Various Chiropractic Conditions

Various Chiropractic Conditions (10)

RESEARCHED CHIROPRACTIC CONDITIONS-CARE 

This page contains only Peer Reviewed, or Evidenced Based research on Conditions that Chiropractors Treat

The US Chiropractic Directory will only post information about chiropractic that has been proven in a published research setting
 

Chiropractic Scores Highest Among Professional Students in

Understanding Musculoskeletal Conditions 

A report on the scientific literature 


William J. Owens Jr DC DAAMLP

Mark Studin DC, FASBE(C), DAAPM, DAAMLP

 

According to Wikipedia: The musculoskeletal system (also known as the locomotor system) is an organ system that gives animals (including humans) the ability to move using the muscular and skeletal systems. The musculoskeletal system provides form, support, stability, and movement to the body. It is made up of the body's bones (the skeleton), muscles, cartilage, tendons, ligaments, joints, and other connective tissue that supports and binds tissues and organs together. The musculoskeletal system's primary functions include supporting the body, allowing motion, and protecting vital organs. The skeletal portion of the system serves as the main storage system for calcium and phosphorus and contains critical components of the hematopoietic system. 

Musculoskeletal conditions range from neck, mid and low back pain to certain type of headaches and arm and leg pain. Most sports injuries are musculoskeletal in nature as well and most degenerative conditions (arthritis) that prevents the use of an limb over time. If it has to do with moving, lifting, sitting or carrying, it is usually a musculoskeletal condition responsible for the inability to perform that action, or have pain with completing the task related to movement. 

In a recent article written by Humphreys, Sulkowski, McIntyre, Kasiban, and Patrick (2007), they stated, “In the United States, approximately 10% to 25% of all visits to primary care medical doctors are for MSK [musculoskeletal] complaints, making it one of the most common reasons for consulting a physician...Specifically, it has been estimated that less than 5% of the undergraduate and graduate medical curriculum in the United States and 2.26% in Canadian medical schools is devoted to MSK medicine” (p. 44). 

Musculoskeletal complaints have a major impact on the healthcare system and although many patients believe that traditional providers are highly trained, recent publications relating to basic competency have shown otherwise.  For example, the authors cited another study stating, “A study by Childs et al on the physical therapists’ knowledge in managing MSK conditions found that only 21% of students working on their master’s degree in physical therapy and 25% of students working on their doctorate degree in physical therapy achieved a passing mark on the BCE [Basic Competency Evaluation]” (Humphreys et al., 2007, p. 45).  

The authors reported, “The objective of this study was to examine the cognitive (knowledge) competency of final-year chiropractic students in MSK [musculoskeletal] medicine" (Humphreys et al., 2007, p. 45).  "The typical chiropractic curriculum consists of 4800 hours of education composed of courses in the biological sciences (ie, anatomy, embryology, histology, microbiology, pathology, laboratory diagnosis, biochemistry, nutrition, and psychology), chiropractic sciences, and clinical sciences (ie, clinical diagnosis, neurodiagnosis, orthorheumatology, radiology, and psychology).  As the diagnosis, treatment, and management of MSK disorders are the primary focus of the undergraduate curriculum as well as future clinical practice, it seems logical that chiropractic graduates should possess competence in basic MSK medicine” (Humphreys et al., 2007, p. 45). 

The following results were published in this paper for the Basic Competency Examination and various professions that are in the front line of the diagnosis and treatment of musculoskeletal conditions.  In Table 2 on page 47, the following results were shown when the passing score was established at 73% or greater: 

Recent medical graduates (18%), medical students, residents, and staff physicians (20.7%), osteopathic students (29.6%) physical therapy  (MSc level, 21%), physical therapy (doctorate level, 26%), chiropractic students (51.5%). 

In Table 2 on page 47, the following results were show when the passing score was established at 70% or greater.  

Recent medical graduates (22%), medical students, residents, and staff physicians (NA), osteopathic students (33%) physical therapy  (MSc level, NA), physical therapy (doctorate level, NA), chiropractic students (64.7%). 

Although many professions offer significant training in musculoskeletal conditions, chiropractors, based upon their training and outcomes in comparative studies are shown to be highly competent in caring for musculoskeletal conditions. It is therefore in the public's best interest to consider chiropractic as a "first-line" treatment option or the primary care for "all things musculoskeletal." 

Reference: 

1. Human Musculoskeletal System, Retrieved from: http://en.wikipedia.org/wiki/Musculoskeletal_system

2. Humphreys, B. K., Sulkowski, A., McIntyre, K., Kasiban, M., & Patrick, A. N. (2007). An examination of musculoskeletal cognitive competency in chiropractic interns. Journal of Manipulative and Physiological Therapeutics, 30(1), 44-49.

