Skip the Steroids for Shoulder Pain? Chiropractic/Physical therapy as effective as injections.

For relief of shoulder pain, chiropractic/physical therapy and steroid shots provide similar results.

Researchers have compared the nonsurgical approaches in adults suffering from shoulder pain caused by rotator cuff problems, tendinitis or bursitis.

Whether you have a steroid injection or chiropractic/physical therapy, the improvement is the same.  Improvement is 50 percent or more and this improvement can be maintained for a year or more.

Patients that receive injections use more health care services and have significantly more shoulder-related doctor visits increasing the cost of medical care.

In addition, patients that have injections end up going to chiropractic/physical therapy anyway, and about 40 percent who get shots need more than one injection.

This information should reassure patients who prefer to avoid injections, that chiropractic/ physical therapy is a great and effective option for shoulder pain

Steroid injections may work as part of a treatment plan when chiropractic/physical therapy is not enough.

Shoulder pain is a very common condition, and treatment decisions aren't uniform, in my opinion, "An accurate diagnosis needs to be established before initiating treatment. An experienced physician needs to evaluate the patient and consider appropriate diagnostic tests, such as X-ray and/or MRI," 

Chiropractic/Physical therapy should include a combination of joint and soft-tissue manipulation, manual therapy, stretching, muscle contraction-relaxation techniques and exercises to promote movement in the shoulder, chest or neck. Home exercises should be given to reinforce the therapy goals as well.

Chiropractic Cut Migraine Pain by 68%

Mainstream medical treatment of migraine headache relies heavily on using pharmaceuticals to manage and control migraine pain. But medications can come with a slew of side effects like nausea, dizziness, vomiting, and even more headaches from medication overuse.

Fortunately natural remedies exist that can ease migraine without the adverse effects of drugs. A 2012 study found that chiropractic adjustments and massage resulted in a 68% reduction in the intensity of migraine headache.
The study included ten male migraine sufferers who were treated with gentle massage, stretching, and chiropractic adjustments of the upper back and neck. Within an hour after receiving an adjustment the average patient reported a reduction in pain scores from a 5 to 0.5. (Pain was rated on a scale of 1 to 10.) No significant side effects were reported.

While further research is needed to fully understand the many causes of migraine, this study adds to previous research indicating the benefits of chiropractic for treating migraine. In addition to using chiropractic adjustments, a doctor of chiropractic can counsel you on ways to prevent migraine through exercise, nutrition, and eliminating headache triggers.

Reference
Jahangiri JN, Vatankhah N, and Baradaran HR. Reduction of Current Migraine Headache Pain Following Neck Massage and Spinal Manipulation. Journal of Therapeutic Massage and Bodywork. 2012; 5(1): 5–13.

Written by: Marissa Luck 

How to Break the Cycle of Back Pain

You tweaked your back, pulled a muscle, or injured yourself lifting something incorrectly and suddenly you’ve got a shooting pain in your back. These sudden, temporary episodes of low back pain are characterized as acute low back pain rather than chronic pain. Acute low-back pain episodes are thought to last no longer than three months. This type of back injury may be compared to the common cold because of its temporary nature and because of the belief that each episode of pain is unlikely to recur. In other words, episodes of pain are thought to be independent events, like when you catch different viruses each year.

A new study turns this conception of acute low back pain upside down, suggesting that the natural progression of acute low-back pain may differ dramatically from what experts previously thought.

In the study, 589 acute back-pain patients answered extensive questionnaires on their current episode of pain as well as their history of back pain in general. After analyzing their responses, the researchers found that unlike the common cold, episodes of back pain tend to build off of one another. In the study, 73 percent of patients reported that they had previous episodes of low-back pain. Sixty six percent of those patients said their symptoms were significantly worse during their current episode of back pain compared to their last. The researchers wrote that recurring and worsening nature of back pain suggests that “whatever initiates the pain usually subsides but remains capable of repeating the cycle again.”

If you’re suffering from an episode of acute low-back pain, a chiropractor can help you heal from a current episode of acute low-back pain while helping you learn to practice healthy habits to prevent it from returning.

Reference

Donelson R, McIntosh G, Hall H. Is it time to rethink the typical course of low-back pain?. Physical Medicine and Rehabilitation 2012; doi:10.1016/j.pmrj.2011.10.015.(In press, corrected proof version).

