Thursday, May 10, 2018

Back Pain: What Helps and What Doesn't

An important collection of papers published in research journal The Lancet highlight the global impact of low back pain, the ineffectiveness of current medical treatments, and the value of spinal manipulation and other nondrug options before turning to medication is receiving substantial media attention. One of the brightest spotlights: a "Health Alert" segment on a recent episode of "Good Morning America" titled "New Research on Lower Back Pain: Are Millions of People Getting Ineffective Treatment?"

"GMA" anchor Robin Roberts opened the segment with this statement to the show's estimated 4.5 million viewers regarding lower back pain: "As many as 540 million people suffer from it. According to new research, many treatments, [including surgery and pain medication] ... could be all wrong."
She then introduced Dr. Jennifer Ashton, chief health and medical editor for the show. Dr. Ashton, who described the papers as the "magnum opus on low back pain" and The Lancet as "very reputable," said the material "[draws] attention to the massive gap between evidence-based medicine and what's really going on" when it comes to the treatment of back pain.

According to Dr. Ashton, reporting on the papers, back pain is a "massive global public health burden." First-line treatments include staying active ("the worst thing you can do is get in bed") and education: learning "what works and doesn't from reputable sources." Second-line treatment options (Dr. Ashton urged viewers, "This is really what I want people to pay attention to") include superficial heat, spinal manipulation, massage and acupuncture. [Italics mine]

Good Morning America - Copyright – Stock Photo / Register Mark Dr. Ashton added that NSAID medication (nonsteroidal anti-inflammatory drugs, commonly available as over-the-counter pain meds such as Advil, Aleve, etc.) is also considered a second-line treatment according to The Lancet papers, but should be utilized "only if the other things are not working."

The Lancet content on lower back pain, published online on March 21, features two "series" papers, a "viewpoint" and a "comment," all of which are available in full-text format free of charge on the journal's website:
  • "What Low Back Pain Is and Why We Need to Pay Attention" (Series 1) (Hartvigsen J., et al.)
  • "Prevention and Treatment of Low Back Pain: Evidence, Challenges and Promising Directions" (Series 2) (Foster N.E., et al.)
  • "Low Back Pain: A Call for Action" (Viewpoint) (Buchbinder R., et al.)
  • "Low Back Pain: A Major Global Challenge" (Comment) (Clark S., et al.)
The "GMA Health Alert" on LBP is also available online in its entirety, and can be accessed by clicking here. To access the Lancet content, click the links above. To learn more about the value of chiropractic spinal manipulation for low back pain and why pain medication isn't your first option, talk to your doctor.

Thursday, April 12, 2018

Can Headaches Come From The Neck?



Headaches are a very common problem that can have multiple causes ranging from stress to trauma.  To make matters worse, there are MANY different types of headaches. One such type is the “cervicogenic headache” (others include migraines, cluster headaches, etc.). "Cervicogenic" means a headache caused by problems in the neck.

The main distinction between the symptoms associated with cervicogenic headaches and those associated with migraine headaches are a lack of nausea, vomiting, aura (a pre-headache warning that a headache is about to strike), light and noise sensitivity, increased tearing with red eyes, one-sided head, neck, shoulder, and/or arm pain, and dizziness. The items listed above are primarily found in migraine headache sufferers.   The following is a list of clinical characteristics common in those struggling with cervicogenic headaches:

·        Unilateral (one-sided) head or face pain (rarely is it on both sides).
·        Pain is localized or stays in one spot, usually the back of the head, frontal, temporal (side) or orbital (eye) regions.
·        Moderate to severe pain intensity.
·        Intermittent attacks of pain that last hours to days.
·        Pain is usually deep, non-throbbing, unless migraines occur at the same time.
·        Head pain is triggered by neck movement, sustained awkward head postures, applying deep pressure to the base of the skull or upper neck region, and/or taking a deep breath, cough or sneeze can trigger head pain.
·        Limited neck motion with stiffness.

Infrequently, the cervicogenic headache sufferer can present with migraines at the same time and have both presentations making it more challenging to diagnose.

The cause of cervicogenic headaches can be obvious such as trauma (sports injury, whiplash, slip and fall), or not so obvious, like poor posture. A forward head posture can increase the relative weight applied to the back of the neck and upper back as much as 2x-4x normal. Last month, we discussed the intimate relationship between the upper two cervical vertebra (C1 & C2) and an anatomical connection to the covering of the spinal cord (the dura) as giving rise to cervicogenic headaches. In summary, the upper three nerves innervate the head and any pressure on those upper nerves can result in a cervicogenic headache. Doctors of chiropractic are trained to examine, identify, and treat these types of potentially debilitating headaches.

Thursday, January 18, 2018

Smoking = Back Pain

If you're a current smoker, we hope you're speaking with a health care professional right now about how to quit. If you're not, we urge you to consider doing so, because your risk of suffering one or more of any number of diseases appears to increase dramatically if you're a smoker. In fact, even back pain occurs more frequently if you're a smoker, and the pain may lead to surgery.

Lumbar spinal stenosis, a condition characterized by spinal canal narrowing that causes low back pain due to the increased pressure on spinal nerves, appears to be more prevalent in smokers because nicotine constricts blood flow and promotes inflammation. In a study published in The Spine Journal, researchers discovered that smokers were more likely not only to suffer from lumbar spinal stenosis, but also to eventually undergo surgery for the condition. In fact, compared to nonsmokers, heavy smokers (15 or more cigarettes per day) were 46 percent more likely to undergo surgery, while moderate smokers (14 or less cigarettes daily) had a 31 percent higher risk and even former smokers had a 13 percent increased risk.

spine pain - Copyright – Stock Photo / Register Mark What's the takeaway? Smoking can lead to back pain requiring surgery, and the more you smoke, the worse the risk. And while even ex-smokers have a small increased risk compared to nonsmokers, it's significantly lower than the risk inherited by smokers. Just another reason to say no to smoking. Talk to your doctor about the smoking cessation program that's right for you.

