Harvard Health Recommends Chiropractic Care

Where to turn for low back pain relief

In most cases, a primary care doctor or chiropractor can help you resolve the problem.

Low back pain is one of the most common complaints on the planet. And you may wonder where to turn when you start experiencing some of those aches or twinges in the lower part of your back. Take heart. “In most cases, you won’t need a specialist,” says Dr. Robert Shmerling, a rheumatologist at Harvard-affiliated Beth Israel Deaconess Medical Center.

When pain strikes

There are many causes of low back pain. Some of the most common include an injury to a muscle or tendon (a strain), an injury to a back ligament (a sprain), and a herniated or “slipped” disc (when the soft material inside of a disc between spinal bones leaks and irritates nerves). Many of these issues will eventually resolve on their own.

But some causes of low back pain, such as a narrowing of the spinal canal (spinal stenosis), may require a specialist. “A referral makes sense when conservative measures have failed to address your back pain, symptoms aren’t improving or are getting worse, or there’s a suspicion that surgery might be needed,” says Dr. Shmerling.

Where to turn

Since you shouldn’t try to diagnose your own back pain, make your first call to a professional who can assess your problem, such as a primary care physician or a chiropractor. “Both can serve as the entry point for back pain,” says Dr. Matthew Kowalski, a chiropractor with the Osher Clinical Center for Integrative Medicine at Harvard-affiliated Brigham and Women’s Hospital. “And 35% to 42% of people with their first episode of back pain will consult a chiropractor.”

Chiropractors use posture exercises and hands-on spinal manipulation to relieve back pain, improve function, and help the body heal itself. They often work in conjunction with other doctors, and they can prescribe diet, exercise, and stretching programs. “A well-trained chiropractor will sort out whether you should be in their care or the care of a physical therapist or medical doctor,” Dr. Kowalski explains.

The next step

If you do need a specialist on your team, there are many experts who can help, depending on your needs. You may be referred to any of these:

A neurologist, a doctor specializing in treatment of the nervous system. “Back pain is commonly associated with lower-extremity symptoms, such as numbness and tingling. These symptoms can also be caused by neurological conditions that are not spine-related, such as multiple sclerosis. Neurologists are great at sorting this out and offering solutions,” says Dr. Kowalski.

A physiatrist, a doctor with expertise in physical medicine and rehabilitation. “This may be helpful for back pain related to a sports injury, if surgery is not needed, and when medications are not working,” says Dr. Shmerling.

A rheumatologist, a doctor who treats diseases of the joints, muscles, and bones. “Referral is most appropriate when there is inflammation of the joints in the back, or if the back pain might be related to an inflammatory disease, such as psoriatic arthritis,” explains Dr. Shmerling.

A physical therapist, a licensed therapist who can help you strengthen back and core muscles to absorb pressure on the spine.

A pain management physician, a doctor who can prescribe medications, provide injections, and consider other approaches. “People with symptoms that aren’t responding to treatment are great candidates for pain management, such as injections or procedures to smaller joints in lower back,” says Dr. Kowalski.

An orthopedic spinal surgeon or a neurosurgeon who primarily does spine surgery, if surgery is likely needed for severe, unrelenting pain that may be due to a disc or spinal column problem.

Keep in mind

It may take several types of tests, such as x-rays, MRIs, and blood tests, to determine the exact cause of your back pain.

And you may need more than one expert managing your back pain. It just depends on the situation. “Most people who see more than one expert have more than one problem or have not improved with prior treatments,” says Dr. Shmerling.

But for back sprains, strains, and herniated discs, a visit to your primary care physician or chiropractor may be all it takes to feel better. Make that initial call if back pain is interfering with your day.

For more information, check out the Harvard Special Health Report Back Pain: Finding solutions for your aching back.

https://www.health.harvard.edu/pain/where-to-turn-for-low-back-pain-relief

RAND Report: Chiropractic Scores Big in the Military

RAND Corporation research report on availability, documentation, coding, credentialing / privileging practices, and demand for CAM services at military treatment facilities (MTFs) shows chiropractic enjoying substantial success within MTFs in terms of availability, utilization and effectiveness.

