Everett Chiropractic Center Blog

May 10, 2017

Consumer Reports: Real Relief from Back Pain

WSDOTworker150x150   (How many safety features can you find on this WSDOT site photo – arguably the largest organization in the State dedicated to safety? Yet, he doesn’t bend over correctly at all.)

I keep forgetting to mention that the current issue of Consumer Reports features a cover story on back pain. It is a very good review of what most of mainstream medicine recommends, and therefore what most people are doing – the lack of effectiveness, cost, and risks associated with that approach. And it covers alternative methods of addressing back pain, the proven effectiveness (which is why it is the cover story), cost savings, and safety. All of that is old news if you have been reading this Blog long (and if you search any of the key words in this Post you will find many posts – there are over a thousand here – on that subject).

Two things are interesting to me about the article: what is right in plain sight, but missed entirely due to mindset; and how, still, the recommendations regarding how to bend and lift are erroneous – harmful even.

First, the mindset thing. Modern medicine is about treating symptoms: some will argue that but just look at what is said and what is the object of all the focus – back pain (a symptom) in this case, but it is everywhere all of the time if you look. And while they fairly accurately talk about the causes, they fail to conclude that substantially addressing these causes would be a means of preventing the symptom. Instead they point out, for example, that abnormal findings on X-rays is common among people who do not suffer with back pain. (That should be a clue, why isn’t it?)

Secondly, but related, is this whole business of correct bending and lifting technique – how could they get it so thoroughly wrong so consistently. How could they not connect the dots – remember the ‘they’ is the authoritative bodies of professional experts spewing opinions, guidelines, and recommendations (shifting gazillions of dollars within the economy)… but let’s not go down the cynical path.

I share all of this because we have a copy in the reception room – with the best parts highlighted (be me:-). Read it, but ignore the part about how to bend and lift, and talk with me about that.

DrD

March 10, 2017

Another Health Care Professional Who Doesn’t Know How to Bend Over

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January 25, 2017

Left Knee Pain

Today a patient wanted me to know that her left knee pain, a pain that she didn’t even tell me about (that part impressed her the most), went away immediately after her last visit – and she hasn’t had that pain since.

Patients often like to hold back from telling me what is bothering them when they come in for any particular visit; and I don’t always  ask. They like to see if I can ‘find’ it without them telling me. Then, when I do, they make a big deal out of that.

When we accept people as patients we try to explain that ours is an “alternative” approach. That we are looking for something (the subluxation complex), and if that have that, they can be a chiropractic patient – as long as it is safe for us to address the subluxation with what we do (in our case the Activator Method). If they do not have that particular condition, they do not qualify as a chiropractic patient; if it wouldn’t be safe to adjust them in the way that we do in this office, they still do not qualify as a chiropractic patient, in this office at least.

Most all of that is lost on most people. They hurt, that is the problem. And they think that it is critically important for them to tell us where they hurt for us to do our job. We go along with the conversation and keep trying to help them understand the difference between a symptom-based approach and the chiropractic approach. First patients have to feel better. We know that. The rest is a bonus.

 

December 26, 2016

If This Describes You, Maybe We Can Help

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November 28, 2016

Chiropractic Better Than NSAIDS and PLACEBO

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Von Haimann, W et al. (2013) Spinal High-Velocity Low Amplitude Manipulation in Acute Nonspecific Low Back Pain: A Double-Blihnided Randomized Controlled Trial in Comparison With Diclofenac [Volteran] and Placebo. spine 38 (7): 540-548

“In a subgroup of patients with nonspecific LBP, spinal manipulation was significantly better than non steroidal anti-inflammatory drug diclorfenac (Volteran) and clinically superior to placebo.”

November 10, 2016

Opioids Do Not Help Chronic Low-Back Pain

That’s according the BottomLineInc and the recent report. Here is what they had to say about it:

“The slightest relief the provide is little better than that of NSAIDS, such as aspirin. Self-defense: Regular exercise and education about its benefits reduce the risk of developing lower-back pain by as much as 45%.  Analysis of date from 20 trials including 7,295 patients by researchers at University of Sydney, Australia, published in JAMA Internal Medicine.”

Huh? No mention of chiropractic care, imagine that. What is important here is that the meds most often recommended (still), don’t work – instead we have an epidemic of the consequences of their use.

What is also important is that exercise is a big deal and will work. Of course, not all exercises, are equal: what to do, when to do it, how to do it; what not to do and why are factors to consider. I think it’s important to consult someone who knows something about these things.

