Pain Relief Chiropractic

Low back pain (LBP) from a herniated disk often leads to surgical intervention. However, there are patients with this painful malady who can successfully “ride it out” and repeat MRI imaging six to twelve months later often fails to show little, if any, evidence of the original herniated disk that was initially very obvious. How is this possible?

The proposed theory is that there must be some unique interplay between molecular signals that might explain why some herniated disks heal themselves while others do not. Researchers at Vanderbilt University Medical Center are investigating this and published a report on their progress in the January 2016 issue of the Journal of Clinical Investigation.

LBP affects 60-80% of Americans during their lifetime, and there are upwards of 300,000 surgeries for herniated disks annually in the United States alone. A disk can herniate when its outer fibers tear or give way, allowing the semi-fluid center to leak out. If the herniated disk material hits the nerve root exiting the spine, the classic sciatica, or pain down the leg, can result.

Dr. Dan Spengler states that about 50% of patients with disk herniation will improve within six weeks, and the actual herniated material may completely resorb over time. What troubles Dr. Spengler and other researchers is why this doesn’t occur with everyone.

Looking specifically at the molecules that are frequently present when disks herniate, researchers have identified a group of proteins called matrix metalloproteinases (MMPs). Certain MMPs have the ability to act like “Pac-Man” and literally chew through other proteins making it highly suspect that MMPs may be at the forefront of why some disks resorb while others do not! Additionally, when a disk herniates, bleeding occurs and white blood cells—specifically macrophages, which are immune system cells in our blood that ingest foreign materials and bacteria—also flood into the area.

What most surprised the authors was the interplay between the macrophages and the MMPs. They found that when the blood/macrophages and one of two specific MMPs interacted in a very specific manner, disk resorption occurred and they were even able to replicate this process in a lab. They concluded the following, “These enzymes are more complicated and interesting than we originally thought. Rather than being big bulldozers, they’re a fine pair of scissors that cut certain things.”

The TAKE-HOME MESSAGE here is unless you are having progressive neurological loss (meaning muscle weakness or sensory pain that is progressing, and/or especially bowel or bladder weakness), there is NO RUSH to run and have surgery! Doctors of chiropractic can offer natural, non-invasive treatments to manage pain while you let your body manage the herniation!

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.

According to the National Institutes of Health, circadian rhythms include physical, mental, and behavioral changes that roughly follow a 24-hour cycle, responding largely to environmental light and darkness. Most living things possess this trait including animals, plants, and many microbes.

So how does this relate to low back pain? Recent studies reveal that the intervertebral disk (IVD)—the “shock-absorbers” located between our vertebrae in our spine—contain intrinsic circadian clocks that are regulated by age and cytokines and are linked to degeneration. This means we have a 24-hour rhythm producing various changes in an organized way throughout the day in each of the disks in our spine!

Researchers have found at least 600 genes with 24-hour patterns of expression representing several essential pathways associated with disk pathology. In experiments on mice, scientists have observed that when the normal expression of these genes is disrupted, disk degeneration may occur. The study concludes, “These results support the concept that disruptions to circadian rhythms may be a risk factor for degenerative IVD disease and low back pain.”

So what can we do about this? These findings support an important concept that improves overall health, quality of life and longevity: our sleep habits! We know our circadian rhythms influence sleep-wake cycles, hormone release, body temperature, and many other important bodily functions and are linked to various sleep disorders.

Researchers have linked abnormal rhythms with obesity, diabetes, depression, bipolar disorder, and seasonal affective disorder (SAD), to name a few. We also know how we feel when we fly from California to New York and the alarm rings at 7am in NYC but our biological clock says 4am!

The importance of sleep cannot be overstated. Longevity is shortened when sleep duration is altered (either too little OR too much sleep) and we know quality of life is negatively affected in swing-shift workers. Now, we’ve learned that the cells in our disks also have a circadian rhythm, and alteration of that rhythm can lead to disk degeneration resulting in low back pain!

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

Have you ever wondered “What type of mattress is best for my back?” Between the many types of mattresses available on the market—foam, coiled, water, as well as combinations of all these, not to forget further options between soft, medium, or firm—where do we begin? All of these variables make finding the right one truly difficult!

An orthopedic surgeon survey found that 95% of the surgeons polled believed that the mattress played a role in back pain management, and 76% recommended a firm mattress. But is this supported by research?