Tuesday, November 28, 2017

Exercise: Back Pain's Kryptonite?

Eight in 10 people experience back pain at some point in their lives, and according to a recent Gallup survey, the statistics are even more concerning, particularly if you include neck pain in the conversation. Per the survey, back and/or neck pain has been an "ongoing problem" (lasting five years or more) in more than half of people who visited a health care professional in the previous 12 months for one or both of those complaints.

Now here's where it gets interesting. According to the same survey, nearly eight in 10 (78 percent) would rather try nondrug pain-relief options before using a prescription pain medication. (Chiropractic would be a great option, of course.) And to reduce pain intensity (or perhaps even prevent it from striking in the first place), here's a simple strategy to combine with your periodic chiropractic wellness care: exercise.

risk analysis - Copyright – Stock Photo / Register Mark Yes, research suggests people who exercise are less likely to develop low back pain – 33 percent likely, according to a review of 16 previously published studies published in the American Journal of Epidemiology. Exercises that strengthen and stretch the lumbar (low back) and abdominal muscles, or strengthening and aerobic exercises combined, seem to do the trick, according to the lead study author. And it gets better: Back pain severity and resulting disability were also lower in patients who exercised.

Thursday, October 26, 2017

Alternatives to Drugs and Surgery for Back and Neck Pain


It's a great time to visit your chiropractor, and a recent Gallup survey makes it clear: pain is a major issue for many people, and overwhelmingly, they would rather try nondrug pain-relief therapies such as chiropractic care versus pain-relieving medications. Well, they're in luck, because chiropractic offers the answer.

According to the 2017 Gallup-Palmer College of Chiropractic Annual Study of Americans, pain is an ongoing issue for many Americans, particularly neck and back pain (two conditions commonly treated by chiropractors): "About one in four adults in the U.S. (27%) have seen a healthcare professional for significant neck or back pain in the last 12 months. More than half of those adults (54%) have had an ongoing problem with neck or back pain for five years or more."

But medication is not the preferred option, particularly in light of the opioid epidemic: Nearly eight in 10 (78 percent) of Americans "prefer to try other ways to address their physical pain before they take pain medication prescribed by a doctor." And yet pain medications are still widely used: "Among those who have had ongoing neck or back pain for less than 12 months, seven in 10 have taken a nonsteroidal anti-inflammatory drug (NSAID), such as Advil®, aspirin or Aleve®, to manage the pain, and 45% have taken acetaminophen, such as Tylenol.®"

time for chiropractic - Copyright – Stock Photo / Register Mark So, let's sum up: Americans are in pain, don't want to take prescription pain medication, but often take over-the-counter pain medication. Sounds like it's time for chiropractic instead, especially in light of the fact that according to the survey, Americans perceive chiropractic as safer than both prescription and OTC medication and back surgery for neck / back pain.

Don't risk the potential side effects of pain medication – drugs that only temporarily relieve the symptom (pain) – when your chiropractor can relieve your pain without drugs while addressing the root cause of your problem. It's time for chiropractic.

Thursday, September 28, 2017

How Sleep Effects Back and Neck Pain

Not getting enough sleep – or not enough quality sleep that leaves you refreshed and ready to take on the day, rather than fatigued, irritable and ready to crawl right back into bed? A major health issue could be in your future: chronic pain. In fact, your odds of suffering chronic pain due to poor quality and/or quantity of sleep may increase by a factor of two or three compared to people who experience better sleep.

A large multi-national review of 16 studies spanning 10 countries and involving 61,000 participants arrived at this disturbing conclusion, with the lead study author even declaring that the impact of sleep on pain may be more significant than the impact of pain on sleep – often regarded as a major contributor to poor sleep.

poor sleep - Copyright – Stock Photo / Register Mark And that wasn't the only finding: Poor sleep also was associated with impaired responses to bacteria, viruses and other foreign substances, poor physical functioning, increased inflammation, higher cortisol levels, and other markers of pain, fatigue and overall compromised health.

Chronic pain isn't something to mess with, but you don't have to, thanks to your doctor of chiropractic. Discuss any pain you're experiencing and don't forget to mention any sleep issues. Whether poor sleep is causing your pain, or pain is causing poor sleep, your chiropractor can help determine the cause and correct it. Now that's called a win-win.

Thursday, August 3, 2017

Can Children Get Back Pain Too?

As adults, we get used to a variety of daily or near-daily aches and pains, particularly as we age. But what about our children? Don't they seem immune to many, if not all, of the pain complaints we have – despite the fact that for the most part, they're exponentially more active?

Maybe not. A study of schoolchildren ages 12-15 revealed a startling statistic: More than half (57 percent) reported experiencing back pain in the past year. As you might expect, "remaining seated at school" was a primary pain trigger, particularly for back pain lasting up to seven days.

These findings not only point to the universality of back pain – and the need for it to be addressed by qualified health care professionals such as doctors of chiropractic; but also the need to recognize and avoid situations that may increase the risk of experiencing an episode of back pain.

back pain - Copyright – Stock Photo / Register Mark For example, evidence implicates ergonomic flaws both in the school and workplace (desk / chair height, etc.) in back pain, not to mention carpal tunnel syndrome, neck pain and other conditions. What's more, the act of sitting alone creates undue stress on the spinal column and encourages poor posture whether at school, work or home, a major initiator of back pain and related conditions.

If anyone in your family is suffering from back pain, do something about it. Talk to your doctor about the potential causes and solutions.