Neck Pain – Chiropractic and the Older Patient

People of all ages suffer from neck pain, and many frequently turn to chiropractors for care because it’s been found to be one of the most effective and efficient forms of treatment available, and it carries minimal side effects! It has been projected that by 2030, nearly one in five residents in the United States will be 65 or older. Currently, approximately 14% of the patients treated by chiropractors are 65 or older, making it one of the most frequently utilized forms of complementary and alternative care used by older adults. What kind of care can a senior citizen expect when seeking treatment from a chiropractor?

Let’s take a look…

Musculoskeletal pain—pain in the neck, back, arms, and/or legs—drives the majority of elderly patients to chiropractors. While low back and neck pain are the most common complaints, it’s not unusual for patients to also have one or two other conditions (or more) that they did NOT know chiropractic care could help. In fact, common “goals” for managing every patient (not just the elderly) include services related to patient assessment, maintenance of health, and prevention of illness, in addition to treatment of illness or injury. Common chiropractic treatment approaches include spinal manipulation and/or mobilization, nutritional counseling, physical activity/exercise, and (especially important for the elderly population) fall prevention.

Cervical-Strain-Sprain

We will now focus on neck pain as it relates to the elderly population and the various chiropractic management strategies that might be encountered by an elderly patient. Common reasons patients present regarding the neck include limited movement, stiffness, and pain. Neck pain can also interfere with sleep, as finding a comfortable position in bed can be quite challenging! Lifting, carrying, and playing with grandchildren is a very common issue for either causing a new complaint or irritating an existing one. Neck pain may also interfere with reaching and lifting. Thus, activities like yard or garden work may become more difficult and less enjoyable. Neck pain is often associated with headaches, which can make daily tasks even more challenging.

When an elderly patient visits a chiropractor for the first time or for a new complaint, he/she can expect to fill out some initial paperwork, as well as provide a history of the main complaint and any lesser complaints. This may also include providing a family and medical history. The examination usually includes general observations, palpating or feeling for muscle tightness, tenderness, warm/cool, range of spinal motion (neck, back, extremities), orthopedic tests, neurological tests, and possibly x-rays. Treatment of the neck may include massage or mobilization to loosen up the neck, manipulation to free up restricted joint motion, and even exercise training. The goal of treatment is to improve neck motion, activity tolerance, and quality of life (less pain, improved sleep, etc.). So, whether you are 10, 20, 50, 70, or 90 years old, give chiropractic a chance to help you manage your neck pain.

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Back Pain and Posture

Low back pain (LBP) is one of the most common ailments that chiropractors treat. That’s probably because MOST of us will suffer from low back pain that requires outside help at some point in our lives! Posture has long been studied as a potential cause of low back pain, and this month’s topic will take a closer look at some recent research discussing this issue.

A December 2014 study looked at low back posture in two groups of LBP patients and its relationship with problems associated with intervertebral disk diseases. Looking at a person from the side, have you noticed that the low back area has an arched or inward curve? This is called the “lumbar lordosis” (or, the “sway back” area), and this can be highly variable in terms of the angle or amount of arch. It normally differs between males and females. Degenerative disk disease (DDD) is a common condition affecting virtually all of us at some point in time. DDD results in narrowing of the disk spaces, which there are five total in the lumbar spine (twelve in the thoracic spine/mid-back, and six in the cervical spine/neck).

One particular study evaluated a group of 50 patients with long-term intractable (chronic) low back pain with intervertebral disk disease and a group of 50 chronic LBP patients without DDD that served as a “control group.” Researchers measured the degrees of lordosis, or amount of curve (lumbar lordosis), by looking at the person from the side using two different methods in the two patient groups and compared the data. The group with degenerative disk disease had an overall reduction in the lumbar lordosis curve (less arched) using both methods of measuring. The authors concluded that the patients with intervertebral disk lesions had a straighter, or more flat curve (less sway back), when compared to those without disk degeneration. What they were unable to determine was which came first, the disk degeneration or the reduction in the lumbar lordosis?