The report is based on a survey of MTFs commissioned by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury and conducted from August-October 2015. The survey had an impressive 94 percent response rate from the 142 MTFs, yielding numerous positive findings regarding

  • More than half (55 percent) of the 110 MTFs that offer CAM services provide chiropractic care.
  • Chiropractic is by far the most frequently utilized service (14,000 estimated visits per month – “nearly double the utilization figures for acupuncture, biofeedback, hypnosis and massage combined”). Overall, DCs see almost 3 percent of all MTF-directed outpatient care.
  • Back pain and chronic pain are the most common reasons for chiropractic use within MTFs.
  • Chiropractic patients are more likely to adhere to care than any other CAM patient (61 percent showing “high adherence” and 22 percent “moderate adherence”). Acupuncture is second at 56 percent and 24 percent, respectively.
  • More than half (51 percent) of MTFs report reductions in medication use by patients receiving chiropractic care (second only to acupuncture at 61 percent).
  • The Military Health System boasts more than 100 FTE [full-time equivalent] staff and contract chiropractors, making DCs the fourth most common provider type after medical physicians (370), clinical psychologists (350) and social workers (206).
  • Almost two-thirds of MTFs say chiropractic improves patient satisfaction and patients’ quality of life (65 percent and 63 percent, respectively); 57 percent say it improves functional status; 55 percent say it improves work performance; and 45 percent say it improves sleep.

 

FDA recommends Chiropractic and Acupuncture

The FDA has proposed that doctors learn about acupuncture as an alternative treatment for pain

As a Doctor of Chiropractic practicing since 1998, we have seen a steady rise in opiate prescription for patients that we have co-managed. With the unfortunate death toll now at over 183,000 people just since 1999, new guidelines from the FDA now recommend Chiropractic and Acupuncture as a front line approach before prescription of opiates.

Overdose deaths involving prescription opioids have quadrupled since 1999,1,2  and so have sales of these prescription drugs.3 From 1999 to 2015, more than 183,000 people have died in the U.S. from overdoses related to PRESCRIPTION opioids.1,2

Chiropractors and acupuncturists who have lobbied for a bigger role in treating pain have won a preliminary endorsement from federal health officials.

The Food and Drug Administration released proposed changes Wednesday to its blueprint on educating health care providers about treating pain. The guidelines now recommend that doctors get information about chiropractic care and acupuncture as therapies that might help patients avoid prescription opioids.

“[Health care providers] should be knowledgeable about the range of available therapies, when they may be helpful, and when they should be used as part of a multidisciplinary approach to pain management,” the agency wrote in the proposal.

The suggested changes come as chiropractors and other alternative medicine providers have stepped up lobbying Congress and state legislatures to elevate their role in treating chronic pain. They’ve scored several big victories in recent years.

As opioid crisis flares, naturopaths and chiropractors lobby for bigger roles in treating pain

In Oregon, the state Medicaid program decided to cover chiropractic care for lower back pain starting in 2016. Other states are considering similar moves. And earlier this year, the chiropractic industry cheered when the American College of Physicians recommended non-surgical treatments such as acupuncture, yoga, and chiropractic care as the first options for treating lower back pain.

The FDA’s draft blueprint isn’t final — and drug makers, doctors, and alternative medicine providers will all have a chance to weigh in. The FDA will take public comments through July 10.

The blueprint released this week is part of a strategy the FDA rolled out in 2011 to address a crisis of prescription drug abuse. The FDA required opioid manufacturers to provide education for health providers who prescribe their pain medications — but didn’t mention chiropractic care or acupuncture in its initial blueprint for what that education ought to look like.

Now, the agency is seeking to give prescribers more information on a broader range of approaches to manage pain, including non-pharmacologic therapies, said Sarah Peddicord, a spokesperson for the FDA.

Read the original article on STAT. Copyright 2017.

If you or someone you care about is dealing with chronic pain, please forward this.  It just may save their life.  Dr. Jeffrey Swanson at Cedar Park Chiropractic and Acupuncture has 19 years experience treating and managing patients.  Feel free to contact us at 512-335-0641

The 1%. Great hotels, private jets, and..hospitals?

 


Bottom Line: The Four Seasons, the Ritz-Carlton, The W, and….your local hospital.  Wait, what?!?  What do they have in common?  All of them charge you an arm and a leg for a visit, but some you would rather visit than others. Let’s face it, heading to the hospital is expensive. Did you know a recent study showed that people who use chiropractic care reduced their hospital stays by 59%?
Why it Matters: Hospital visits are unbelievably expensive. We have all heard the stories of the $400 aspirin. Well, it’s no fluke that people who are under the care of a chiropractor are more active and more engaged in staying healthy. And staying healthy can save you money.

Next Steps: Congrats! You are in the right place, but your friends may not be. Take this handout and give it to a friend who has children. Getting their family under chiropractic care may end up saving them a ton of money. Looking out for each other’s health. That’s what friends are for!
Science Source: Clinical Utilization and Cost Outcomes from an Integrative Medicine Independent Physician Association: An Additional 3-Year Update Journal of Manipulative and Physiological Therapeutics May 2007

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Sick of Wasting Money on Medications?