Written by: Marissa Luck 

Sciatica Risk Runs in Families

Scientists have discovered an additional risk factor for developing sciatic pain: your genes. Though researchers suspected that genes play a role in this often debilitating back problem, a 2012 study examined the impact of familial history on the risk of lumbar disc disease, which frequently causes sciatica.

A group of orthopedists from the University of Utah School of Medicine analyzed records from the Utah Population Database, which includes data dating back to early settlers. Using familial genealogy of 1, 264 patients, the researchers track the presence of lumbar disc disease over several generations. They found that having a close relative quadrupled your risk for lumbar disc disease. But if you’re parents didn’t have lumbar disc disease, you’re not off the hook: even having a distant cousin can elevate your risk.

Genetics isn’t the only cause of sciatica; mechanical stress on the spine, occupational loading, aging, and even smoking has been linked to sciatica. Learning whether you have a genetic risk of lumbar disc disease can help you take additional steps to prevent or minimize sciatic nerve pain. Contact a chiropractor to find out ways to ease sciatica and prevent it from returning.

References

Patel, Alpesh. William Ryan Spiker. Michael Daubs, Darrel Brodke, and Lisa A. Cannon-Albright. Evidence for an Inherited Predisposition to Lumbar Disc Disease. The Journal of Bone and Joint Surgery. February 2011; 29(3): doi

Written by: Marissa Luck on August 8, 2014.on August 6, 2014.

Exercise After Whiplash: Don’t Do It Alone

Marissa Luck June 23, 2014 Auto Injury News, Exercise, Neck Pain  No comments

Countless studies have pointed to the benefits of exercise for recovering from spinal injuries like whiplash. But is staying physically active enough to combat minor auto injuries? A new study sought to answer that question by comparing general exercise to therapist-led interventions for whiplash.

The study included 216 patients with chronic whiplash-associated disorders. Participants were randomly assigned to receive one of three treatments: physiotherapist-led neck exercises; behavioral interventions plus physiotherapist-led neck exercises; or a generalized exercise program.

Researchers discovered that specific neck exercises led by a trained therapist increased patients’ odds of recovery. After six months, 39-44% of patients in the specific exercise groups had a significant reduction in pain, compared to 28% in the generalized exercise group. Adding a behavioral intervention to the neck exercises did not appear to make a significant difference in this study.

What this means is that auto injury patients do indeed benefit from the skills of a medical professional trained in exercise treatments, such as a physiotherapist or a chiropractor. Doctors of chiropractic can also use spinal manipulation to enhance exercise therapies. The study also demonstrates that even patients with chronic pain can improve with targeted interventions. Contact a chiropractor to discover how these non-invasive therapies can expedite rehabilitation after an auto accident.

Reference

Ludvigsson ML. The effect of neck-specific exercise with, or without a behavioral approach, on pain, disability and self-efficacy in chronic whiplash-associated disorders: a randomized clinical trial. Clinical Journal of Pain 2014.

Written by: Marissa Luck on June 23, 2014.

Hitting the Gym Could Stop Your Neck Pain

Chronic neck pain is typically treated with specific methods that focus on the affected area, thereby decreasing the level of tenderness and increasing range of motion. However, News Medical recently reported that a new study published in the International Journal of Rheumatic Diseases suggests that treating the whole body via regular physical exercise may bring about better results.

The Research

Researchers set out to discover whether level of physical fitness or status of mental health (via depression and anxiety) has any effect on persons with chronic neck pain. They studied 160 participants, 80 of whom had no neck pain and 80 of whom reported chronic neck pain. Each group consisted of 40 males and 40 females.

They tested each participant in several areas to ascertain their strength, flexibility, pain threshold, disability level, depression levels, anxiety levels, and overall quality of sleep. They then compared the results of the group with chronic neck pain to the group that had no reported neck pain and they found some significant differences between the two – especially when separated by sex.

The Results

Women with chronic neck pain were weaker, had lower pain thresholds, and reported a lower quality of life than the group with no reported neck issues (regardless of gender). The females studied also tended to experience higher levels of depression and anxiety, and they reported getting less-than-restful sleep. Men with chronic neck pain also reported a lower quality of life, generally had higher body fat percentages, and their sleep quality was affected as well.

