Could Chronic Low Back Pain Lead to a Stroke?

Chronic low back pain, or LBP that lasts for more than about three months, often means it's been ignored for some time, or masked with over-the-counter / prescription medications instead of a proven option such as chiropractic. Think you can just fight your way through back pain, day after day, month after month, even when it becomes chronic? After all, if you can put up with the pain, what else can go wrong? How about a stroke?

Yes, chronic low back pain may increase stroke risk, suggests a new study published in Clinical Neurology and Neurosurgery. The study compared more than 10,000 chronic LBP patients with 20,000-plus patients without low back pain, finding that over an eight-year tracking period, chronic LBP patients  had significantly higher risks of suffering any type of stroke or one of two specific types of stroke: hemorrhagic and ischemic. (The increased risk associated with ischemic stroke was the most significant, according to the authors' findings.) Interestingly, the increased risk was highest in patients under age 50.

With that in mind, let's revisit the all-too-common reality of chronic low back pain: often ignored, endured or masked (but not appropriately treated) with pain medications.  For these people, is a stroke in their future? According to recent statistics, that means an estimated 8-10 percent of U.S. adults could be at risk. And don't forget that an estimated 80 percent of adults experience at least one episode of low back pain during their lifetime. Without appropriate care, that episode could become chronic as well.

It's time for a safe, effective solution to low back pain; a solution that addresses the cause, not just the symptoms. It's time to manage back pain before it ever has a chance of becoming chronic. It's time for chiropractic – before your low back pain leads to a stroke. Talk to your doctor for more information.

Headaches and Back Pain- Treat Both!

Can't seem to shake that back pain?

Continually plagued by headaches?

 You're not alone. Chronic back and headache pain are among the most prevalent and disabling disorders worldwide. Even more troubling, experiencing one of these conditions may raise your likelihood of experiencing both.

 But here's the good news: the potential reason why these two disorders may be connected points to a single solution: chiropractic care.

According to research published in the Journal of Headache and Pain, people who suffer persistent back pain or headaches are approximately twice as likely to suffer from both. Their findings are based on a review of studies involving more than 450,000 total participants suffering from back pain and headaches. Overall, the researchers found 14 studies that reported an association between "primary headache disorders and persistent low back pain."

While the study authors do not spell out the cause of the connection between these two common, debilitating conditions, abundant previous evidence suggests musculoskeletal dysfunction, particularly involving the spine and spinal nerves, is a potential factor with both headaches and back pain.

That makes chiropractic care a great option when you're experiencing either condition – or both. In fact, since a chiropractor can help both back pain and headaches, there's a good chance that if you're only suffering from one, chiropractic care may prevent the other from occurring at all.

 Now that's a two-for-one win with chiropractic!

Chiropractic Better Than Medication for Neck Pain

A study published in the research journal Annals of Internal Medicine and widely reported by mainstream media suggests chiropractic spinal manipulation is more effective than over-the-counter and prescription medication for relieving acute and subacute neck pain. Spinal manipulative therapy was more effective than medication in both the short and long term.

The study involved 272 adults ages 18-65 with neck pain of two to 12 weeks' duration. Participants were recruited from a university research center and a pain management clinic in Minnesota. Spinal manipulation was provided courtesy of a doctor of chiropractic. According to the study, six chiropractors, each with at least five years' experience, provided treatment, with the specific spinal level to be treated and the number of treatments provided left to the discretion of the individual chiropractor.

Instead of chiropractic care, some patients in the study group received medication as monitored by a licensed medical physician. Nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen (aspirin), or both served as the first line of pharmacological therapy. With patients who did not respond to or could not tolerate these drugs, narcotic medications and muscle relaxants were prescribed. With each patient, the MD determined the type of medication administered and the number of patient visits.

Self-reported outcomes, including pain, were measured six times during the 12-week treatment period: at two initial (baseline) appointments; two, four, eight and 12 weeks after treatment began; and on two occasions post-treatment (weeks 26 and 52). Objective measures of cervical spine motion were measured at four and 12 weeks by seven trained examiners who were unaware of which treatment the patients were receiving.

After 12 weeks of treatment, a significantly higher proportion of the SMT group experienced reductions of pain of at least 50% [compared to the medication group]. Specifically, at week 12, more than 82 percent of the SMT group reported a 50 percent or greater reduction in pain; 57 percent reported at least a 75 percent reduction and 32 percent reported a 100 percent reduction. By comparison, the medication group reported reductions of only 69 percent, 33 percent and 13 percent, respectively.

In terms of long-term improvement, 75 percent of the SMT group reported at least a 50 percent reduction in pain after 26 weeks, while nearly 81 percent reported at least a 50 percent reduction at 52 weeks. The medication group's improvement fluctuated from 59 percent reporting pain reduction of 50 percent or more at 26 weeks to 69 percent reporting the same reduction at 52 weeks.

"Participants who received medication seemed to fare worse, with a consistently higher use of pain medications for neck pain throughout the trial's observational period," said the study authors. In other words, chiropractic was a much better choice than medication for neck pain.

Interestingly enough, a third group of patients who received home exercise advice instead of chiropractic care or medication also fared better than the medication group during the study period. That means two forms of conservative, drug-free care - both of which are commonly provided by doctors of chiropractic - were more effective than over-the-counter and/or prescription drugs. The moral of the story? The next time you or someone you know is suffering from neck pain, don't turn to the medicine cabinet or a medical doctor; turn to your doctor of chiropractic.

The Good News- Bad News About Lower Back Pain

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THE GOOD NEWS:
90% of people with low back pain will recover in four to six weeks.
THE BAD NEWS:
10% of people develop chronic low back pain, an epidemic that costs society up to $100 billion a year.

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THE GOOD NEWS:
Spinal manipulation is one of the only treatments consistently recommended for dealing with acute low back pain.
THE BAD NEWS:
Far too many people don't visit a chiropractor for their pain and instead choose to pop over-the-counter pain medication at alarming rates.

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THE GOOD NEWS:
While bed rest may seem like the rational thing to do when in pain, evidence suggests proper exercises to increase mobility and reduce loss of muscle strength are key to recovery.
THE BAD NEWS:
One of the biggest predictors of chronic back pain is called "pain avoidance behavior," which means once you get the pain, you do everything you can to avoid anything that will cause pain

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]

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.

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.

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.

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.