Newsletter Archives > ChiroPlanet.com Monthly Health Newsletter: May 2017 Health Newsletter

May 2017 Health Newsletter


Current Articles

» Chiropractic Reduces Falling Risk in the Elderly
» Leaning While Texting May Result in Health Problems
» Painkillers Should Not Be Kept Within Reach of Small Children
» Dangers of Energy Drinks

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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Leaning While Texting May Result in Health Problems

Recent increases in the number of patients suffering from upper-back and neck pain may be related to poor posture during prolonged smartphone use. Many young people are reporting herniated disks and alignment problems. As these health issues more so typically affect middle-aged and elderly people, the new surge of problems in youth may have to do with the way the neck bends when a person is texting. The normal curvature of the neck is reversed when people look down, such as when using and viewing a phone. Overtime, continuation of this unnatural position leads to stresses and imbalances in the supporting tissues of the neck and upper back. Pain, soreness, fatigue and even reversal of the normal curvature of the neck and upper back can occur. Given that some young people text for hours a day, itís no wonder experts are seeing an increase in neck and back issues.† Studies show the problem is present mainly when people use mobile devices, as using laptops doesnít require any abnormal or unnatural posture. The 45-degree angle many people hold their neck at while texting on mobile devices can lead to issues which may become even worse if the person is sitting. This impact on the back worsens at higher flexed postures. With a 15-degree flex, the head (which weighs roughly 10-12 pounds) can feel over twice as heavy. The stress increase on the spine can lead to a 60-degree flex feeling like an additional 60 pounds of pressure. There is a serious concern among professionals about the effects this will have on young people.†† Fortunately, doctors of chiropractic are specifically trained to evaluate and treat neck and back issues. If you or a loved one is suffering from neck and/or back issues including those that may be related to the use of a phone, book a no obligation consultation today!

Author: ChiroPlanet.com
Source: The Spine Journal, online March 20, 2017.
Copyright: ProfessionalPlanets.com LLC 2017


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Painkillers Should Not Be Kept Within Reach of Small Children

Most homes carry some type of pain relievers. More specifically, opioids like hydrocodone and codeine are common across the country. Unfortunately, these medicines arenít always kept out of the reach of small children.† Roughly a third of adults store prescription opioid mediation in cabinets with locks. Less than 10 percent of adults with kids and teenagers recall storing these substances properly.† Researchers have noted a near doubling of hospitalization rates for issues related to medicine over the past few decades. While some parents may feel that they know their children well enough to pass on locking up these substances, the prevalence of these medicines in the home warrants safe and secure storage.† A survey conducted with adults who consume these medicines relievers within the past year and who had kids in the home revealed that a third of those with children under 7 said they secured their medicine. That number was slashed by roughly two-thirds when it comes to households with teens, and less than one-third of families with both kids and teens used lockable storage for their medicine. Adults with young kids were usually more concerned about the medicine being accessed, while those with teens were less likely to view this as a concern.† The use of this medication has skyrocketed in the US in recent years, with most opioid medication being used for post-surgery pain.

Author: ChiroPlanet.com
Source: Pediatrics, online February 23, 2017.
Copyright: ProfessionalPlanets.com LLC 2017


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Dangers of Energy Drinks

According to a new study, consuming enough energy drink can lead to certain concerning characteristics in heart function and blood pressure outside of those seen solely from caffeine.† Energy drinks are extremely popular with hundreds of versions currently available for sale. Unfortunately, these beverages have become associated with emergency-room visits and even death. While the makers of energy drinks claim that the products pose no more dangers than those related to caffeine, the evidence does not necessarily reflect this assertion. Caffeine in certain doses is considered normal by the FDA. For example, approximately 400 mg of caffeine can be found in about five cups of coffee. While the dangers of energy drinks are usually related to their caffeine content, it is the other ingredients which may pose the risk. The physical changes in a group of subjects (both male and female) were observed after the subjects had consumed an energy drink and a caffeinated beverage that lacked the other types of ingredients energy drinks are known for. These additional ingredients include 4 ounces of sugar, taurine, B vitamins, and other contents found in brand-name energy drinks like Red Bull, 5-Hour Energy, and Monster. The results showed certain concerning cardiovascular changes including an increase in blood pressure after the consumption of energy drinks. Be smart and play it safe. If you choose to consume energy drinks, do so in moderation and ensure you do not suffer from any sort of cardiovascular conditions or issues or other health ailments that could result in a visit to the emergency room or worse.

Author: ChiroPlanet.com
Source: Journal of the American Heart Association, online April 26, 2017.
Copyright: ProfessionalPlanets.com LLC 2017


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