This study suggests that it takes a whole-body approach when treating chronic neck pain. Therefore, in addition to participating in regular chiropractic visits to realign the cervical vertebrae and treat the cause of the pain, both male and female patients should be encouraged to participate in an exercise program to further enhance the benefits.

Doing so can potentially increase their quality of life, make them stronger, lower their body fat percentages, and allow them to engage in more restful sleep. Additionally, regular physical exercise helps lower anxiety and depression, making it an effective tool for improving quality of life as well as reducing neck pain. Combining chiropractic with specific exercises is particularly effective for spinal pain, research suggests.

 Reference

Yalcinkaya, H et al. Do male and female patients with chronic neck pain really have different health-related physical fitness, depression, anxiety, and quality of life parameters? International Journal of Rheumatic Diseases. May 9, 2014.

 Written by: Christina DeBusk on June 6, 2014. Last revised by: Marissa LuckJune 4, 2014.

http://www.chironexus.net/2014/06/hitting-gym-stop-neck-pain/

Do you want to Golf Better?

After several patients saw the recent posts about the Pain Relief Centre golf outing, I started getting some questions from several avid golfers that come into the clinic. The questions were about stretching? How should I stretch before golfing? What stretches do you recommend? Like most golfers, stretching is minimal at best. Who has time for stretching or even going to the range before you play your round of golf?  Think about how nice it would be to add yards to your drive the net time you play. Maybe even win some skins in your next match.  Stretching is important and it's much less expensive than another lesson from the golf pro.

Lack of range of motion, muscle stiffness and tightness will make your swing short and narrow, which reduces the distance on your drive. Stretching improves flexibility, range of motion, and lets the muscles know they are going to be used for activity.

Plus, when you stretch you reduce the risk of injury.  Low back complaints are particularly common in golfers.  Stretching can help reduce your trips to my office.

There are many stretches.  Here are a few that might be helpful

1. Triceps & Shoulders
2. Pectoralis
3. Shoulders
4. Deltoids
5. Obliques
6. Hand, Wrist & Forearms
7. Glutes
8. Hamstrings
9. Waist & Torso
10. Calf & Achilles Tendon
11. Quadriceps

These stretches are copywrited and pictures of these stretches are located at http://golfballmassage.com/stretching-boring-golfer-bother/

http://golfballmassage.com/stretching-boring-golfer-bother/

How To Control Weight With Minimal Exercise

Are you trying to get your weight under control and you just don’t know where to begin?  Control of weight with minimal exercise is possible, but realistically, you may lose a small percentage of weight this way. Reaching your ultimate weight goal will be almost impossible without exercising at least some of the time.

Also, you should keep in mind that weight loss is NOT exactly the same as fat loss. Some people can manage to lose a lot of weight in a short time but, the loss may be mostly made up of protein, water and some other nutrients, and only a small amount coming from stored body fat. If this is the case, then most of the weight will probably be regained at a later date!

Ideal fat loss and weight control is going to come from roughly 75% diet and 25% exercise, but trying to lose excess body fat with little exercise will be almost impossible if you’re not prepared to maneuver more with your dietary choices.

Fat loss without exercising means you’ll need additional help with some good fat loss tips, so listed below are some quick tricks for fat loss in order to make up for lack of those exercise benefits.

1. Eating breakfast:  Protein Should be eaten first thing in the morning.  Most American breakfast is full of carbohydrates.  A good fat burning trick is to begin with a breakfast that can help kick-start the fat burning process. Protein rich foods, such as omelets or even a protein shake can be a great start to the day. Eating high protein foods can increase your metabolism by up to 25%, giving a great boost to results over the first few months of any weight loss program.
2. Morning Exercise: Always try to do some form of exercise in the morning, preferably before breakfast. You should eat a banana first as its light in calories and will give just a little sugar to help push you through the exercise session. If morning exercise is out of the question, then try for mid-afternoon.
3. Eat within half hour after exercising. Exercise causes the enzymes that process nutrients to be highly active, thus eating at this stage makes sure all nutrition and energy is utilized for recovery and replenishment purposes.
4. Try not to eat late at night. Our metabolism slows down towards bedtime, so eating late means any calories have a greater chance for storage as fat. If you must eat, just snack on fruit or something just as light.
5. Use supplements: If you would like a supplement to boost your fat burning potential then think about taking L-Carnitine. This is an amino acid in protein, especially red meat. It has been shown to push body fat into the cells and prompts it to be burned as fuel.

