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Back pain, back pain, everywhere there's back pain. Back pain is second only to the common cold as the most frequent cause of sick leave, accounting for approximately 40% of all work absences. It's also the most common reason for filing workers' compensation claims (about 25% of all claims filed in the U.S.).
How bad is the situation? A study in the American Journal of Public Health analyzed data from a national health interview survey and found over 30,000 respondents who reported daily back pain of one week or more in the 12 months prior to the survey. From this data, the authors estimated that more than 22 million people suffer from back pain that lasts one week or more; these cases result in an estimated 149 million lost workdays.
These estimates didn't even include workers who reported back pain of less than one week, or who missed work for the entire study period! If you've managed to escape back pain to this point, it's probably just a matter of time until you're caught. So make an appointment with your doctor of chiropractic, the expert on preventing and managing back pain.
Guo HR, Tanaka S, Halperin WE, et al. Back pain prevalence in U.S. industry and estimates of lost workdays. American Journal of Public Health, July 1999: Vol. 89, No. 7, pp1029-1035.
If your chiropractor recommends exercise along with spinal adjusting to help prevent back pain, they're on to something: Research continues to assert the benefits of exercise for preventing low back pain. The most recent evidence: a study published in the Journal of the American Medical Association (JAMA) Internal Medicine, which reviewed a large body of eligible research (23 studies representing more than 30,000 participants) and determined exercise alone or combined with education reduced the risk of suffering an episode of LBP.
Too many people turn to the medicine cabinet, their local pharmacy or even worse (because of the potential side effects / complications) their medical doctor for a prescription-strength medication or surgical consult when back pain flares up. As this review study suggests, there's no need to take such drastic steps, at least until conservative measures have been exhausted. Talk to your chiropractor about natural ways to prevent low back pain. You'll be glad you did.
There is a widespread understanding within the profession of the general guidelines for care of the concussion patient. These include guidelines for physical and cognitive rest, return to normal activities and so forth. What has not been sufficiently discussed is the potential role of the chiropractic adjustment itself for victims of concussion and post-concussion syndrome. The following is a brief review of a small sample of the evidence within the clinical literature supporting a role for the chiropractic adjustment in concussion care. The manifestations of concussion that responded under chiropractic care in these case reports included deficits in attention, vestibular function and vision.
Deficits in attention and short-term memory are not uncommon in concussion. Lovett and Blum (2006) reported the case of a 6-year-old boy who struck his head during a fall from a slide at a playground.1 The impact of the fall knocked the boy unconscious. Eighteen months later, the mother brought the boy to a DC. Although she "did not believe in chiropractic care," the mother was "at her wit's end" due to her inability to alleviate her son's headaches and neck pain with pain medication.
In addition to headache and neck pain, the boy was suffering from stomach pains and frequently had bloodshot eyes. Attention-deficit symptoms included an inability to sit still, deteriorating grades at school, and being disruptive and inattentive in class. None of this was present before the cranial trauma at the playground.
Sacro-occipital technique (SOT) examination protocols revealed evidence of C2-3 subluxation and category II sacroiliac subluxation. Minimal-force adjustments were utilized, due to the mother's apprehension, at a frequency of once per week for the first two months of care.
At three weeks of care, typical spelling test scores were 80 percent (compared to typical scores of 20 percent pre-intervention), along with vast improvement in penmanship. After two months of care, steady academic and behavioral improvement were noted by the school and parents, and the boy's eyes were consistently clear (not bloodshot). Stomach pains, neck pain and headaches also were much improved.
Pfefer, et al. (2011) discussed a 16-year-old football player with daily headaches and neck pain five weeks after a head injury that left him with a sense of "fogginess."2 He was unable to concentrate on homework. Previous treatment included nonsteroidal anti-inflammatory drugs and narcotics for pain control.
Cervical and thoracic diversified adjustments were administered. Significant symptomatic relief was noted after the second visit. Virtually complete symptomatic resolution was noted after the fifth visit (two weeks into care), although return to athletic activity created some exacerbation. Seven weeks into chiropractic care, the patient was able to return to full game play, symptom free.
