Monday, January 5, 2015

Still Waiting

I has now been 21 years since the Federal Government came out with guidelines for the treatment of acute lower back pain in adults.  It was researched by a group called the Agency for Healthcare Policy and Research or AHCPR.  Their task was to find out the best and most efficient ways to treat common medical conditions such as lower back pain.  In lower back pain it recommended non steroid antiinflammatory medication, spinal manipulation, and exercise as the most effective treatments.

Today research continues to show that these three treatments are the best option for lower back pain.  A guideline from 2007 in the Annal of Internal Medicine suggested the same treatments to be the most effective treatments for lower back pain.  Here is a link to the study from the National Institutes of Health.  In 2010 a research article from the journal Spine suggested the same treatments.  They recommended NSAID and spinal manipulation for acute lower back pain and the addition of exercise for chronic back pain.  Here is a link from the NIH  And finally this is another study from 2010 which states that when MDs and DCs used lower back treatment guidelines that patients had "significant improvement in condition specific functioning.  Here is a link to the study
Why talk about an old study?  Well I have a friend who has lower back pain and was prescribed 3 opioid pain medications, 2 muscle relaxers, and two anti inflammatory medications for his lower back.  All the current (and past evidence) guidelines have not shown these types of treatments to be effective at all. In fact they are harmful.   No one has mentioned spinal manipulation or exercise for this patient.  Sadly with the AHCPR its funding was killed by Congress in 1998 after a group of spinal surgeons got mad that it suggest the lower back surgery was often unnecessary and harmful.
So here we are 21 years later still using ineffective and dangerous treatments in the treatment of lower back pain.  Hope I don't have to wait another 21 years for people to do the right thing?

Monday, September 22, 2014

The Most Disabling Disease in the World

So what do you think could be the most disabling disease in the world today? Diabetes, Cancer, Heart Disease, Malaria, well the answer is no to all those conditions. Lower back pain is the most disabling disease worldwide today.
Here are some facts; effects more people than AIDS, breast and lung cancer, malaria, stroke, diabetes, Alzheimer's disease, depression or traffic accidents. Sadly in third world country's many people that suffer disabling lower back pain will die from starvation due to the inability to earn and living and lack of a social program to help them. The Global burden of disease is moving away from infectious disease like malaria to musculoskeletal disorders. It effects women more than men, rural more than urban, poor more than wealthy. There is an estimate that in the U.S. if you take health care costs, disability, and lost productivity the result is $250 billion a year which is equal to all the gold in Fort Knox. So what does current research tell us. Well one thing it shows is that the more we spend the worse the patient gets. A study by orthopedist, Richard Deyo, M.D. demonstrated that procedures such as spinal injections were up 600%, opioid prescriptions were up over 400%, MRI's are up over 300%, and lower back surgery is up 220% over the last 10 years. So these expensive procedures are way up but so is the rate of disability it has jumped from 20 to 30%. So what works? Well I know I sound like a broken record but NSAID (aspirin, ibuprofen, and Alleve) spinal manipulation and exercise therapy have been shown to work the best, cost the least, and prevent disability. The University of Pittsburgh Medical Plan has mandated that MDs must send a patient to a chiropractor or physical therapist before they see an orthopedic surgeon or pain management doctor if the patient has chronic lower back pain. The chiropractic profession is currently working with a company made up of researchers, MDs, pain management doctors which would like to try something radically different in the treatment of lower back pain. They want to send anyone with lower back pain to a chiropractor or physical therapist first before seeing a medical doctor. They have suggested that one insurance company alone could save $30-40 million/year out of a lower back surgery budget of $50 million/year. That is quite a bit of savings up to 60-80%. This approach has been attempted and it was found that the chiropractors could successfully treat 83% of the patients that came into their office. The other 16% were referred out to specialists. Out of the 83% successfully treated 95% rated their care as excellent. So we are working on trying to improve care and outcomes. I don't know if something like this will really catch on but I think it is worth a try.

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Suffering from back or neck pain give modern chiropractic a try and call our office at (512) 556-8223.

Thursday, June 26, 2014

How about those Headaches?

Headaches are currently the 3rd most common reason for seeing a doctor of chiropractic. Migraine headaches are the most common reason to seek medical care. Over 30 million Americans suffer migraines each year. There is currently some good research on what types of headaches respond best to chiropractic care. Most of the current research suggests that chiropractic care works best with cervicogenic and migraine headaches. It seems that the number of treatments vary from 8 to about 16 over 4 to 8 weeks of care. In a high quality systematic review (the highest standard of research)it was found that for cervicogenic headaches spinal manipulation was more beneficial than physical therapy, massage, drug therapy and no intervention. Most headache guidelines recommend a trial of spinal manipulation over a 4 week period to see if this may help a patient with headaches. This is important to me personally because I suffer from migraines. I will get a headache where I have to go lie down in a dark room and sometimes will vomit before I feel better. I hate them. If I do get regular chiropractic adjustments this goes a long way to prevent them for occurring in the first place. If you know someone who has been suffering have them call our office we might just be able to get them to become headache free.

Thursday, April 10, 2014

Addicted to sugar?

Great little video on sugar addiction

Addicted to sugar?

Avoid artificial sweetners and keep sugar to less than 2 Tbs/day

Thursday, April 3, 2014

Where Are You Headed?

"The greatest thing in the world is not so much where we are, but in what direction we are moving." O.W. Holmes

Where Are You Headed?

"The greatest thing in the world is not so much where we are, but in what direction we are moving." O.W. Holmes