GOT WATER?

Are you drinking enough water? Do you have any of these symptoms or diagnoses? Fatigue, Hypertension, High Cholesterol, or Constipation. Your amount of water consumption could be contributing to your symptoms or even your condition. You may be dehydrated.  Your body is 75% water. You need to make sure you drink at least 8 8oz glasses of water a day. In Florida where we live make it 10.  If you feel thirsty it may be to late, you may already be dehydrated.  The average adult loses about 10 cups of water a day simply by breathing, sweating, urinating, and eliminating waste. Make the decision to drink more water today. Your health depends on it.

Posture While Sleeping

The Question of the Day:  Doc what kind of mattress should I get? 

Suggestions: sleep on a firm, flat mattress. You just have to go and try them out.  I don't recommend a specific brand.  I don't think a pillow top is a good idea.  It is best to sleep on your side with your knees and hips bent and a pillow under your head, or on your back with pillows beneath your head and knees. If you must sleep on your stomach, place a pillow under your hips to reduce the curve in your lower back (do not sleep on your stomach in late pregnancy). Another tip - watch out for waterbeds. Many do not offer the support your back needs. 

BACK PAIN: The Structures Involved

There are three main types of structures and tissues involved in low back pain:
1. Connective tissue
2. Nerves
3. Muscles

50% of Americans admit to having back pain symptoms each year.

80% of the population will experience a baqck problem at some time in our lives.

Americans spend at least $50 Billion each year on back pain.

Most cases of back pain are mechanical or non-organic–meaning that they are not caused by serious conditions.

Causes of low back pain include overuse and injury, weakness, degeneration, nerve impingement, abnormal bone growth (osteoarthritis), and postural misalignments.

The pelvis can be rotated. The pubic bone can be out of alignment. Your pelvis can flare in and out, or go up or down. Your leg length can be off. And, your vertebra can be stuck out of rotation.

Chiropractic care is a great choice for both the diagnosis of the cause of the pain, and to correct that cause. Chiropractic adjustments correct pelvic and lumbar misalignments. The adjustments also help restore movement to structures that don’t move very well.

Check out this infographic on low back pain and the structures involved. from: http://www.a-health-blog.com/lower-back-pain-infographic.html

7 Ways to Prevent Back Pain in Golfers

It’s no wonder that golfers have low back pain. It’s a baby boomer sport and growing every year in the number of new golf enthusiasts.  Twenty-five percent of the 26 million golfers are over the age of 65.  But age isn’t the only factor in golf injuries, and a recent literature review from the journal Sports Health helps to explain why lower back pain is such a common occurrence among golfers.

At face value, golf may not look strenuous or taxing on the body, but as you age, spinal mobility tends to decline. The ability of the spine to absorb forces decreases with age. The predominant injury amongst golfers is low back injury that lasts between two and four weeks of injury in those who get it.  Surprisingly, the golfer’s low back injury won’t incapacitate most of them suddenly but instead, the pain will creep up on them the more they play the sport.

Swinging Styles Contribute to Back Pain

It’s actually the modern way of playing the sport that is detrimental to the spine. For example, to swing correctly, you’ll have to separate your hips and shoulders during the backswing. At the end of the swing, you’ll be in a position of lumbar hyperextension. Also, by contracting your abdominal muscles during the follow-up phase and rotating your trunk with feet planted in one place, the intervertebral disc is highly stressed.

The increased pressure in the spine during the downswing to follow-through is great enough to be considered equivalent to football linemen hitting a sled. The pressure experienced in golfing exceeds the pressure needed to cause a prolapse of the disc. However, with older individuals more prone to develop osteoporosis later in life, the increased pressure in the spine from golf could be enough to fracture a rib or vertebrae, let alone cause stress fractures.

Another common occurrence in golfers is injury to the paraspinal muscles. MRI scans have revealed tears in these muscles, especially in amateur golfers.  Treatment of the muscle injuries is generally centered on rest and relaxation, core muscle strengthening sessions, and correcting the incorrect movement pattern that caused the injury to begin with.