In an Oklahoma State University study, researchers provided 59 healthy people whose beds were at least five years old with new beds featuring a medium-firm, foam-encased spring mattress. ALL the study subjects said they had less back pain, less shoulder stiffness, improved sleep quality, and greater comfort after 28 nights on the new beds. However, when these researchers reviewed prior studies that compared foam vs. coil vs. water beds, the reviews were mixed, raising the question, “Would any new bed be better than an old one?”

Several studies have measured the difference between mattresses—including a chiropractor-led study that looked at two factors: spinal distortion and maximum pressure. The researchers concluded that the two goals of a mattress were to exhibit LOW maximum pressures and LITTLE spinal distortion.

Another study, this time from a team of South Korean researchers, found that participants gave the highest ratings when their spinal curve while lying down was similar to their standing spinal curve. This prompted a six-day/night follow-up study where researchers measured brain waves, eye movements, heart rhythm, chin movements, and body temperature overnight in a sleep laboratory. They found that sleep efficiency and deep sleep percentages were higher AND the participants woke up less often when the participant rated the mattress as “comfortable”.

A Spanish study found a connection between higher comfort scores how well the pressure of a user’s body distributed over the mattress.

Another study that included 313 adults with chronic low back pain divided participants into two groups that slept on either a medium-firm or a firm mattress for 90 days. The study found that those on the medium-firm mattress had the best outcomes for pain in bed, pain on rising, and disability.

So after ADDING up ALL these findings, it appears that doctors should recommend a mattress that does not distort the spine, distributes weight evenly, and is medium-firm in density.

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

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.

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

Last month, we reviewed studies that compared chronic low back pain (cLBP) exercisers to non-exercise control groups and examined how those in the exercise groups experienced significant improvements in pain and disability/function compared with those who remained inactive, regardless of the type of exercise. We also reviewed a few popular Swiss or gym ball exercises. This month, we will introduce some core stabilizing exercises that can be done on the floor.

There are benefits to Swiss ball exercises like balance or proprioception stimulation. In fact, five minutes of ball exercises equals 35 minutes of floor exercising when focusing on balance or proprioception. It is a well-known fact that as we age, we lose our “kinesthetic sense”, or balance skills, so incorporating balance into any exercise program is a good idea!

However, the “con” of Swiss ball exercises is convenience, as such a piece of equipment is less portable. We cannot easily travel with a gym ball, but we all have access to the floor regardless of our location. Also, with exercises performed on the floor, you can achieve stronger muscle contractions due to greater stability. Ideally, MIX the two together! Also, include a 20-30 minute brisk walk for aerobic benefits!

Here are some great floor core stabilization exercises (try holding for 5-10 seconds, repeating 5-10 times, whatever is tolerated):

• Pelvic tilts – First, with the knees bent about 90° with your feet on the floor, flatten your low back against the floor by rocking your pelvis back.
• Dead Bug – On your back with hips and knees both bent 90° (like sitting in a chair on your back), straighten out the right arm and left leg simultaneously and alternate sides SLOWLY.
• Superman – Lay on your stomach with your arm and legs stretched our (like “Superman” flying). Raise one arm and the opposite leg (i.e. right arm/ left leg) and slowly alternate between the other opposing pair. Make it harder by raising BOTH arms and legs at the same time! NOTE: A pillow under the waist helps.
• Bridge – Lay on your back with your knees bent. Lift the buttocks off the ground and push your heels into the floor. Do one leg at a time to make it more challenging.
• Sit-ups – There are three leg positions to make it progressively harder (knees bent/feet flat on floor, knees & hips both bent 90°, etc.). Lift your breast bone towards the ceiling and alternate between coming straight up and left and right trunk twists.
• Side Bridge (Plank) – If no shoulder problems exist, lay sideways propped up on an elbow and lift the hips off the floor to a straight body position.
• Standing squats – Try a quarter, half, or full squat (knee pain dependant) with or without hand weights and with or without a ball squeezed between the knees. Lunges can be substituted or added, if desired.
• 4-point Quadruped – Kneeling on all fours, straighten out the right arm / left leg and alternate. At the same time, suck in your belly (“abdominal hollowing”) to facilitate the deep transverse abdominis and multifidus muscles. Add a dynamic component by rotating the trunk and approximating your hand to the floor / opposite leg up in the air keeping the body in a straight line.

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 back pain, we would be honored to render our services.

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