Newsletter Archives > ChiroPlanet.com Monthly Health Newsletter: July 2016 Health Newsletter

July 2016 Health Newsletter


Current Articles

» The Cost of Your Lower Back Pain
» Is Chiropractic Care Safe for Children?
» Chiropractic Care and Falls
» Chiropractic Reduces Falling Risk in the Elderly

The Cost of Your Lower Back Pain

Chronic lower back pain is incredibly common. In fact, up to 50% of individuals may be affected by low back pain at some point, which has spurred the Global Burden of Disease Study to investigate worldwide impairment from this pain. A common type is known as "uncomplicated low back pain," which does not radiate to other areas of the body, and is not associated with damage to the spine or other structures. This pain can be debilitating and expensive, with the global costs estimated at $20 billion annually. New research suggests there may be therapies to lessen both the costs and discomfort of low back pain. The Journal of Manipulative and Physiological Therapeutics published a study that revealed chiropractic treatments significantly lowered costs for patients with low back pain. The researchers found that patients treated by a both a DC (Doctor of Chiropractic) and an MD spent hundreds of dollars less than back patients treated exclusively by an MD, or even an MD and a physical therapist. These findings show the potential for chiropractic treatment to improve uncomplicated lower back pain in a way that is cost-effective and sustainable.

Author: ChiroPlanet.com
Source: J Manipulative Physiol Ther. 2016 May;39(4):252-62.
Copyright: ProfessionalPlanets.com LLC 2016


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Is Chiropractic Care Safe for Children?

Children are different than adults. Their growing bodies have different needs, and children require a different medical approach than their adult counterparts. Pediatric medicine, therefore, specializes in treatment tailored specifically to the needs of children, whether those needs are dental, orthopedic, or emotional. Chiropractic care is no exception, and can be an incredibly beneficial component of a growing child's care. This month, the American Chiropractic Academy (ACA) published a statement that "pediatric chiropractic care, when administered properly, is effective, safe and gentle." This statement came on the heels of a report last month from the Chiropractors' Association of Australia (CAA) about the demonstrated safety of childhood chiropractic care in Australia. Both the ACA and the CAA illustrated the safety and effectiveness of chiropractic treatment for children in scientific literature. Large studies from the Journal of Manipulative and Physiological Therapeutics show that serious adverse events in pediatric chiropractic care are extremely rare. Furthermore, chiropractic treatment has been investigated as an effective approach for colic in infants, as well as for suboptimal breastfeeding. A cross-sectional survey of 956 chiropractors in Europe revealed that pediatric chiropractors also treat gastrointestinal, immune-related, and neurologic conditions. There is overwhelming evidence that with proper application, chiropractic care for children can be a safe and effective treatment for many conditions. Most chiropractors have pediatric patients, and extensive specialized training in pediatric chiropractic care ensures the best possible outcomes. Children rely on a robust healthcare team for their best overall health, and chiropractors are a valuable member of that ensemble. Strict regulation, rigorous training, and precise guidelines ensure that children are receiving the best, safest chiropractic care to support their optimal well-being.

Author: ChiroPlanet.com
Source: ACAToday.org. June 1, 2016.
Copyright: ProfessionalPlanets.com LLC 2016


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Chiropractic Care and Falls

According to the Centers for Disease Control and Prevention, one in three individuals over 65 years old falls each year. Further, 2.5 million of these falls lead to emergency room visits annually. These incidents can have devastating results, from hip fractures, to head injuries, or even death. The CDC reports that the number of deaths from unintentional falls have risen by approximately 25 percent from 2004-2013, and medical expenditures for falls cost upwards of $34 billion annually. An important step in preventing falls is to identify why people fall. There are many reasons individuals can sustain a fall, from strength, to reflexes, to sight, and more. One growing area of research is the effect that chiropractic treatment may have on minimizing risk factors for falls, particularly in the elderly. A study released recently by the Journal of Manipulative and Physiological Therapeutics assessed this potential through a program that attempted to improve sensorimotor function, proprioception (the sense of the ankle joint's position), and other outcomes in elderly participants after 12 weeks of chiropractic therapy. Those receiving chiropractic care were compared to participants who received no intervention. After 12 weeks, participants who received chiropractic care saw significant improvements over those who did not. The group who received treatment had improved stepping reaction time, proprioception, and health-related quality of life. While the researchers acknowledged that these improvements do not prove that these individuals are at lower risk for falling, the study does strongly suggest that chiropractic care can minimize potential risk factors for sustaining a fall in the elderly population. The authors concluded with a call for further research on the promising topic of minimizing fall risk through chiropractic care.

