New research published this month in the Annals of Internal Medicine finds spinal manipulative therapy (SMT) and exercise more effective at relieving neck pain than pain medication. The study divided participants into three groups that received either SMT from a doctor of chiropractic, pain medication (over-the-counter pain relievers, narcotics and muscle relaxants) or exercise recommendations. After 12 weeks, about 57 percent of those who met with DCs and 48 percent who exercised reported at least a 75 percent reduction in pain, compared to 33 percent of the people in the medication group. After one year, approximately 53 percent of the drug-free groups still reported at least a 75 percent reduction in pain; compared to just 38 percent pain reduction among those who took medication.

The study, funded by the National Center for Complimentary and Alternative Medicine and co-authored by ACA’s 2011 Researcher of the Year Dr. Roni Evans, is making headlines across the country. The results of the study have appeared in AARP Blog, The New York Times, the Wall Street Journal, WebMD and “World News with Diane Sawyer” among other media outlets.

With this heavy heavy snow we are having in October, I thought this would be good to repost

Chiropractic Tips for Snow Removal
Winter is here and snow removal is a major problem for many people. The following tips are offered for shoveling driveways and walks:

1. Warm up: Before beginning any snow shoveling, warm-up for five to ten minutes to get the joints moving and increase blood circulation. To do this march on the spot, climb stairs, or go for a quick walk around the block. Follow this with gentle stretches for the back (knee to chest), arms and shoulders (body hug), and legs (forward bends from a seated position). This will ensure that your body is ready for action.
2. Don’t let the snow pile up: Removing small amounts of snow on a frequent basis is less strenuous in the long run.
3. Pick the right shovel: Use a lightweight, non-stick, push-style shovel.
4. Use non-stick cooking spray or WD-40 on the shovel to avoid the snow from sticking to it.
5. Push, don’t throw: Push the snow to one side and avoid throwing. If you must throw, avoid twisting and turning. Position yourself to throw straight at the snow pile.
6. Bend your knees: Use your knees, leg, and arm muscles to do the pushing and lifting while keeping your back straight.
7. Watch for ice: Course sand, ice salt, ice melter, or kitty litter can help give where you walk and drive more traction, reducing the chance of a slip or fall.
8. Wear proper footwear: Shoes and boots with solid treads on the soles can help to minimize the risk of slips and falls.
9. Take a break: If you feel tired or short of breath, stop and take a rest. Make it a habit to rest for a moment or two for every 10 to 15 minutes of shoveling. This is especially important if the snow is wet and heavy. Stop shoveling immediately if you feel chest or back pain.

And consider this before shoveling

Those most at risk for a heart attack include:

Anyone who has already had a heart attack.
Individuals with a history of heart disease.
Those with high blood pressure or high cholesterol levels.
Smokers.
Individuals leading a sedentary lifestyle.

If you are inactive and have a history of heart trouble, talk to your doctor before you take on the task of shoveling snow.

Be heart smart! Don’t eat or smoke before shoveling snow. Avoid caffeinated beverages. These are stimulants and may increase heart rate and cause blood vessels to constrict.

If you experience pain of any kind, stop immediately and seek assistance. If you do overdo it, your chiropractor can help you feel better and prevent more injury.  Complete Chiropractic Allentown Chiropractor

Migraines can be a debilitating and frustrating  problem.  The cause is not always known and there are lots of different triggers to cause the migraine.  Migraines can make it so that you can not function and can last up to 72 hours (3 full days).  Often times you have both light sensitivity and sound sensitivity so that you can not work, read, or watch tv.   Medications can help, but not always the same medication will work for everyone and not all the time.

Please note exercise, proper posture, looking for food triggers and nutrition, stress reduction, and chiropractic can also help with migraines.

For more information about headaches and migraines and chiropractic, please visit Headaches – Complete Chiropractic Allentown, Pa

Below is an excerpt  of an article going over medication and natural supplements.

Full article is here

Prevention of Migraine Headache

This information is provided to you for use in conjunction with your clinical judgment and the specific needs of the patient.

Dwain M. Daniel, D.C.

A very recent review of prophylaxis of migraine was published in the Canadian Medical Journal (1).  To say the least, their findings were remarkable.  Although this was a medically oriented review, several herbal and nutritional approaches were rated as effective as drug therapy with significantly fewer reported adverse events.  Table 1 is a summary of the findings of the review for interventions when the outcome measure used was the odds ratio of a 50% decrease in frequency of migraine.  All findings were based on studies that were graded by the authors as A or B evidence based on the United States Preventive Services Task Force criteria.