This study points out several important points. When treating patients with low back pain, some patients feel better when placed in a bent forwards position, or they favor a flat low back curve. Others have the opposite response, or their position of preference favors a more curved (arched) lower spine. The reason for this difference is that LBP is generated from different tissues in the low back, and some tissues favor or feel better in one position and typically feels worse in the opposite direction when injured. The intervertebral disks in the spine lie between the vertebral bodies and serve as “shock absorbers” for the spine and trunk. The center, or “nucleus,” of the disk is liquid-like and is usually well contained inside the disk, held by a tough, outer fibrocartilage material (the “annulus”).

posture

The disk is approximately 80% water, and as we age, the water content gradually reduces and the disk spaces narrow, thus limiting the mobility of that part of the spine. More importantly, DDD usually narrows the size of the canals through which the spinal cord and nerve roots travel. When we bend forward, these canals open up wider placing less pressure on the nerves and/or spinal cord.This is why we often see elderly people leaning on grocery carts when shopping, as it hurts less and they can walk longer / farther. Those with herniated disks tend to be the opposite, as they favor bending backwards as this position shifts the nucleus or liquid center forwards and away from the nerve root thus reducing the pinched nerve resulting in less or complete elimination of radiating leg pain.

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What’s This Tingling in My Leg?

When you think of low back pain, you may visualize a person half-bent over with their hand on the sore spot of their back. Since many of us have experienced low back pain during our lifetime, we can usually relate to a personal experience and recall how limited we were during the acute phase of our last LBP episode. However, when the symptoms associated with LBP are different, such as tingling or a shooting pain down one leg, it can be both confusing and worrisome – hence the content of this month’s article!

Let’s look at the anatomy of the low back to better understand where these symptoms originate. In the front of the spine (or the part more inside of the body), we have the big vertebral bodies and shock absorbing disks that support about 80% of our weight. At the back of each vertebrae you’ll find the spinous and transverse processes that connect to the muscles and ligaments in the back to the spine. Between the vertebral body and these processes are the tiny boney pieces called the pedicles. The length of the pedicle partially determines the size of the holes where the nerves exit the spine.

Digital blue human rubbing highlighted red lower back pain

When the pedicles are short (commonly a genetic cause), the exiting nerves can be compressed due to the narrowed opening. This is called foraminal spinal stenosis. This compression usually occurs later in life when osteoarthritis and/or degenerative disk disease further crowds these “foramen” where the nerves exit the spine. Similarly, short pedicles can narrow the “central canal” where the spinal cord travels up and down the spine from the brain.

Later in life, the combined effects of the narrow canal plus disk bulging, osteoarthritic spurs, and/or thickening or calcification of ligaments can add up to “central spinal stenosis.” The symptoms associated with spinal stenosis (whether it’s foraminal or central) include difficulty walking due to a gradual increase in tingling, heavy, crampy, achy and/or sore feeling in one or both legs. The tingling in the legs associated with spinal stenosis is called “neurogenic claudication” and must be differentiated from “vascular claudication”, which feels similar but is caused from lack of blood flow to the leg(s) as opposed to nerve flow.

At a younger age, tingling in the legs can be caused by either a bulging or herniated lumbar disk or it can be referred pain from a joint – usually a facet or sacroiliac joint. The main difference in symptoms between nerve vs. joint leg tingling symptoms is that nerve pinching from a deranged disk is located in a specific area in the leg such as the inside or outside of the foot.

In other words, the tingling can be traced fairly specifically in the leg. Tingling from a joint is often described as a deep, “inside the leg,” generalized achy-tingling that can affect the whole leg and/or foot or it may stop at the knee, but it’s more difficult to describe by the patient as it’s less geographic or specific in its location. Chiropractic management of all these conditions offers a non-invasive, effective form of non-surgical, non-drug care and is the recommended in LBP guidelines as an option when treating these conditions.

Chiro-Trust.org


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Neck Function and Balance

In the nervous system, there are three primary areas that regulate our balance: the cerebellum (located in the back of the brain), the dorsal columns (located in the back of the spinal cord), and the inner ear (the “vestibular” part of our cranial nerve VIII). There are also small, microscopic “proprioceptors” or mechanical receptors located in our joint capsules, muscles, and tendons that relay information to the brain and work hard to keep us upright when we walk, run, and play!

Conditions that can result in balance problems include, but are not limited to, BPPV (Benign Paroxysmal Positional Vertigo), spinal stenosis (narrowing of the spinal canal where our spinal cord is located), dorsal column disease, cerebellar lesions, and/or circulation loss into the back of the brain. Other conditions associated with light headedness include low or high blood pressure, hydration, medications, postural or orthostatic hypotension, diabetes, endocrine disorders, hyperventilation, heart conditions, and vasovagal syncope. However, issues with BPPV/inner ear are the most common reported cause of dizziness.