If you are in Everett, WA or the surrounds, that could be me:-)

November 9, 2016

Chiropractic IS Effective, Cost-Effective, and Safe

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Bishop, et al. (2010) The Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) Study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain. The Spine Journal 10: 1055-64

 

“This is the first reported randomized controlled trial comparing CPG-based treatment, including spinal manipulative therapy administered by chiropractors, to family physician-directed usual care in the treatment of patients with acute mechanical low back pain.”

“Compared to family physician-led usual care, full clinical guidelines-based treatment including chiropractic spinal manipulative therapy is associated with significantly greater improvement in condition specific functioning.”

November 7, 2016

A Tale of Two Studies

Workers’ Back Pain: Causes, Costs & Solution

By Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher

You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.

Examining Workplace Risk Factors for LBP

The first paper comes from the Journal of Manipulative and Physiological Therapeutics(JMPT).1 The authors examined how certain workplace risk factors impact the prevalence of low-back pain (LBP). Here are some of their important findings:

  • More than a fourth of workers experienced LBP in the previous three months (25.7 percent).
  • Female and older workers were at increased risk for LBP.
  • Women working 41-45 hours a week and young people working more than 60 hours had an increased risk of LBP.
  • Work-family imbalance, a hostile work environment and job insecurity were significantly associated
    with LBP.

Treatment Options: DC vs. MD vs. PT Care

The second paper, published in the Journal of Occupational Rehabilitation, also looked at workers’ back pain.2 This paper examines provider effectiveness through the lens of worker’s compensation costs. The authors evaluated the experience of workers with back pain who saw a DC, MD or PT and discovered the following:

  • [T]he median number of days of the ï¬ï¿½rst episode of any wage compensation were 8.0 (95% CI 6.6–9.4), 10.0 (95% CI 9.5–10.0) and 25.0 (95% CI 20.3–29.7) for the workers who ï¬ï¿½rst consulted chiropractors, physicians and physiotherapists, respectively.”
  • 15.0% (n = 92) of the chiropractic care seekers, 16.2% (n = 738) of the physician care seekers and 23.7% (n = 40) of the physiotherapist care seekers had a second compensation episode.”
  • When compared with medical doctors, chiropractors were associated with shorter durations of compensation and physiotherapists with longer ones. Physiotherapists were also associated with higher odds of a second episode of ï¬ï¿½nancial compensation.”
  • These differences raise concerns regarding the use of physiotherapists as gatekeepers for the worker’s compensation system.”

Together, these studies tell employers that one-fourth of their workers will have back pain each quarter. Women, older workers, those working significant overtime and workers under certain psychosocial pressures will experience more back pain, leading to more time off work and lost productivity.

However, they can help offset these challenges by encouraging their workers to seek chiropractic care. Chiropractic care has been shown to shorten the time off work, reduce the likelihood of relapse and save substantial amounts of money in worker’s compensation claims and lost production – more than any other provider.

Let Employers Know

Unfortunately, most employers will never see these studies or hear this important information. This is where you come in.

Begin to share this information with your patients, particularly the ones who are in management positions. Make an appointment with local businesspeople in your area regarding how to reduce worker’s compensation costs and lost production in their company. Write a cover letter (use the content in this article shamelessly) and let the business leaders in your community know you have important information that can save them money.

A little action on your part can change the understanding and appreciation of chiropractic for literally thousands of workers. It’s well-worth the time and effort required.

References

  1. Yang H, Haldeman S, Lu M-L, Baker D. Low back pain prevalence and related workplace psychosocial risk factors: a study using data from the 2010 National Health Interview Survey. J Manipulative Physiol Ther, 2016;39:459-472.
  2. Blanchette M, Rivard M, Dionne CE, et al. Association between the type of first healthcare provider and the duration of financial compensation for occupational back pain. J Occup Rehabil, 2016 Sep 17 (epub ahead of print).

October 31, 2016

Chiropractic IS Effective, Cost-Effective, and Safe

Schifrin, L.G. (1992). Mandated Health Insurance Coverage for Chiropractic Treatment: An Economic Arrangement with Implications for the Commonwealth of Virginia. Richmond, Virginia. 

“A fair interpretation of the evidence accumulated to date indicates that the impact of chiropractic mandates comes close to the “best case” scenario of low costs and high benefits.”