Pharmaceutical interventions are obviously favored by the medical community even when, at least according to this review, riboflavin and butterbur demonstrate equal or superior effectiveness in A graded studies yet report infrequent adverse effects.

Butterbur:  A 2006 systematic review reported on 2 randomized trials (RCT) of butterbur extract (Petasities hybridus) which totaled 293 patients.  In these studies a 150 mg dose of butterbur was more effective than a 100 mg dose over a period of 3 to 4 months.  Overall butterbur demonstrated a decreased frequency of migraine in over 50% of patients.  The brand name of the form of butterbur used in this study was Petadolex (2).  In an open label study of 109 children and adolescents the authors found 77% of all patients reported at least a 63% reduction in the frequency of migraine (3).  Although no significant adverse effects have been reported in the studies mentioned above, concerns relating to hepatotoxicity have been reported in the literature.  A recent study utilizing Petadolex found it to be “free of signals for drug induced liver injury” (3).  Several authors have suggested butterbur may be a valuable tool in the prevention of migraine (4-7).

Feverfew:  Feverfew is herb that has demonstrated effectiveness in the prevention of migraine in some studies and conflicting results in other studies.  Three Cochrane reviews have been published relating to feverfew.  The original review could not demonstrate efficacy for feverfew (8) but an update published the same year reported “feverfew is likely to be effective in the prevention of migraine (9).  The third review returned to the original position stating “there is insufficient evidence” to suggest an effect (10).  A separate article suggested the reason for lack of efficacy reported in the most recent Cochrane review was the 400% variation in the active ingredient in the studies evaluated (5).  One RCT published after the Cochrane reviews showed migraine attacks decreased from 4.76 attacks per month to 1.9 when using MIG-99 after 3 months.  A dosage of 6.25 mg t.i.d. were used (11).  All studies reported a favorable safety profile.

Coenzyme Q10:  Coenzyme Q10 has demonstrated efficacy in 1 RCT and several open trial design studies.  The RCT was a study of 42 patients.  The dosage was 100 mg t.i.d. There was a 50% decrease in headache frequency in 42.6% of the patients in the active treatment group compared to 14.4% in the placebo group after 3 months.  The number needed to treat was 3 (12).  Another case series found similar benefits using 150mg daily (13).  None of the studies on coenzyme Q10 reported adverse effects.

Riboflavin:  A RCT compared a combination of riboflavin (400 mg), magnesium (300 mg) and feverfew (100 mg) to 25 mg of riboflavin.  Both groups achieved statistically significant improvements over baseline.  The authors noted both groups exceeded the normal placebo response reported in other migraine prevention studies.  This study suggests a small dose of riboflavin may be an effective prophylaxis for migraine (14).  Another RCT using 400 mg daily reported statistically significant improvements in headache frequency and headache days after 3 months.  The number needed to treat in this study was 2.3 (15).  Unfortunately 2 studies of riboflavin in children did not demonstrate improvement (16;17).

Magnesium:  A 2008 RCT examined the prophylactic effect of 600 mg of magnesium citrate daily for 3 months compared to a placebo.  Statistically significant improvements in frequency and severity were found in the treatment group.  Additionally cortical blood flow increased significantly in the treatment group (18).   A second RCT also found a statistically significant decrease in migraine frequency after 3 months using  360/mg per day (19).  Not all RCTs have shown magnesium to be of effective.  A 1996 RCT  found no benefit when using magnesium (20).  Soft stools and diarrhea were a common mild adverse event occurring in 18.6% (19) to 47.7% (20) in the magnesium groups.

Click to find rest of the article

Note:  Should be used topically only!!!.  Orally has shown some mutagenic properties with a chemical in it, pyrrolizidine alkaloids (PA).

Some manufacturers claim their topical creams are PA free.

Comfrey Root has been used for a long time for wounds and sprains/strains. Recently research has been done to show effectiveness.

There are several alternatives to normal pain medicine for relief.  Bromalain is also a very good anti-inflammatory.  Herbs can have less side effects than medication, but they do have possible issues.  They can interact with certain drugs and certain people can be allergic to comfrey root.

Herbs should be used under supervision of an educated healthcare practitioner and you should inform your primary care physician of all herbs/supplements because of possible interactions with medications.

Some people  do not want to discuss alternative treatments they are doing with their primary physician because they might think they would get lectured or thought of differently.  More and more research is showing benefits to ‘main stream’ medicine and your doctor most likely is embracing this.