Emergency actions should be exercised when dizziness is associated with chest pain, shortness of breath, or palpitations. If eating helps resolve the dizziness, blood testing for hypoglycemia is appropriate. If confusion, memory lapses, changes in speech, facial droop, weakness on one side of the body, or acute headache occur, these could be signs of a stroke or a brain bleed or tumor and should be quickly evaluated.

Balance

If ANY of these signs or symptoms is present, we will refer you to the appropriate specialty for further evaluation.

The upper cervical spine has also been found to affect balance, and it’s a primary area of treatment that we as chiropractors focus on when patients complain about balance dysfunction. Unique to this upper cervical region is the fact that the nucleus of cranial nerve V (the trigeminal nerve) extends down the spinal canal to the C2 level and adjustments in this region can have significant benefits for several other conditions, including trigeminal nerve problems as well as BPPV (inner ear dysfunction such as dizziness) where small crystals dislodge from the ampulla of the semicircular canal and interfere with the flow of fluid inside the canal with resulting dizziness. Adjustments and the BPPV exercises (Epley’s and / or Brandt-Daroff) significantly benefit this cause of dizziness.

You can depend on our evaluation to determine if chiropractic is the right choice in managing your balance disturbance.

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The Relationship of the Hip, the Low Back, and Knee

The hip is a very unique joint. The depth of the socket, the strength of the muscles and ligaments surrounding it, and the way it functions in weight bearing activities is unlike any other joint in the body. The focus this month is on the relationship between the hip and the rest of the body.

The hip joint is a synovial joint, meaning it moves freely. It is a ball-and-socket joint that is made up of the femoral head (the “ball”) and the acetabulum (the “socket”). The ball is largely contained within the cup or socket, though there are genetic and cultural differences with regards to the depth and shape of the hip joint in any one individual.

The relationship between the hip and the surrounding joints is intimate in that each joint affects the next. For instance, ankle pronation—or the inward rolling of the foot and ankle—results in a knocked knee, which can then shift the hip outwards. The pelvis then drops down on that side, the tailbone or sacrum becomes unleveled or sloped, and the lower spine curves to compensate with the ultimate goal of keeping your eyes level. Hence, when your hip hurts, your doctor of chiropractic will examine and treat the ENTIRE lower kinetic chain—the foot, ankle, knee, hip, pelvis, and spine—as ALL are so closely related to each other. When it comes to managing you and your hip pain, be prepared for management of any of the following:

Ankle pronation: This is the inward rolling of the ankle often associated with a flat foot. When viewing someone with ankle pronation from behind, the angle from the Achilles tendon to the ground will lean inward when it normally should be perpendicular. A valgus correction in a “rear foot post”—a heel wedge thicker on the inside—of a foot orthotic (customized arch support) is needed to correct this.

  • Knocked-knees: Ankle pronation can result in “knocked-knees” (genu valgus) which overloads or jams the outer knee joint, over-stretching the inner knee joint and ligaments. The knee cap (patella) then rides  excessively hard on the outer surface of the femoral groove in which it glides as one bends and straightens their knee, causing knee cap pain.
  • Hip inward angulation (or coxa vera): As the knee shifts inward or knocks, the head of the femur moves outward, leaving the joint less stable.
  • Leg length deficiency (LLD)—or a short leg—occurs when the pelvis drops on that side further destabilizing the lower kinetic chain.hip, knee

Once ankle pronation is properly corrected with a rear foot post and the hind foot is repositioned back to neutral (if LLD persists) a heel lift can be placed under the foot orthotic to corrective this imbalance. ONLY then will the pelvis become level and stable so it can properly serve as a strong foundation for the spine the rest of the body to rest on!

We haven’t touched the subject of muscle imbalance, strengthening of commonly weak hip extensor muscles, or stretching of overly tight hip flexors and adductor muscles—topics for another day! The good news—doctors of chiropractic can help you with this common problem!

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Posted in Back pain, Chiropractic, Knee, Leg Length, Orthotics, Pain, Sports-Injuries, tingling in leg | Tagged , , , , , | Leave a comment

Balance and Brain Health

During the course of the history and examination with new patients, it’s quite common to encounter seemingly unrelated complaints that may benefit from chiropractic care. For example, last month we looked at alternative nutritional approaches to treating high cholesterol rather than jumping at the use of statin medications. We’ve also discussed the association between balance and the neck and how important chiropractic adjustments are to the upper cervical spine in managing balance-related complaints such as Benign Paroxysmal Positional Vertigo (or BPPV). This month, let’s investigate the relationship of balance and how it relates to the health of the brain!