Bottom Line: Sick of spending money on medications that don’t fix your problems? Well, new research has shown that utilizing chiropractic care can decrease the money you spend on medications by up to 85%! We both know that a dollar saved is a dollar earned.

Why it Matters: See people dance through fields of dandelions on television? You know, the standard big pharma interpretation of “health” costs a lot of money. However, all that money spent on commercials does not necessarily make you have a greater quality of life. Top research papers have shown conservative care, such as chiropractic, to reduce pain and improve quality of life. So, not only is saving money a benefit of chiropractic care, but you also can look forward to spending more time doing the things you love, with the people you love.

Next Steps: Take this copy of Research That Matters and share it with a friend who is sick and tired of taking too many medications. It could be their first step towards getting their life back. There may be a better, more natural way for them to find relief with chiropractic care.  Dr. Jeff Swanson has helped countless patients in Cedar Park and Austin since 1999 achieve health without medications or invasive procedures.

Science Source: Clinical Utilization and Cost Outcomes from an Integrative Medicine Independent Physician Association: An Additional 3-Year Update Journal of Manipulative and Physiological Therapeutics May 2007  

https://www.ncbi.nlm.nih.gov/pubmed/17509435

If you would like to schedule a consultation with Dr. Jeff Swanson at Cedar Park Chiropractic, contact us at 512-335-0641.  Our office is location is 345 Cypress Creek Rd. #103 Cedar Park, TX 78613 or online at www.cedarparkchiro.com

Chiropractic Patients Recover Faster, Spend Less Money

Back pain is an expensive health problem for both patients and businesses. A 2012 study reported that we spend about $635 billion on pain every year, with a significant amount of that spent on back pain. Over the years, quite a few studies have shown that chiropractic care is more effective for back pain than medical care, plus chiropractic patients spend less money on their care than medical patients do.

Because back pain is such a common problem, a group of Canadian researchers recently investigated the role that the type of primary caregiver has on financial compensation.

This was a large study of 5,511 patients who experienced a work-related back injury in Ontario, Canada. The patients saw the following providers for their first visit:

  • 85.3% saw a medical doctor
  • 11.4% saw a chiropractor
  • 3.2% saw a physical therapist

The authors set out to “compare the duration of financial compensation for back pain” among patients from each care group.

The study found that chiropractic patients had the shortest amount of time receiving compensation for their pain and also were less likely to have a recurrence.

In addition, chiropractic patients didn’t need to see other healthcare providers for their pain. 75% of chiropractic patients saw no other provider, while 58.6% of physical therapy patients also saw a medical doctor.

The authors conclude:

“The type of healthcare provider first visited for back pain is a determinant of the duration of financial compensation during the first 5 months. Chiropractic patients experience the shortest duration of compensation, and physiotherapy patients experience the longest.”

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. Journal of Occupational Rehabilitation 2016 Sep 17.

By Michael Melton

Efficacy of Chiropractic Care on Cervical Herniated Discs

When studying chiropractic care in relationship to herniated discs and degeneration, we must first look carefully at each component to ensure that we are consistent with language to ensure a better understanding. There have been many reports in the literature on chiropractic care and its efficacy. However, the reporting is often “muddled” based upon interchangeable terminology utilized to describe what we do. The etiology of the verbiage being used has apparently been part of a movement to gain acceptance within the healthcare community, but this attempt for a change in view by the healthcare community has cost us.

Currently, the scientific community has lumped together manipulation performed by physical therapists or osteopaths with chiropractic spinal adjustments because all three professions perform “hands on” manual therapy to the spine. For example, Martínez-Segura, De-la-LLave-Rincón, Ortega-Santiago, Cleland, and Fernández-de-Las-Peñas (2012) discussed how physical therapists commonly use manual therapy interventions directed at the cervical or thoracic spine, and the effectiveness of cervical and thoracic spine thrust manipulation for the management of patients with mechanical, insidious neck pain. Herein lies the root of the confusion when “manipulation” is utilized as a “one-size-fits-all” category of treatment as different professions has different training and procedures to deliver the manipulation, usually applying different treatment methods and realizing different results and goals.

In addition, as discussed by Sung, Kang, and Pickar (2004), the terms “mobilization,” “manipulation” and “adjustment” also are used interchangeably when describing manual therapy to the spine. Some manipulation and virtually all chiropractic adjusting “…involves a high velocity thrust of small amplitude performed at the limit of available movement. However, mobilization involves repetitive passive movement of varying amplitudes at low velocity” (Sung, Kang, & Picker, 2004, p. 115).