From

http://www.chiroaccess.com/Articles/Comfrey-Root–Evidence-Based-Safety-and-Effectiveness.aspx?id=0000306

Comfrey root has been used for centuries in the treatment of wounds and sprains and strains (1).  Yet, in spite of common usage, Medline did not index a clinical trial relating to comfrey until 2001 (2)  .  Since then 6 additional trials have been published which provide valuable evidence relating to the safety and effectiveness for several conditions which are common in chiropractic practice (3-8) .

Possibly the greatest obstacle to the wide spread use of comfrey is the concern over the presence of pyrrolizidine alkaloids (PA) in comfrey root which have demonstrated hepatotoxic, carcinogenic and mutagenic properties in oral preparations (9).  For this reason only topical preparations are considered safe.  Some manufacturers claim their product is PA free (9;10).

Back Pain:  The effectiveness of comfrey root extract was recently demonstrated in a double blind randomized clinical trial (RCT) with 120 subjects over 5 days for acute upper and lower back pain.  The primary outcome measure was the visual analog scale (VAS) on active movement.  Included in the secondary outcome measures were the VAS during rest.  The treatment group experienced a 95.2% decrease in pain while the placebo group experienced a 37.8% decrease in pain.  Dosage of comfrey root ointment was 4 grams of ointment 3 times per day.  The authors concluded the results were “clear cut and consistent” and reported improvement began within 1 hour of application (4).  An earlier RCT of 215 patients compared a 10% comfrey ointment to a 1% ointment.  Pain on motion, rest and palpation was significantly improved in the 10% cohort for upper and lower muscular back pain.  Tolerability of the comfrey was good to excellent in all patients (7).

Osteoarthritis:  In 2007 another RCT investigated the effectiveness of a comfrey root ointment in the treatment of knee osteoarthritis over a period of 3 weeks.  This study enrolled 220 subjects with an average age of 57.9 years.  Dosage in this trial was 2 grams 3 times per day.  In this study the VAS dropped 54.7% in the treatment group and 10.7% in the placebo group.  Statistical significance was achieved (p<.001).  Additionally statistically significant improvements were noted in quality of life, mobility, and physician and patient assessment.  There were no adverse reactions reported (5).

Ankle Sprain:  Three separate studies have demonstrated the effectiveness of comfrey root ointment in the treatment of acute ankle sprains.  In one observational study 492 questionnaires were returned from patients with ankle sprains and their physicians.  Overall 45-47% improvement in pain and tenderness was observed (3).  Two other RCTs with 162 and 142 patients respectively found comfrey root to be superior to the placebo in 1 study (6) and equal in effectiveness to Diclofenic gel in the other (8).  Of interest in the Diclofenac study was the author observation that comfrey root may actually be superior based on primary and secondary variables.

It should be noted that many of the clinical trials referenced above were funded by product manufacturers.  The physician should be alert to possible bias in these studies as a result.

Note:  These mini-reviews are designed as updates and direct the reader to the full text of current research.  The abstracts presented here are no substitute for reading and critically reviewing the full text of the original research.  Where permitted we will direct the reader to that full text.

Come Join us if you can for the 2011 Buddy Walk supporting the National Down Syndrome Society.  We will be there if it is raining or sunny.

Thanks

Walk Details: Eastern PA Down Syndrome Center Buddy Walk

A recent research article published in the peer-reviewed journal JMPT,  helps show what chiropractors and others have been saying and seeing for years; that both structural changes in one area can effect  areas above and below and neurological changes (changes in nerve firing)  effects different areas.  In this study, patients that had outside elbow pain had a significant decrease in measurable pain to touch with their neck adjusted (cervical manipulation) with also decrease in mid back adjustment (thoracic manipulation) but not as much as the neck.  Basic anatomy shows that the nerves sending signals of pain (and others) go into the spinal cord at the cervical region (neck).  This study is showing that if there is a restriction at the neck this can effect the nerves entering from the elbow and by removing that restriction (and irritation to the nerve where it enters)  that you can have decreased pain at the elbow.

Examination of Motor and Hypoalgesic Effects of Cervical vs Thoracic Spine Manipulation in Patients With Lateral Epicondylalgia: A Clinical Trial

Abstract

Objectives

The purpose of this study was to compare the effects of a cervical vs thoracic spine manipulation on pressure pain threshold (PPT) and pain-free grip strength in patients with lateral epicondylalgia (LE).