Author: ChiroPlanet.com
Source: J Manipulative Physiol Ther. 2016 May;39(4):267-78.
Copyright: ProfessionalPlanets.com LLC 2016


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Chiropractic Reduces Falling Risk in the Elderly

 

Chiropractic Care Improves Senses and Reduces Risks of

Falling in the Elderly Population

 

By: Mark Studin DC, FASBE(C), DAAPM, DAAMLP

William J. Owens DC, DAAMLP

 

As our population ages, our most senior are being told that their heart diseases or cancers won’t be as likely to cause death as sequella from a fall. Therefore, doctors are urging that sect of population to rely more and more on canes, walkers and other devices to help offer greater support when balance issues become even slightly problematic. According to Holt et. Al (2016) “Falls account for more than 80% of injury related hospital admissions in people older than 65 years and they are the leading cause of injury related death in older adults. Approximately 30%-40% of community-dwelling older adults suffer from at least 1 fall per year.” (pg. 267)

 

Holt et. al. listed the following risks associated with falls

  1. Lower limb weakness
  2. Recent History of Falling
  3. Gait Deficits
  4. Deterioration of the sensorimotor system that occurs regularly with normal aging

 

The National Institute of Health (NIH) expanded the list of risk factors in older adults to include:

  1. Muscle weakness
  2. Balance and gait
  3. Blood pressure drops
  4. Postural hypotension
  5. Reflexes slower
  6. Foot problems
  7. Sensory problems
  8. Vision issues
  9. Confusion
  10. Medications

(http://nihseniorhealth.gov/falls/causesandriskfactors/01.html)

 

Comparatively speaking, both the Holt et. Al. and the NIH are in agreement that falling can be a multifactorial issue with often no single cause or solution. However, if an older person, who has one or more of the above risk factors can minimize those risks, the likelihood of falling can be decreased and potentially extend their life. Holt et. al. continued “There is however, a growing body of basic science evidence that suggests that chiropractic care may influence sensory and motor systems that potentially have an impact on some of the neuromuscular risk factors associated with falling.” (pg. 268) In short, the evidence has suggested that chiropractic can reduce the risk of falling in older adults.

 

Holt et. al. found that the mechanisms where chiropractic may influence sensorimotor functions are:

  1. Neuroplastic processes in the central nervous system through altered afferent input.
  2. Pain and altered cognition as a result with respect to attention focus and physical function
  3. Muscle strength and muscle activity patters
  4. Deterioration of the sensorimotor system that occurs regularly with normal aging

Looking at those neuroplastic processes or effects of chiropractic on the central nervous system, Gay et al. (2014) reported, “…pain-free volunteers processed thermal stimuli applied to the hand before and after thoracic spinal manipulation (a form of MT).  What they found was that after thoracic manipulation, several brain regions demonstrated a reduction in peak BOLD [blood-oxygen-level–dependent] activity. Those regions included the cingulate, insular, motor, amygdala and somatosensory cortices, and the PAG [periaqueductal gray regions]” (p. 615). In other words, thoracic adjustments produced direct and measureable effects on the central nervous system across multiple regions, which in the case of the responsible for the processing of emotion (cingulate cortex, aka limbic cortex) are regarding the insular cortex which also responsible for regulating emotion as well has homeostasis. The motor cortex is involved in the planning and execution of voluntary movements, the amygdala’s primary function is memory and decision making (also part of the limbic system), the somatosensory cortex is involved in processing the sense of touch (remember the homunculus) and, finally, the periaqueductal gray is responsible for descending pain modulation (the brain regulating the processing of painful stimuli).

 

This is a major step in showing the global effects of the chiropractic adjustment, particularly those that have been observed clinically, but not reproduced in large studies.  “The purpose of this study was to investigate the changes in FC [functional changes] between brain regions that process and modulate the pain experience after MT [manual therapy]. The primary outcome was to measure the immediate change in FC across brain regions involved in processing and modulating the pain experience and identify if there were reductions in experimentally induced myalgia and changes in local and remote pressure pain sensitivity” (Gay et al., 2014, p. 615). 