To offset confusion between chiropractic and any other profession that involves the performance of some type of manipulation, for the purpose of clarity, we will be referring to any type of spinal therapy performed by a chiropractor as a chiropractic spinal adjustment (CSA) and reserve manipulation for other professions who have not been trained in the delivery of CSA. Until now, the literature has not directly supported the mechanism of the CSA. However, it has supported each component and the supporting literature, herein, will define the neuro-biomechanical process of the CSA and resultant changes.

HERNIATED DISCS

When considering disc issues, Fardone et. Al (2014) defined the nomenclature that has been widely accepted both in academia and clinically and should be adhered to, to ensure that reporting and visualizing pathology is consistent with the morphology visualized. In the past, this has been a significant issue as many have called a bulge a protrusion, a prolapse or herniation. In today’s literature Fardone’s document has resolved much of those problems.

Herniated Disc: “Herniated disc is the best general term to denote displacement of disc material. The term is appropriate to denote the general diagnostic category when referring to a specific disc and to be inclusive of various types of displacements when speaking of groups of discs. The term includes discs that may properly be characterized by more specific terms, such as ‘‘protruded disc’’ or ‘‘extruded disc.’’ The term ‘‘herniated disc,’’ as defined in this work, refers to localized displacement of nucleus, cartilage, fragmented apophyseal bone, or fragmented annular tissue beyond the intervertebral disc space. ‘‘Localized’’ is defined as less than 25% of the disc circumference. The disc space is defined, craniad and caudad, by the vertebral body end plates and, peripherally, by the edges of the vertebral ring apophyses, exclusive of the osteophyte formation. This definition was deemed more practical, especially for the interpretation of imaging studies, than a pathologic definition requiring identification of disc material forced out of normal position through an annular defect.” (page E1454)

 

SPINAL DEGENERATION

Spinal degenerating is typically associated with vertebral body endplate changes, or degeneration of the bones of the spine and it starts at the edges. These changes were classified by Michael Modic MD, Neuroradiologist in 1988 and were classified into 3 categories:

Viroslav (2016) reported:

On histopathologic section, type 1 changes are associated with fissuring of the endplates and infiltration of vascularized fibrous tissue. Increased osteoclasts, osteoblasts, and reactive woven bone are also found, indicating that type 1 changes are due to an inflammatory-type response. Type 2 changes occur due to conversion of red marrow to fatty marrow, and type 3 changes represent subchondral sclerosis…. later studies have shown that endplate changes can fluctuate between types, and some changes can regress completely. Mixed Modic endplate changes are commonly seen, and support the contention that all of the changes are manifestations of the same process at different stages. Modic changes can also regress following lumbar fusion. (http://radsource.us/vertebral-endplate-changes/)

In short, Modic changes are stages reflective of the process the vertebrate undergoes in degeneration. First there is inflammation, then the marrow changes to fat preventing nutrients to feed the bone, followed by sclerotic or degeneration of bone. In the context of this article, how are spinal herniations responding to chiropractic care in lieu of inherent degenerative changes.

 

CHIROPRACTIC CARE
Kressig et. Al (2016) reported:

Although patients who were Modic positive had higher baseline NDI (Neck Disability Index) scores, the proportion of these patients improved was higher for all time points up to 6 months. Pg. 565

The results of the present study on patients with CDH (Cervical Disc Herniation), which indicate better treatment outcomes for patients with CDH with MCs (Modic Changes), are generally consistent with those reported for patients with LDH (lumbar disc herniation), other than the fact that the patients with CDH and MC reported no relapses…It is also important to mention that none of the patients in the present study reported worsening of their condition. Cervical HVLA manipulation (chiropractic spinal adjustment) has been controversial, with suggestions that it can lead to vertebral artery dissection and stroke. However, in 2007, a prospective national survey by Thiel et al studied almost 20 000 patients who were treated with cervical HVLA manipulation or mechanically assisted thrust. There were no reports of serious adverse events, which were defined as symptoms with immediate onset after treatment and with persistent or significant disability. Pg. 572

CONCLUSION

This report on the literature verifies that chiropractic care renders significant improvement in patients with cervical disc herniation in the presence of inflammation and/or degenerative changes using an accepted disability index in a verifiable scenario. This, in conjunction with other numerous report on the efficacy of chiropractic successfully treating patients with herniated discs offers solutions to an injured public.