Methods

A single-blind randomized clinical trial was completed with 18 participants with LE. Each subject attended 1 experimental session. Participants were randomized to receive either a cervical or thoracic spine manipulation. Pressure pain threshold over the lateral epicondyle of both elbows pain-free grip strength on the affected arm and maximum grip force on the unaffected side were assessed preintervention and 5 minutes postintervention by an examiner blind to group assignment. A 3-way analysis of variance with time and side as within-subject variable and intervention as between-subject variable was used to evaluate changes in PPT and pain-free grip.

Results

The analysis of variance detected a significant interaction between group and time (F = 31.7, P < .000) for PPT levels. Post hoc testing revealed that the cervical spine manipulation produced a greater increase of PPT in both sides compared with thoracic spine manipulation (P < .001). For pain-free grip strength, no interaction between group and time (F = .66, P = .42) existed.

Conclusions

Cervical spine manipulation produced greater changes in PPT than thoracic spine manipulation in patients with LE. No differences between groups were identified for pain-free grip. Future studies with larger sample sizes are required to further examine the effects of manipulation on mechanisms of pain and motor control in upper extremity conditions.

Many of you have heard the term back pack safety but do you know how your child should be using their backpack? Aches and pains, injuries and even potential future problems in young children can often be attributed to the incorrect use of back packs.

“In a recent survey by the American Academy of Orthopedics, 71% felt that backpacks are a clinical problem for children and 58% of the doctors reported seeing youngsters whose back and shoulder pains could be attributed to carrying backpacks that were too heavy for them.”

Tips for back pack safety

• · Children should carry no more than 5-10% of their body weight (adults up to 15%)
• · Keep the heaviest items closest to the back
• · Distribute the load evenly from left to right
• · Use both shoulder straps
• · Strengthen the lower back and abdominal muscles
• · Use the waist strap if the bag has one
• · Adjust backpack so the bottom of the bag is about 1-2 inches above waist

What To Look For In a Backpack

• · Wide, heavily padded shoulder straps that are easy to adjust
• · Waist straps to keep the backpack fitting close to the body
• · Separate compartments to help distribute the load evenly
• · Try it on for comfort to see how it feels

My Child Has Back Pain, Now What?

If the pain is gone by Monday morning, this is a good sign the backpack was causing the problem.  Follow guidelines given in this article.

Heavy backpacks can cause postural distortions in your child’s spine that may cause pain or lead to pain in the future.  Have your child evaluated by a chiropractor to check for scoliosis or any other structural problems.

Whether your child has back pain or not, an ill-fitting or incorrectly worn backpack can cause stress on the body that may not show up for years.

From  http://www.uschirodirectory.com

Based upon the Joint Report to the Governor (2009) and the statistics rendered by Cifuentes et al. (2011), the savings with chiropractic care utilized exclusive from medicine and physical therapy ranges from $1,759,942,556 with physical therapy to $3,983,027,890 with medicine. Understanding that most medical physicians utilize physical therapy as a primary tool for back related pain, we will average the savings to $2,871,485,223 by utilizing chiropractic care.

Cifuentes et. al (2011) started by stating, “Given chiropractors are proponents of health maintenance care…patients with work related Low back pain who are treated by chiropractors would have a lower risk of recurrent disability because that specific approach would be used (p. 396). They concluded by stating, ” After controlling for demographic factors and multiple severity indicators, patients suffering nonspecific work-related LBP who received health services mostly or only from a chiropractor had a lower risk of recurrent disability than the risk of any other provider type (Cifuentes et. al, 2011, p. 404).

Work Related Injuries, Recurring Low Back Pain, Chronic Care and Chiropractic Treatment:

A Proven Solution to Save Federal, State and Private Insurers $2,871,485,223

Workers Compensation Boards, public and private insurers and governmental agencies who assume the risk of the injured have an underutilized avenue to save billions. It is called chiropractic care.

In difficult economic times, politics and special interests are driving the cost of healthcare upwards to maintain the status quo. I urge you to share this will your local, state and federal elected officials so that we can contain healthcare costs, lower insurance premiums and lower our taxes. A more cost effective solution to one of the most common symptoms seen in a doctor’s office will end up saving you money.

To learn more, click on the link below or copy and paste to your Web browser.

Click below or copy:

http://www.uschirodirectory.com/index.php/chiropractic-research/item/305-work-related-injuries-recurring-low-back-pain-chronic-care-and-chiropractic-treatment-a-proven-solution-to-save-federal-state-and-private-insurers-2871485223-

This research is offered as a community service

from our office.