Tips for Avoiding Back Pain from Golf

Simple preventive steps can go a long way in preventing low back pain in golfers. Here’s a list of some of those steps.

1. Make sure your club fits your body.
2. Treat golf like you might treat running – not as a weekend athlete, but someone who plays the sport two or three times a week every week. This will prevent the “de-conditioning” of your muscles that occurs between golf sessions that makes you more susceptible to injury. Avoid golf sprees of five times in one week and none the next.
3. Push that golf cart. Don’t pull it.
4. Use a long putter during one round. This will decrease stress on the spine.
5. To carry a golf bag, use the ones that have a dual backpack strap.
6. Lose any excess weight before you start the sport.
7. See your local chiropractor to ensure you’re using proper body mechanics to prevent back injuries from golf and everyday activities. Chiropractors can also keep your spine properly aligned to reduce your risk of herniated discs and pain from osteoarthritis.

Then go out and have your best and greatest golf season yet!

 Reference

Finn, Christopher. Rehabilitation of Low Back Pain in Golfers: From Diagnosis to Return to Sport. Sports Health: A Multidisciplinary Approach 2013. DOI: 10.1177/1941738113479893.

Written by: Donna Schwontkowski 

Headaches can be helped by chiropractic

The cervicogenic headache has been researched extensively. It is just one of many types of headaches.  Chiropractic seems to work best for this type of headache. Duke University recently looked into treatment for tension-type headache and cervicogenic headache are two of the most common non-migraine headaches. Population-based studies suggest that a large proportion of adults experience mild and infrequent (once per month or less) tension-type headaches, and that the one-year prevalence of more frequent headaches (more than once per month) is 20%-30%; a smaller percentage of the population (roughly 3%) has been estimated to have chronic tension-type headache (³ 180 days per year). Estimates of the prevalence of cervicogenic headache have varied considerably, due in large part to disagreements about the precise definition of the condition. A recent population-based study, which used the diagnostic criteria of the International Headache Society (IHS), found that 17.8% of subjects with frequent headache (³ 5 days per month) fulfilled the criteria for cervicogenic headache; this was equivalent to a prevalence of 2.5% in the larger population.

Spinal manipulation was associated with improvement in headache outcomes in two trials involving patients with neck pain and/or neck dysfunction and headache. Manipulation appeared to result in immediate improvement in headache severity when used to treat episodes of cervicogenic headache when compared with an attention-placebo control. Furthermore, when compared to soft-tissue therapies (massage), a course of manipulation treatments resulted in sustained improvement in headache frequency and severity. However, among patients without a neck pain/dysfunction component to their headache syndrome – that is, patients with episodic or chronic tension-type headache – the effectiveness of cervical spinal manipulation was less clear. No placebo or no-treatment control studies of manipulation have been performed in these populations. In one trial conducted among patients with episodic tension-type headache, manipulation conferred no extra benefit when added to a soft-tissue therapy (deep friction massage). In another trial conducted among patients with tension-type headache, amitriptyline was significantly better than manipulation at reducing headache severity during the 6-week treatment period; there was no significant difference between the two treatments for headache frequency during the same period. Interpretation of these results is difficult because all patients received the same relatively low dose of amitriptyline (30 mg). Despite the uniform and relatively low dose of amitriptyline, however, adverse effects were much more common with amitriptyline (82% of patients) than with manipulation (4%). During the 4-week period after both treatments ceased, patients who had received manipulation were significantly better than those who had taken amitriptyline for both headache frequency and severity. Although amitriptyline is usually continued for longer than 6 weeks, the return to near-baseline values for headache outcomes in this group contrasts with a sustained reduction in headache frequency and severity in those who had received manipulation. 

If you suffer from headaches that start with pain in the back of your neck or head you may want to call the Pain Relief Centre for a consult.  The research suggest we may be able to help. 904-823-8833


http://www.chiro.org/LINKS/FULL/Behavioral_and_Physical_Treatments_for_Headache.htmlhttp://w

ww.cnn.com/video/data/2.0/video/health/2014/04/23/exp-hm-migraine-treatment.cnn.html