A 2014 study published in the journal Stroke found that difficulty balancing on one leg (eyes open) for at least 20 seconds is a possible sign of brain damage in an otherwise healthy person. In other words, there appears to be an association between poor balance and an increased risk for small blood vessel damage and reduced cognitive function (memory, association, the ability to communicate well, stay on task, etc.) in people who appear to be healthy. The authors state, “Our study found that the ability to balance on one leg is an important test for brain health.” In this study, 841 women and 546 men (average age was 67 years old) were asked to stand on one leg for up to 60 seconds with their eyes open. Each participant repeated the exam twice and researchers recorded the best time. Next, each participant had a brain MRI to assess for small vessel disease and completed a computer based-questionnaire to measure cognitive function. Researchers found an association between the presence of small vessel disease and the inability to stand on one leg with their eyes open for more than 20 seconds. More importantly, they found a similar association with subclinical (no symptom expression) blood clots/micro bleeds and cognitive loss with this balance impairment. In a similar study in early 2014, other researchers reported that an association exists between the amount of time 53-year-old men and women are able to stand on one leg and “…all cause mortality rates.” When the small arteries in the brain are damaged and lose their flexibility, blood flow is interrupted to the brain depriving oxygen to the tissue, something that is more likely to happen with advancing age. 5-Exercises-to-Improve-Balance-for-Multiple-Sclerosis-722x406

We encourage our readers to “test” their balance by standing on one leg with their eyes open for up to 30 seconds and eyes closed for up to 25 seconds (“normal” = 25 seconds for up to age 59; age 60-69 = 10 seconds, and age 70-79 years old = 4 seconds). Don’t forget to repeat this process on the other leg! If you are unable to do this, your doctor may recommend doing “proprioception exercises” followed by re-testing this skill every 15-30 days to track your progress. This is a very common problem, and it usually improves with balance-challenging exercises. These exercises include simply standing on one leg while in the kitchen, watching TV, standing in line… you name it! Take advantage of your standing time and do some balance challenging exercises! Of course, if you’re wobbly and find yourself “windmilling” to maintain your balance, do this in a safe environment—in the corner of a room, for example. To make the exercise even more challenging, try standing on a pillow or a folded up towel and/or shut your eyes to REALLY make your brain work! Your doctor of chiropractic can also train you on the use of a rocker board, wobble board, and gym ball for adding more fun and are very effective ways to improve your proprioceptive skills. He or she can test you to see what your balance skills are and according the latest research. This test may even reveal additional important information.                    

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What’s This Tingling in My Leg?

When you think of low back pain, you may visualize a person half-bent over with their hand on the sore spot of their back. Since many of us have experienced low back pain during our lifetime, we can usually relate to a personal experience and recall how limited we were during the acute phase of our last LBP episode. However, when the symptoms associated with LBP are different, such as tingling or a shooting pain down one leg, it can be both confusing and worrisome – hence the content of this month’s article!

Let’s look at the anatomy of the low back to better understand where these symptoms originate. In the front of the spine (or the part more inside of the body), we have the big vertebral bodies and shock absorbing disks that support about 80% of our weight. At the back of each vertebrae you’ll find the spinous and transverse processes that connect to the muscles and ligaments in the back to the spine. Between the vertebral body and these processes are the tiny boney pieces called the pedicles. The length of the pedicle partially determines the size of the holes where the nerves exit the spine.

When the pedicles are short (commonly a genetic cause), the exiting nerves can be compressed due to the narrowed opening. This is called foraminal spinal stenosis. This compression usually occurs later in life when osteoarthritis and/or degenerative disk disease further crowds these “foramen” where the nerves exit the spine. Similarly, short pedicles can narrow the “central canal” where the spinal cord travels up and down the spine from the brain. Later in life, the combined effects of the narrow canal plus disk bulging, osteoarthritic spurs, and/or thickening or calcification of ligaments can add up to “central spinal stenosis.”

The symptoms associated with spinal stenosisnormal-vs-spinal-stenosis-in-vertebrae-01 (whether it’s foraminal or central) include difficulty walking due to a gradual increase in tingling, heavy, crampy, achy and/or sore feeling in one or both legs. The tingling in the legs associated with spinal stenosis is called “neurogenic claudication” and must be differentiated from “vascular claudication”, which feels similar but is caused from lack of blood flow to the leg(s) as opposed to nerve flow.

