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.

Does Maintained Spinal Manipulation Therapy for Chronic Nonspecific Low Back Pain Result in Better Long-Term Outcome?

Senna, Mohammed K. MD; Machaly, Shereen A. MD

Chiropractic care is standard for many pro golfers and increasingly for many Senior Golfers as well. Professional golfer Lori West attributes the reason she’s playing today to chiropractic. Nearly two decades ago, she began visiting a chiropractor for pain in her shoulders and neck. According to West, the care has infinitely improved her golf game.

The problem is that the golf swing, in and of itself, isn’t conducive to having a healthy back. To have a good swing you create tension in your spine. (This enables you to get good distance). The tension comes from the hips stopping and the shoulders continuing to rotate. Basically, you make a coil. You’re uncoiling when you start your downswing. Since that’s an awkward movement for your back, many golfers end up with lower back problems.

Here’s some chiropractic advice.

• Before your game, do some basic stretches. Stretch out hamstrings and groin area.

• Put a club across your shoulders and lean left and right.

• Get in a position of where you would be in a swing and bend left and right.

• Grab a club behind your back and raise it up, stretching your shoulder muscles.

• Grab the club backwards – so if you normally swing right-handed, you’d grab it like you’d be swinging left-handed- and take 10 practice swings that way. You’re stretching different muscles and it will help you loosen up considerably.

• Do neck stretches. Stiff neck muscles inhibit the rest of the body from turning freely.

Anything that helps your flexibility eventually helps with your game. As you get older, your swing naturally shortens since the muscles aren’t as supple. During the winter, work on stretching the muscles of the arms, shoulders and back. Flexibility is very important for older golfers.

Also, you have to have good balance if you want to hit the golf ball consistently. A healthy spine is paramount to proper balance and posture. Improve your balance and you’ll improve your consistency. In needed, orthotic stabilizers for your shoes can help improve balance so your swing is better.

Chiropractors care for your body as a whole, not just the back. So if your golf game is feeling out of sync, chiropractic may be just the very adjustment that your body and game needs!

The American Pregnancy Association recommends chiropractic care during pregnancy.

Please visit their website for more information

http://www.americanpregnancy.org/pregnancyhealth/chiropracticcare.html

or please contact me if you have any questions on pregnancy and chiropractic.