References:

  1. Kressig, M., Peterson, C. K., McChurch, K., Schmid, C., Leemann, S., Anklin, B., & Humphreys, B. K. (2016). Relationship of Modic Changes, Disk Herniation Morphology, and Axial Location to Outcomes in Symptomatic Cervical Disk Herniation Patients Treated With High-Velocity, Low-Amplitude Spinal Manipulation: A Prospective Study.Journal of manipulative and physiological therapeutics,39(8), 565-575.
  2. Martínez-Segura, R., De-la-LLave-Rincón, A. I., Ortega-Santiago, R., Cleland J. A., Fernández-de-Las-Peñas, C. (2012). Immediate changes in widespread pressure pain sensitivity, neck pain, and cervical range of motion after cervical or thoracic thrust manipulation in patients with bilateral chronic mechanical neck pain: A randomized clinical trial. Journal of Orthopedics & Sports Physical Therapy, 42(9), 806-814.
  1. Sung, P. S., Kang, Y. M., & Pickar, J. G. (2004). Effect of spinal manipulation duration on low threshold mechanoreceptors in lumbar paraspinal muscles: A preliminary report. Spine, 30(1), 115-122.
  2. Viroslav A. (2016) Vertebral Endplate Changes, Retrieved from: http://radsource.us/vertebral-endplate-changes/
  1. Fardon, D. F., Williams, A. L., Dohring, E. J., Murtagh, F. R., Gabriel Rothman, S. L., & Sze, G. K. (2014). Lumbar disc nomenclature: Version 2.0. Recommendations of the combined task forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology. Spine, 39(24), E1448-E1465.

Written by: Mark Studin DC & William J. Owens DC

5 Lifestyle Hacks to Improve your Spine Health and Wellness

The reason we are so passionate about helping you achieve proper spinal health is not about pain control. We all know that chiropractic care is great at relieving aches, pains and pinched nerves but don’t miss out on the true benefits of what we can offer. 

Once your pain and symptoms are decreased or gone is when chiropractic shines!  The pain is just a symptom of a deeper problem.  Removing the nerve interference allows the spinal nerve impulses to allow the body to function at it’s best.  

The reason we feel the following list is so important is underscored by a recent peer reviewed study done by Spine Journal.  In this study it demonstrated that the two main factors that determine how well patients responded with chiropractic care was 1. Spinal flexibility 2. Multifidus muscle strength i.e core strength.  

The following is a short list of extremely affordable products and concepts that will help with assist with Dr. Swanson’s  spinal adjustments, your response and overall health.                                                                             

  1. Trigger Point Foam Roller- “The Grid”.  ($32 on Amazon). You all want a traction table at home right?  Well, this is the next best alternative.  It will help keep your muscles and tendons relaxed between your appointments.
  2. Lacrosse Balls. ($10 on Amazon). This is one step up from the foam roller, but it will allow you to pin point the tight muscles and make your adjustments much more effective!  They are much more dense than a tennis ball, but your body will love it!
  3. Sitting Disc ($24 on Amazon). For all the techies and desk warriors out there this will make sitting at work fun! Well, maybe not but It will help you have better posture and keep the mobility in your spine and pressure off your discs.
  4. Chiroflow Water Pillow ($58 on Amazon).  We all know sleep is so important, so why not have a great pillow to make sure you don’t wake up with headaches or pain??  This is the #1 Chiropractic recommended pillow on the market.  Dr. Swanson has personally used this pillow for the past 18 years.
  5. Fitness Blender.com; FREE!  In addition to chiropractic you need to do your homework in the form of exercise.  This is a totally free site done by personal trainers.  There are over 500 online videos you can do at home with little or no equipment.  Search by core, yoga, pilates, barre, abs….
  6. Personal Training/Workouts:  If you prefer to have more accountability in your workouts here are a few local options to check out!  We have many patients that utilize these different facilities and have had great things to say!  Check them out and see what fits your style best!!

If you have any questions please contact our office to see Dr. Jeff Swanson at 512-335-0641 or online at www.cedarparkchiro.com

 

Office Tour

  • The following are pictures of Cedar Park Chiropractic & Acupuncture.

Chiropractic treatment of Low Back and Pelvic Pain in Pregnancy

The results of this randomized controlled study showed that patients that were seen by a chiropractor showed clinically significant reductions in both pain and disability.  Dr. Jeff Swanson has over 18 years experience working with expecting moms and their OB/GYN.  If you have further questions on how we can help you throughout and after your pregnancy, feel free to contact us at 512-335-0641.