At a younger age, tingling in the legs can be caused by either a bulging or herniated lumbar disk or it can be referred pain from a joint – usually a facet or sacroiliac joint. The main difference in symptoms between nerve vs. joint leg tingling symptoms is that nerve pinching from a deranged disk is located in a specific area in the leg such as the inside or outside of the foot. In other words, the tingling can be traced fairly specifically in the leg. Tingling from a joint is often described as a deep, “inside the leg,” generalized achy-tingling that can affect the whole leg and/or foot or it may stop at the knee, but it’s more difficult to describe by the patient as it’s less geographic or specific in its location.

Chiropractic management of all these conditions offers a non-invasive, effective form of non-surgical, non-drug care and is the recommended in LBP guidelines as an option when treating these conditions.

Chiro-Trust.org


Posted in Back pain, Chiropractic, herniated disc, Pain, Pinched nerve, spinal vertebrae, tingling in leg | Tagged , , , | Leave a comment

What Are Cervicogenic Headaches?

Headaches are a very common problem that can have multiple causes ranging from stress to trauma.  To make matters worse, there are MANY different types of headaches. One such type is the “cervicogenic headache” (others include migraines, cluster headaches, etc.).

The main distinction between the symptoms associated with cervicogenic headaches and those associated with migraine headaches are a lack of nausea, vomiting, aura (a pre-headache warning that a headache is about to strike), light and noise sensitivity, increased tearing with red eyes, one-sided head, neck, shoulder, and/or arm pain, and dizziness. The items listed above are primarily found in migraine headache sufferers.   The following is a list of clinical characteristics common in those struggling with cervicogenic headaches:

Headache

  • Pain is localized or stays in one spot, usually the back of the head, frontal, temporal (side) or orbital (eye) regions.
  • Moderate to severe pain intensity.
  • Intermittent attacks of pain that last hours to days.
  • Pain is usually deep, non-throbbing, unless migraines occur at the same time.
  • Head pain is triggered by neck movement, sustained
  • Unilateral (one-sided) head or face pain (rarely is it on both sides).
  • awkward head postures, applying deep pressure to the base of the skull or upper neck region, and/or taking a deep breath, cough or sneeze can trigger head pain.
  • Limited neck motion with stiffness.

Infrequently, the cervicogenic headache sufferer can present with migraines at the same time and have both presentations making it more challenging to diagnose.

The cause of cervicogenic headaches can be obvious such as trauma (sports injury, whiplash, slip and fall), or not so obvious, like poor posture. A forward head posture can increase the relative weight applied to the back of the neck and upper back as much as 2x-4x normal. Last month, we discussed the intimate relationship between the upper two cervical vertebra (C1 & C2) and an anatomical connection to the covering of the spinal cord (the dura) as giving rise to cervicogenic headaches. In summary, the upper three nerves innervate the head and any pressure on those upper nerves can result in a cervicogenic headache. Doctors of chiropractic are trained to examine, identify, and treat these types of potentially debilitating headaches.

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Chiropractic and Obesity

Chiropractic methods are traditionally sought after for pain relief for neuromusculoskeletal conditions or from pain arising from the nervous and musculoskeletal systems. But in the tradition of chiropractic, the WHOLE PERSON is cared for, not just a select region of pain. For example, when a low back pain patient first comes to the office, their history form includes detailed information about their overall health, not just their chief complaint (eg. “low back pain”). A thorough case history form will ask about past accident history, past hospitalizations, current medication list, family and social histories, occupational history, habit history, and a review of all the body’s systems (cardiovascular, respiratory, endocrine, EENT, genitourinary, skin, digestive, blood/lymphatic, and more). Doctors of chiropractic treat the WHOLE person so when obesity is present in a patients, they see treating it as part of the healing process. Granted, the main focus is usually given to the primary or chief complaint, but we must look at all the reasons as to why the low back hurts, especially since, in MOST cases, the cause of low back pain (LBP) is multimodal (there is more than one single cause), though the LAST activity prior the back “…going out,” typically gets the blame. Also, most of us who have had LBP have had it more than once. In fact, most studies report that if you’ve had LBP in the past, you can EXPECT to have it again. That is why your doctor will examine and identify ALL the possible reasons as to why the back was injured and manage everything they can.