Dizziness and vertigo are common manifestations of concussion. Collins and Misukanis (2005) reported the case of a 30-year-old woman first seen three days after a motor vehicle accident.3 She complained of neck pain, headache, mid-thoracic and upper-shoulder pain, numbness and tingling in both arms, and dizziness. Difficulty finding her car keys suggested a deficit in short-term memory. Active cervical range of motion in all directions reproduced the dizziness.
Nine visits over a period of 18 days included low-force diversified adjustments. The patient noted that pain levels were reduced for several hours after each visit. At this point, a neurologist consulted for a second opinion performed an examination and an MRI. The MRI was negative, and the neurologist concluded that the patient had suffered from a severe sprain and strain. The neurologist also advised the patient to continue chiropractic care.
The day after the neurological consultation, the patient experienced lightheadedness, a sensation of the room spinning, blurry vision, vomiting and dyspnea. Emergency-room evaluation ruled out stroke and transient ischemic attack. Evaluation by a neuropsychologist revealed a constellation of cognitive deficits, including memory problems and difficulty with complex logical problem-solving. In the neuropsychologist's opinion, these deficits were consistent with post-concussion syndrome.
Chiropractic adjustments continued with low force. At six months post-injury, the patient enjoyed complete resolution of neck pain and vertigo.
Mayheu and Sweat (2011) described a 23-year-old woman who suffered head trauma during a slip-and-fall injury. She presented at the emergency room with symptoms of nausea, vertigo, neck pain and headache. The diagnosis was concussion.4
At five months post-injury, the patient sought chiropractic care for residual headache, difficulty in concentrating, and vertigo. Physical and X-ray examination findings were consistent with upper cervical subluxation, and adjustments were administered according to Atlas Orthogonal protocols. At the patient's third visit one week following presentation, the patient noted that she had not experienced any vertigo or headaches since the first visit.
Some degree of visual dysfunction is common among concussion victims. Gilman and Bergstrand (1990) described a 75-year-old man who suffered a head injury resulting from a fall.5 He immediately complained of headache and dizziness. The next morning, he stated that he was completely blind.
He underwent examination by both an optometrist and an ophthalmologist. His report of blindness was supported by the absence of a pupillary response in both examinations. Cranial CT was unremarkable, ruling out gross brain injury. Although concussion was not diagnosed as such, the clinical pattern clearly fit the category.
The patient was followed for three months, with no subjective return of vision or objective recovery of the pupillary response. It was at this point that a chiropractic examination was conducted.
The chiropractor found a C1-C2 fixation on motion palpation. He adjusted the patient's upper cervical spine 11 times over a period of three months. After the third adjustment, the patient was able to perceive light. After the 11th adjustment, the patient could see rays of light coming through a window, could distinguish different colors, and demonstrated a normal pupillary response. After another two months of chiropractic care, the patient was able to read.
Sweat and Pottenger (2012) reported the case of a 75-year-old woman who had suffered a concussion resulting from a slip-and-fall injury 10 years previously.6 At the time of presentation to the chiropractic practice, she complained of a left "lazy eye", which interfered with reading.
Chiropractic physical and X-ray examination findings were consistent with upper cervical subluxation. Extraocular muscle examination revealed a strabismus, characterized by the left eye lagging behind when the patient was asked to look to her right. She was unable to walk heel-to-toe, instead using a wide stance to ambulate.
The patient was seen 22 times over a period of 353 days. On the first and 17th visit, she was adjusted according to Atlas Orthogonal protocols. (During the other 20 visits, adjustment was not warranted according to the analysis methods of the technique.) At the time of publication, the patient can walk heel-to-toe and stand on one leg (time was not reported). While left eye control is not perfect, it has improved and she is able to read as long as she wants.
Along with this improvement in extraocular muscle function, she also noted improvements in the brightness, clarity and color perception of her vision. These improvements began shortly after the first adjustment and progressed during this period of follow-up.
Other Concussion Components
Other concussion and post-concussion manifestations that have been reported to respond well under chiropractic care include slowed reaction time, sleep disorders and depression. I look forward to a blossoming of chiropractic research in these areas over the next few years.
- Lovett L, Blum CL. Behavioral and learning changes secondary to chiropractic care to reduce subluxations in a child with attention deficit hyperactivity disorder: a case study. J Verteb Sublux Res, 2006 Oct 4:1-6.
- Pfefer MT, Cooper SR, Boyazis AM. Chiropractic management of post-concussion headache and neck pain in a young athlete and implications for return-to-play. Topics Integrat Health Care, 2011;2(3):1-5.