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Urinary Incontinence May Improve

With Chiropractic Care

A 6 year  "Case Report" study of 21 Cases

A report on the scientific literature 



81% of chiropractic case showed improvement

 

by Mark Studin DC, FASBE(C), DAAPM, DAAMLP

 

Urinary incontinence (UI), according to Cuthbert and Rosner (2012) "occurs when there is leakage of urine that is involuntarily, most commonly in older patients. Incontinence affects 4 of 10 women and 1 of 10 men during their lifetime, and about 17% of children younger than 15 years. A large postpartum study of the prevalence of UI found that 45% of women experienced UI at 7 years postpartum. Thirty-one percent who were initially continent in the postpartum period became incontinent in the future" (pg 50.)

According to Holroyd-Leduc et. al (2010) "Urinary incontinence (involuntary leakage of urine) is of high priority to older women. In a survey of 2,500 women aged 55–95, 64% reported that urinary incontinence was of great concern to them but only 25% perceived that it was being adequately addressed by their healthcare providers. The prevalence rate of urinary incontinence is up to 55% among older women.. Urinary incontinence is associated with poor quality of life, poor self-rated health, social isolation, depressive symptoms, decline in instrumental activities of daily living and out-of-pocket expenses. The majority of older women with urinary incontinence remain under-treated" (pg 228.)

 

Cuthbert and Rosner addresses co-morbidities (other problems) of pelvic pain and imbalances and Holroyd-Leduc et. al cites sensory involvement in addition; both conditions that have historically responded well under chiropractic care.

Cuthbert and Rosner reported in a study of 21 patients, that were followed for 6 years that in 48% of the case, the UI symptoms resolved totally, another 33% considerably improved and a further 19% slightly improved. That equates to 81% of the case studies showing improvement with urinary incontinence. Comparatively, Holroyd-Leduc et. al reported that 50% improved with pharmacological trials.  

Based upon the prevalence of urinary incontinence in our population and the conclusion that the vast majority of the population is being undertreated, the public must take an honest look at treatment choices.

Chiropractic, based upon the results shouldn't be considered an alternative choice, but the first line of care with no side effects to consider from medications.  

 

References: 

Scott, C., Rosner A., (2012) Conservative chiropractic management of urinary incontinence using applied kinesiology: a retrospective case-series report, Journal of Chiropractic Medicine, 11 (1) pp 49-57

Holyrod-Leduc J., Straus. S, Thorpe K., Davis D., Schmaltz H., Tannenbaum C, (2010)  Translation of evidence into a self-management tool for use by women with urinary incontinence, Oxford Journals, 40 (2) pp 227-233

 

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Children and Chiropractic Care:

Birth to 18 Years

Conditions cared for and side effects

2012 Report

A report on the scientific literature 


By

Mark Studin DC, FASBE (C), DAAPM, DAAMLP

 

Chiropractic has been successfully caring for children for various conditions for over a century. The main issues are what conditions are cared for by chiropractors, what is the reported success rate and what is the incidence of side effects. Over time, research has started to catch up on what individual chiropractors have been realizing in their private practices and this article will outline the current state of the literature. 

Marchand (2012) reported that an extensive European study was performed revealing that 8.1% of chiropractic practices were children between the ages of 0-18 (this is lower than the 17.1% of pediatric case loads of American Chiropractors.) This was based upon 921 doctors of chiropractic participating and reporting 19,821 pediatric visits, thereby certifying a valid cross-section of patients to conclude results. 

The pediatric related conditions that were reported to be cared for by chiropractors were the following:

  1. Musculoskeletal
    1. Joint pain
    2. Walking/crawling
    3. Neck pain
    4. Mid back pain
    5. Low back pain
  2. Neurological
    1. Headaches
    2. Autism
    3. Balance
    4. Cerebral Palsy
    5. Movement Disorders
    6. ADD/ADHD
    7. Behavioral
    8. Crying/Irritability/Sleep
    9. Developmental
    10. Growing
    11. Cognitive
  3. Gastrointestinal
    1. Colic
    2. Constipation
    3. Digestive
    4. Eating
    5. Drinking
    6. Reflux
    7. Hiatus hernia
    8. Bowel problems
  4. Genitourinary
    1. Menstrual cramps
    2. Bed wetting
  5. Immune
    1. Allergies
    2. Asthma
    3. Food intolerance
    4. Respiratory
    5. Eczema
    6. Skin rashes
  6. Infections
    1. Ear infections
    2. Ear-nose-throat problems
    3. Common cold
    4. Flu

 

Miller and Benfield (2008) conducted a study of children younger than 3 years old to determine the adverse effects of chiropractic care in that age group, arguably the most susceptible to injury based upon the fragility of that age group. The study was based upon 5,242 chiropractic adjustments and if the results were extrapolated to the wider infant/toddler population that receives chiropractic treatment, the adverse reaction rate is expected to be 1 out of every 1300 chiropractic adjustments. There was less than 1% of patients experiencing negative side effects and all of these adverse reactions to care were mild in nature; transient and required no medical care with serious complications. The typical reaction was transient crying.
 