ChiroIn addition to all the historical information gathered, a family history of obesity is very relevant in these cases. Also, thyroid deficiency can make weight loss next to impossible since it regulates our metabolic rate and when sluggish, we simply can’t break down fat efficiently and fluid is usually retained (another cause for weight gain). Your doctor of chiropractic may ask what you and your family typically eat. Is it “fast food” or does it consist of whole foods in a well-balanced diet? How about snacking habits? These can “undo” a lot of good if there are abuses in that department. Chiropractors will often integrate exercises into the treatment plan as regaining flexibility, strength, stamina, and coordination ALL help, not only the LBP, but also allows for aerobic activity to be better tolerated and enjoyed. If you experience pain every time you get up to walk, you will react by modifying or stopping that activity.

To continue the example above, doctors of chiropractic will look at all possible causes for low back pain and address things like a short leg, flat/pronated feet, knee, hip, and pelvic issues as all of these can affect the frequency, intensity, and duration of LBP. These possible issues can also impede one’s efforts to exercise, and in fact, may worsen every time they try. Your doctor must FIRST reduce the “cause” of the LBP by decreasing inflammation (“RICE”: rest, ice, compress, elevate). He or she will manipulate within the patient’s tolerance to restore spinal and extremity joint function so exercises do NOT hurt.

They can then guide the patient in the process of integrating exercises into their lifestyle GRADUALLY so he or she can identify any exercise that may be too much for them at that particular time. Of course, nutritional consulting with diets that may include calorie counting / restriction diets, the “Paleo” or caveman diet, low carbohydrate diet, and many other options will be considered. Discussing what the patients has tried in the past that seemed to work, as well as those approaches that failed, is important so they don’t waste time.

Chiropractors WANT to help patients find ways that can be continued for the long-term that they like, that make sense, and that work. THEN, the patient can be in control of their weight, their low back pain, and their lives.

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Chiropractic Adjustments vs. Acupuncture vs. NSAIDs

Wouldn’t it be nice if we could assess three common types of treatment for neck and back pain to determine which is the most effective? Here is a look at three studies that compared three popular forms of care for chronic spinal pain to determine the short-term and more importantly, the LONG-TERM benefits of chiropractic manipulation, acupuncture, and non-steroid anti-inflammatory drugs (NSAIDs, like Advil).

The FIRST published study included a pilot group of 77 patients complaining of chronic spinal pain (neck, mid-back, or low-back pain). These patients were separated into one of the three treatment groups and received either NSAIDs, acupuncture, or chiropractic manipulation. Patients received care for four weeks with outcome measures (questionnaires) used to assess changes in pain and disability. After a 30-day time frame, only patients who received chiropractic manipulation (CM) reached a level of statistically significant improvement, supporting CM to offer the best SHORT-TERM BENEFITS for those with chronic back/neck pain.  Spine Pain

The SECOND study included 115 patients, again randomized, to receive either one of the same three treatments, but this time the outcome data was gathered two, five, and nine weeks after the start of treatment. Again, those who received chiropractic manipulation (CM) experienced the best overall improvement at nine weeks.

The THIRD study involved follow-up from the same patient group from the SECOND study two years later. Once again, participants completed outcome assessments that measure pain and disability. This time, the results showed that only patients in the chiropractic manipulation group maintained long-term improvements in pain and disability.

There have been other studies looking at the efficacy and benefits of SMT (spinal manipulative therapy) both in comparison with other forms of care (as presented here) as well as with different conditions or diagnoses. Perhaps the most exciting results were published in 2008 by the International Bone and Joint Decade 2000-2010 Task Force on Neck Pain.

They divided patients into four groups (Group 1: Neck pain with little to no interference with activities of daily living – ADLs; Group 2: Neck pain that limits ADLs; Group 3: Neck pain with radiculopathy or radiating arm pain from a pinched nerve; Group 4: Neck pain with serious pathology such as cancer, fracture, infection, and/or systemic disease.)

The researchers concluded that chiropractic care was highly recommended especially in Grades 1 and 2 (which includes the majority of neck pain sufferers). Interestingly, many multidisciplinary physician groups now incorporate chiropractic care as part of their “team” approach, which also offer pain management in the form of medications, injections, PT, and when necessary, surgery. They have seen the value of spinal manipulation for neck pain and often seek out chiropractic because it’s safe, beneficial, and cost effective.

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Posted in Arm Pain, Back pain, ChicagoSouthSuburbs, Chiropractic, mid back pain, Neck pain, neck stiffness, Pinched nerve | Tagged , , , , , | Leave a comment