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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.

 

Avoiding Chronic Pain After an Auto Injury

Approximately 2.3 million people are injured every year in car accidents in the U.S. While most people are able to heal from their injuries relatively quickly, too many people are left to deal with chronic pain and disability. We see many of these patients here in our Redondo Beach office. Thankfully, Dr. Kari Hawkins is here to help you heal from your auto injury.

The science confirms what we see in our office: A British study was carried out on 28 men and women diagnosed with chronic whiplash pain. Each participant received chiropractic adjustments and 93 percent of them experienced improvements following their adjustments, even though 43 percent of whiplash sufferers overall usually never find relief. This confirms that chiropractic is a great way to avoid chronic pain after an auto injury.

It's important to note that studies have also found that putting off care after a car crash can adversely affect healing time, so getting in to see Dr. Kari Hawkins immediately is key to having a speedier recovery.

Dr. Kari Hawkins has worked with many auto injury sufferers, and we're here to help you, too. Call our Redondo Beach office today for more information or an appointment.

References

  • Association for Safe International Road Travel. Retrieved from http://asirt.org/initiatives/informing-road-users/road-safety-facts/road-crash-statistics
  • Dies S & Strapp J. (1992, September). Chiropractic treatment of patients in motor vehicle accidents: a statistical analysis. The Journal of the Canadian Chiropractic Association, 36(3), 139-145.
  • Woodward M et al. (1996, November). Chiropractic treatment of chronic 'whiplash' injuries. Injury, 27(9), 643-645.
 

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.

 

Chiropractic Cuts Headache Pain By 71%

Trigger point therapy reduced cervicogenic headache pain by 71% for patients in a new study. The patients also experienced a 59% reduction in neck pain symptoms, as well as improved range of motion and muscle function.

Trigger point therapy is a treatment commonly used by chiropractors to relieve trigger points (TrPs), or hyperirritable spots of pain located in taut bands of skeletal muscles. Earlier research has shown that chiropractic spinal adjustments are effective for cervicogenic headache, but few studies have tested the efficacy of trigger point therapy for the condition.

In a new preliminary study, researchers tested the effects of trigger point therapy for the treatment of cervicogenic headache. Twenty patients were randomly assigned to receive either trigger point therapy (TrP therapy) or a sham treatment for three sessions during a one week period. The treatments were applied to active trigger points located in the neck.

Patients receiving TrP therapy experienced markedly better outcomes than the sham group. TrP therapy patients had significantly improved neck range of motion and increased functioning of the deep cervical flexor muscles. They also had substantially reduced pain sensitivity, neck pain, and headache. On average, patients' headache pain scores dropped from a 7.6 out of 10 to a 2.2, or about a 71.1% reduction. Their neck pain scores also decreased from a 7.4 to a 3.0 after treatment, or about a 59.5% reduction.

More research is needed to understand why TrP manual therapy lead to these improvements. It has been hypothesized that trigger points play a role in the development of headache, since earlier studies have reported trigger points present in patients with tension headache, cluster headache, and migraine. However this is one of the first studies to confirm the presence of trigger points in people with cervicogenic headache, and to suggest that trigger point therapy can help.

Chiropractors frequently use trigger point therapy in conjunction with spinal adjustments, spinal mobilization, and exercise rehabilitation. This study adds further evidence of the efficacy of chiropractic care for cervicogenic headache.

Reference

Bodes-Pardo G, et al. Manual treatment for cervicogenic headache and active trigger point in the sternocleidomastoid muscle: a pilot randomized clinical trial. Journal of Manipulative and Physiological Therapeutics 2013; doi 10.1016/j.jmpt.2013.05.022.

 

Chiropractic Reduces Health Care Costs

Recent data suggests that expanding insurance coverage of alternative therapies like chiropractic could drive down overall health-care costs. A new study, published in the January 2013 issue of Health Affairs, provides further information into expenditure patterns and utilization of complementary alternative medicine (CAM). Since chiropractic is the predominant source of CAM utilization, the study sheds light on how chiropractic can contribute to patient savings.

According to the study, between 2002 and 2008 the use and spending on CAM services, which had previously been rising, largely plateaued. This suggests that “Any attempt to reduce national health care spending by eliminating coverage for complementary and alternative medicine would have little impact at best." According to the authors, cutting coverage for CAM and chiropractic services could even have the opposite effect, since excluding services currently covered by private and public insurance could “trigger increased spending.”

The analysis of the Medical Expenditure Panel Survey revealed a trend towards increased usage of CAM services, up 6% from 2002 to 2008. In 2002, there were an estimated 15.2 million adult users; this increased to 16.1 million in 2008. The number of chiropractic patients increased from 11.5 million in 2002 to 11.9 million in 2008, while acupuncture saw a 16% increase in adult visits.

Despite the increasing number of patients, total visits to chiropractors and other CAM providers decreased. Chiropractic visits decreased by 3%, from 98.6 million visits in 2002 to 96.1 million in 2008. Acupuncture visits decreased 16% over the same time period, from 6.4 million to 5.4 million. According to the study authors, “The higher proportion of out-of-pocket responsibility for payment for services may explain the lack of growth.”

The study also investigated the costs associated with chiropractic and other CAM services. Expenditures on chiropractic care increased from $6.2 billion in 2002 to $6.9 billion in 2008. Meanwhile, expenditures on acupuncture, massage, and other CAM treatments remained stable.

This data has important implications for national health-care policy. In their attempt to reduce waste, health-care policy makers often target complementary and alternative medicine services for exclusion. However, this tactic would, at best, result in only a small cost savings. Since CAM appears to be relatively inexpensive when compared with allopathic treatments, if medical providers are able to collaborate with local CAM providers, offering alternative and complementary medicine services could help health-care policy makers achieve their goals of cost savings.

The researchers conclude that health-care policy makers should consider the potential offset effect, in which patients substitute the excluded services with other services, which are covered by their health insurance, at an increased cost.

This study comes at the heels of another recent study suggesting that chiropractic patients have lower annual medical costs than patients in traditional care.

Reference

Davis MA, et al. U.S. spending on complementary and alternative medicine during 2002-2008 plateaued, suggesting role in reformed health system. Health Affairs 2013;32(1):45-52.