“Accordingly, the continuation of mandated chiropractic provider services in health care appears both reasonable and sound. It is a cost-effective provision in health insurance, and one that also serves the important goal of health care cost containment.”

what-controls-the-heart

October 11, 2016

Why the Variable-Height Work Stations Don’t Always Solve The Problem

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(Variable Height!)

I was talking today with a patient about her new variable-height work station and I realized why they don’t always work out that well. Don’t get me wrong, they are a good idea and I support using them.

Here’s the thing, if your posture and the way you relate to (1) the floor, (2) your chair, (3) your keyboard, and (4) your monitor is faulty, and you now stand up but still relate poorly in all but one of those respects, how much better off are you, really?

Up, down, or in between, the work station has to relate to the human’s normal, healthy, correct, posture and alignment or it isn’t doing much good.

I haven’t studied all the newest variable-height work stations but here is what they need to do to accommodate humans: and this applies to both the standing and the sitting postures, they aren’t really that different, except for the chair dynamics.

First, how to stand: the human needs to know how. Someone should teach them. I have offered, and am available (this applies to all that follows and more of course, since it is what I have been Blogging about for the past six years).

(Second: the only thing that changes with sitting is: the human should know how to sit. Someone should teach them…blah, blah, blah.)

As a matter of principle, it makes sense to me that the v-h work station should then match the normally aligned human: if the human bends their elbows to about ninety degrees they should find their keyboard and mouse right under their hands. The humans shoulders, chest, and spinal alignment should not have to change to accommodate the v-h station: if you have to lean forward, hunch, or reach, you loose.

The monitor needs to be positioned so that with the head in neutral and the eyes tracking down gentle angle, the monitor is right there: no goosenecking allowed; and certainly no nose-in-the-air posture like you see all day on the road (look at the driver’s on your left and right the next time you are stopped at a light and you will know what I mean.)

So, in order for the v-h work station to achieve all of this for you it has to be designed so that each component moves independently up, down, forward and back. Anything other than that and you will be trying to adapt to your v-h work station in the same ways you have been trying to adapt to your dest now. If it aint right it aint right.

October 1, 2016

Now That Your Are Up

I recently wrote about stretching briefly before getting out of bed in the morning; then I talked about how to safely get out of bed. Now, that business of putting on socks, pants and shoes: the reported cause of so many episodes of lower back pain.

This is about how to move. How to move properly is basic new patient stuff: what we talk about in those first half dozen or so visits. It’s about bracing, and about breathing. It’s about bending and lifting (you don’t think that you are lifting much but the mechanics are the same, and the forces in your low back when you bend to do shoes or socks would shock you. And it’s about knowing a few tricks.

Here is one trick and I know that for some folks, when I talk about the stretch or lifting you foot onto your knee while in the sitting position and putting on socks or shoes from there, it is already too late: they have lost that level of flexibility and can not do it. Sorry, that is a different level of intervention and not Blog Post stuff.

If you can grab your feet then do it sitting down; bring that foot all the way across so that you are not bent over at the low back just to deal with feet: the flexibility should be in the hip. Use the shock and shoe opportunity to stretch out the hip a little, in sitting position. And it’s the same with pants if you know putting them on standing up is a challenge (remember ‘challenge’, ‘struggle’ and easy from earlier Posts? If not search those terms.)

Most important, probably, is that just like older folks may have to ‘gather’ themselves (be mindful) when they get upright or they could fall down faster than they got up, it is important for you to be paying attention to each step in the process and move deliberately.

August 15, 2016

Back Pain Facts & Questions

 

Mechanical low back pain is one of the most common patient complaints expressed to emergency physicians in the United States, accounting for more than 6 million cases annually. Approximately two thirds of adults are affected by mechanical low back pain at some point in their lives, making it the second most common complaint in ambulatory medicine and the third most expensive disorder in terms of healthcare dollars spent, surpassed only by cancer and heart disease.

Low back pain is considered chronic after 3 months because most normal connective tissues heal within 6-12 weeks, unless pathoanatomic instability persists. A slower rate of tissue repair in the relatively avascular intervertebral disk may impair the resolution of some persistent painful cases of chronic low back pain. An estimated 15%-20% develop protracted pain, and approximately 2%-8% have chronic pain. Of those individuals who remain disabled for more than 6 months, fewer than half return to work, and after 2 years of low back pain disability, a return to work is even more unlikely.

You can lower your risk of getting back pain; call to find out how: (425) 348-5207.

And, of course, if prevention is not your thing and you find yourself in the middle of an episode, we can help with that too!

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