- Collins ME, Misukanis TM. Chiropractic management of a patient with post traumatic vertigo of complex origin. J Chiropr Med, 2005;4:32-38.
- Mayheu A, Sweat M. Upper cervical chiropractic care of a patient with post-concussion syndrome, positional vertigo, and headaches. J Upper Cervical Chirpr Res, 2011 Jan 6):3-9.
- Gilman G, Bergstrand J. Visual recovery following chiropractic intervention. Chiropr: J Res Chiropr Clin Invest, 1990;6:61-63.
- Sweat R, Pottenger T. Seizure, ataxia, fatigue, strabismus and migraine resolved by precise realignment of the first cervical vertebra: a case report. J Upper Cervical Chiropr Res, 2012 Mar 12:20-26.
A January 2016 report released by the Centers for Disease Control and Prevention’s National Center for Health Statistics showed that even though insurance affects how people purchase healthcare, more people than ever are choosing to pay for their chiropractic care. The report was based upon the National Health Interview Survey (NHIS) taken in the years 2002 and 2012.
The study reported on usage for what the researchers termed as “complementary health approaches” which included acupuncture, massage, and chiropractic. They checked the usage of these three services specifically in the years 2002 and 2012. Researchers also looked to see if those surveyed had insurance that covered those services, and if insurance coverage affected the amount of usage of those services.
The results showed that there was increased utilization in all three services from 2002 compared to ten years later in 2012. The rates of utilization in 2002 were: acupuncture – 1.1%, massage – 5.0%, and chiropractic – 7.5%. These figures all increased ten years later to: acupuncture – 1.5%, massage – 6.9%, and chiropractic – 8.3%.
When examining who had insurance coverage, it was noted that the group with insurance coverage did not show an increase in utilization, while those without insurance, who would have to pay for their care, showed a statistically significant increase in utilization. This means that having insurance did not cause more people to seek out these three services. The study stated, “Although increases were observed in the percentage of adults who saw a practitioner for acupuncture, chiropractic, or massage therapy and did not have health insurance coverage for these visits, no changes were observed among those who saw a practitioner and had coverage for these complementary health approaches.”
For chiropractic, the study noted that 18.7% of those who sought those services had full insurance coverage. Partial coverage for chiropractic made up 41.4% of those who went to the chiropractor, while 39.9% had no chiropractic insurance coverage at all. Both acupuncture and massage had considerably less insurance coverage than chiropractic.
In their summary the authors of the CDC study noted, “Increased use of acupuncture, chiropractic, and massage therapy between 2002 and 2012 was previously noted. There was a significant increase in the percentage of adults who saw a practitioner for acupuncture, chiropractic, or massage therapy but did not have health insurance coverage for these approaches. No change in use was observed among those with insurance coverage. These data suggest that consumers are increasingly willing to pay out of pocket for the use of acupuncture, chiropractic, and massage.”
Seasonal Affective Disorder (SAD) is when people experience symptoms of depression during the Fall and Winter months (winter depression) or Spring and summer months (summer depression). It is thought to occur due to the changes in duration of sunlight which then affects our circadian rhythm, serotonin levels and our melatonin levels.
Now that the busy holiday schedule is over, you have all the time in the world to eat healthy right? Probably not...if your schedule is as hectic all year round as some of my patients. So, how do you stay healthy by eating healthy when your schedule is as busy and chaotic as ever? Here's a few tips I give my patients in my clinic of integrative medicine...
In the past decade, recorded cases of asthma have increased exponentially. While studies are being done to connect this prevalence increase to diet and allergies, among other things, it's safe to assume that the culprit, at least in part, could be our increasingly poor air quality. A new NASA world map released in September 2013 compares data from the...
Despite the fact that the overwhelming majority of slow runners instinctively strike the ground with their heels, there is a growing trend among running experts to have recreational runners strike the ground with their mid- or forefoot. Proponents of the more forward contact point suggest that a mid- or forefoot strike pattern is more natural because...
High blood pressure (hypertension) essentially means blood flow through your arteries increases, which can lead to some serious problems over time: we're talking arterial damage (increasing the risk of arteriosclerosis), coronary artery disease, heart attack or heart failure, kidney damage/failure, and stroke.
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.