 

Coronado et al. (2012) reported that, “Reductions in pain sensitivity, or hypoalgesia, following SMT [spinal manipulative therapy or the chiropractic adjustment] may be indicative of a mechanism related to the modulation of afferent input or central nervous system processing of pain” (p. 752). “The authors theorized the observed effect related to modulation of pain primarily at the level of the spinal cord since (1) these changes were seen within lumbar innervated areas and not cervical innervated areas and (2) the findings were specific to a measure of pain sensitivity (temporal summation of pain), and no other measures of pain sensitivity, suggesting an effect related to attenuation of dorsal horn excitability and not a generalized change in pain sensitivity” (Coronado et al., 2012, p. 752).These findings indicate that a chiropractic spinal adjustment affects the dorsal horns at the root levels which are located in the central nervous system.  This is the beginning of the “big picture” since once we identify the mechanism by which we can positively influence the central nervous system, we can then study that process and its effects in much more depth.    

 

One of the main questions asked by Corando et al. (2012) “…was whether SMT (chiropractic adjustments) elicits a general response on pain sensitivity or whether the response is specific to the area where SMT is applied. For example, changes in pain sensitivity over the cervical facets following a cervical spine SMT would indicate a local and specific effect while changes in pain sensitivity in the lumbar facets following a cervical spine SMT would suggest a general effect. We observed a favorable change for increased PPT [pressure pain threshold] when measured at remote anatomical sites and a similar, but non-significant change at local anatomical sites. These findings lend support to a possible general effect of SMT beyond the effect expected at the local region of SMT application (p. 762).

 

The above mechanisms take the effects of chiropractic care out of the realm of theory and validates the processes through which chiropractic works based upon the scientific evidence (literature).

 

 

Holt et. Al found that outcomes measured for both sensorimotor and quality of life increased with chiropractic care. The primary outcomes of improvement choice stepping reaction time (CSRT)and sound-induced flash illusion. The CSRT involves feet placement in a timed scenario and sound-induced flash illusion involves multisensory processing to ascertain reaction to perceived illusions. Both have been significantly related to older populations and falling. Although the results of this study has its limitations, as many studies do. Holt concluded” The results of this trial indicated that aspects of sensorimotor integration and multisensory integration associated with fall risk improved in a group of community-dwelling older adults receiving chiropractic care. The chiropractic group also displayed small, statistically significant improvements in health-related quality of life related to physical health when compared with a “usual care” control. These results support previous research which suggests that chiropractic care may alter somatosensory processing and sensorimotor integration.” (pg. 277)  

 

As with many of our articles from here forward, I would like to leave you with a last and seemingly unrelated statement.  I felt it was important to add this at the end since many of our critics negatively portray the safety of chiropractic care.  This statement shall put that to rest leaving only personal biases left standing. Whedon, Mackenzie, Phillips, and Lurie (2015) based their study on 6,669,603 subjects and after the unqualified subjects had been removed from the study, the total patient number accounted for 24,068,808 office visits. They concluded, “No mechanism by which SM [spinal manipulation] induces injury into normal healthy tissues has been identified” (Whedon et al., 2015, p. 5). This study supersedes all the rhetoric about chiropractic and stroke and renders an outcome assessment to help guide the triage pattern of mechanical spine patients.

 

References:

  1. Holt K., Haavik H., Lee A., Murphy B., Elley C., (2016) Effectiveness of Chiropractic Care to Improve Sensorimotor Function Associated with Falls Risk in Older People: A Randomized Controlled Trial, Journal of Manipulative and Physiological Therapeutics, 39(4) 267-278
  2. Falls and Older Adults, Causes and Risk Factors (n.d.) National Institute of Health, retrieved from: http://nihseniorhealth.gov/falls/causesandriskfactors/01.html
  3. Gay, C. W., Robinson, M. E., George, S. Z., Perlstein, W. M., & Bishop, M. D. (2014). Immediate changes after manual therapy in resting-state functional connectivity as measured by functional magnetic resonance imaging in participants with induced low back pain.Journal of Manipulative and Physiological Therapeutics, 37(9), 614-627.
  4. Coronado, R. A., Gay, C. W., Bialosky, J. E., Carnaby, G. D., Bishop, M. D., & George, S. Z. (2012). Changes in pain sensitivity following spinal manipulation: A systematic review and meta-analysis, Journal of Electromyography Kinesiology, 22(5), 752-767.
  1. Whedon, J. M., Mackenzie, T. A., Phillips, R. B., & Lurie, J. D. (2015). Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66-69 years. Spine, 40(4), 264-270.

Author: Mark Studin DC, FASBE(C), DAAPM, DAAMLP and William J. Owens DC, DAAMLP
Source: US Chiropractic Directory
Copyright: 2016 2016


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