct costs and productivity losses. Indirect costs such as the potential future costs in children with headaches who miss school and the associated interference with their academic progress are much more difficult to calculate.

There are MANY types of headaches, which are classified into types. With each type, there is a different cause or group of causes. For example, migraine headaches, which affect about 12% of the US population (both children and adults), are vascular in nature—where the blood vessels dilate or enlarge and irritate nerve-sensitive tissues inside the head. This usually results in throbbing, pulsating pain often on one side of the head and can include nausea and/or vomiting. Some migraine sufferers have an “aura” such as a flashing or bright light that occurs within 10-15 minutes prior to the onset while other migraine sufferers do not have an aura.

The tension-type headache is the most common type and as the name implies, is triggered by stress or some type of tension. The intensity ranges between mild and severe, usually on both sides of the head and often begin during adolescence and peak around age 30, affecting women slightly more than men. These can be episodic (come and go, ten to fifteen times a month, lasting 30 min. to several days) or chronic (more than fifteen times a month over a three-month period).

There are many other types of headaches that may be primary or secondary—when caused by an underlying illness or condition. The GOOD news is chiropractic care is often extremely helpful in managing headaches of all varieties and should be included in the healthcare team when management requires a multidisciplinary treatment approach.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for neck pain or headaches, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR HEADACHES! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

The Most Important Principles for Staying Young: How Not to Regain That Lost Weight

13 Sep

Our basic premise is that your body is amazing.  You get a do over. It doesn’t take that long, and it isn’t that hard if you know what to do.  In these notes, we give you a short course in what to do so it becomes easy for you and for you to teach others. We want you to know how much control you have over both the quality and length of your life.

If you’ve ever dropped some pounds only to pick every single one back up, then you know firsthand how tough it is to keep weight off once you’ve shed it. Just one in six overweight or obese people who slim down manage to stay that way!   Now, two reports reveal why—and what might help you convince Mother Nature (and your metabolism) to protect your weight loss.

First, there was the headline-grabbing study that tracked 14 Biggest Loser contestants for six years after their season on that wildly popular TV reality show. The contestants lost about 127 pounds apiece (yes, each lost about that) through strict diets and relentless exercise regimens. They radically reshaped their bodies. Some lost more than 200 pounds! And their health improved in countless ways.

Fast-forward six years. Most contestants regained much of the weight they’d lost—on average, about 90 pounds each (although many remained at least 10% slimmer than when they started the show, reducing their risk for diabetes, heart disease, joint pain, and other major health problems ).

A few contestants weighed more than they had before the show.  Why was weight maintenance so difficult?

The answer jumped out when researchers measured the contestants’ resting metabolic rate—the number of calories burned by the body ‘round the clock. The results were shocking. Before their participation in the show began, their metabolic rates were normal. Right after their appearance on the show ended, their metabolic rate had dipped. That was to be expected as it normally occurs following weight loss. But here’s the kicker…

Six years later, the contestants’ bodies were burning about 500 fewer calories every day than expected based on their age and body composition. Their post-weight-loss metabolic dip had never reversed itself. In some cases, a contestant’s metabolism slowed even more as the years went by. And as they gained weight back, their metabolism stayed sluggish. Mother Nature, it seems, was doing everything possible to make their bodies regain weight—a survival tool in prehistoric times of severe famine, a big challenge for 21st-century dieters!

This info coupled with other recent studies on metabolism and weight loss can help you succeed at a task that’s even tougher than losing weight: keeping it off.

Here’s what to do… You must build more muscle mass, especially as you age. Your muscles drive your metabolism, whether you’re sleeping or sweatin’ along to a YouTube exercise video.  The more muscle mass you have (usually), the higher your calorie burn rate. So the smart move is to lose weight slowly, preserving more muscle mass than extreme weight-loss programs allow.

Feed your muscles—then make ‘em work: During your weight-loss phase and afterward, be sure you’re building muscle as you lose fat and are eating enough protein (my favorites are nuts, beans, quinoa, egg whites, and salmon) to feed lean, sexy muscle. Build and maintain muscles with strength-training two to three times a week while losing and after.  Then, boost your metabolism further by adding short bursts of faster, higher-intensity aerobic activity to some of your cardio work-outs, going for 10,000 steps a day.

Try interval walking: Walk faster for 30 seconds, then back to your usual pace for a minute, repeat a couple of times.

And most importantly, keep the weight down for a year. That’s right, give yourself a year to let your new weight become your “new normal.” A recent University of Copenhagen study found that levels of the “feed me!” hormone ghrelin rise during weight loss, urging you to eat and making it tough to maintain a lower weight. But if you stick to your healthy eating and exercise plan it’ll get easier—we promise! The researchers found that ghrelin levels drop to normal about a year after weight loss.

Slash stress. Stress boosts your levels of the appetite-stimulating hormones.  Turn to exercise, progressive muscle relaxation (breathe calmly as you tense and relax muscle groups from your toes to your head), yoga, time with friends, and your favorite hobby to soothe stress instead of reaching for sweets and snacks.

Thanks for reading. Feel free to send questions—to youdocs@gmail.com, and some of them we may know enough to answer (we’ll try to get answers for you if we do not know).

Young Dr Mike Roizen (aka, The Enforcer)

 

 NOTE: You should NOT take this as medical advice. This article is of the opinion of its author. Before you do anything, please consult with your doctor.

 

You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week).  The YOU docs have tow newly revised books: The patron saint “book” of this column YOU Staying Young—revised and YOU: The Owner’s Manual…revised —yes a revision of the book that started Dr Oz to being Dr Oz.  These makes great gifts—so do YOU: ON a Diet and YOU: The Owner’s Manual for teens.  And, the new book by Dr Mike Roizen: This is YOUR Do-Over

 

Michael F. Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. His radio show streams live on http://www.radioMD.com Saturdays from 5-7 p.m. He is the co-author of 4 #1 NY Times Best Sellers including: YOU Staying Young.

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