The “Practical Application” reported by Miller and Benfield was that chiropractic adjustments were safe for young children and adolescents.
 

Marchand (2012) also reported the negative side effects of chiropractic care in children to be less then 1% (0.23%,) which is consistent with what Miller and Benfield reported 4 years prior in an independent study. However, Marchand went further to categorize the negative side effects into mild, moderate and severe. In a 1 year study of 237,857 pediatric patients, there was a reported 534 mild side effects (0.2%) and 23 (0.009%) had moderate side effects with 0 (zero) reporting any severe side effects. 

To render perspective on the safety of chiropractic care and children Le, Nguyen, Law and Hodding (2006) reported  "The incidence of adverse drug reactions among hospitalized children in the United States has not been well studied. Because clinical trials involving neonates, infants, children, and adolescents are limited, the safety and tolerability of many pharmacologic agents are not well established. Often the pharmacologic actions of drugs in neonates, infants, and children are not similar to those identified for adults; therefore, information obtained from research with adults cannot be applied directly. On the basis of a meta-analysis of 17 prospective studies conducted in the United States and Europe, the incidence of adverse drug reactions among hospitalized children was 9.5%, with severe reactions accounting for 12% of the total (pg. 557.) 

The above study indicates that side effects need more researched  in many sects of health care, but comparatively speaking, chiropractic is a much safer choice than most alternative options. 

Over time, research will continue to render more outcome statistics on the efficacy of chiropractic care. However based upon the current statistical conclusions, chiropractic is being utilized to help an array of maladies worldwide in the pediatric population with minimal to no side effects.

 

References:

  1. Marchand, Aurelie (2012) Chiropractic Care of Children From Birth to Adolescence and Classification of reported Conditions: An Internet Cross-Sectional Survey of 956 European Chiropractors, Journal of Manipulative and Physiological Therapeutics, 35 (5) 372-380
  2. Miller, J. E., & Benfield, K. (2008). Adverse effects of spinal manipulative therapy in children younger than 3 years: A retrospective study in a chiropractic teaching clinic. Journal of Manipulative and Physiological Therapeutics, 31(6), 419-423.
  3. Studin M. (2010, September). Chiropractic and Children; A Study in Adverse Effects, US Chiropractic Directory. Retrieved from  http://uschirodirectory.com/index.php?option=com_flexicontent&view=items&id=261
  4. Le, J., Nguyen, T., Law, A., Hodding, J. (2006) Adverse Drug reactions Among Children Over a 10-Year Period, Pediatrics, 118 (2) 555-562

 

 

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PRINTED IN THE DYNAMIC CHIROPRACTIC June 17, 2011

Chiropractic Saves Federal and Private Insurers

$15,897,840,000 and Adds $692,160,000

in Wages to Americans

 

A report on the scientific literature 


by Mark Studin DC, FASBE(C), DAAPM, DAAMLP

It was reported by Zigler in 2011 that 200,000 spinal fusion surgeries are performed each year, just in the United States alone. An equal number of microdiscectomies are performed as reported by Mayer (2006), which is considered by many to be a conservative number. Let's consider the chiropractic impact of exposing the public to treatment that could avoid needless surgeries, using the 400,000 disc surgeries as a conservative number, not to mention how this could change the unnecessary cost to government and private insurers and lost revenue to both governmental agencies and workers from absenteeism. Allen and Garfin (2010) reported that spine-related health care expenditures totalled over $97.5 billion (2011 inflation adjusted), a 65% increase from 1997. With an aging population, this trend, based on the biomechanics of the aged, will continue.

It was reported by McMorland, Suter, Casha, du Plessis, and Hurlbert in 2010 that over 250,000 patients a year undergo elective lumbar discectomy (spinal surgery) for the treatment of low back disc issues in the United States. The researchers did a comparative randomized clinical study comparing spinal microdiscectomy (surgery) performed by neurosurgeons to non-operative manipulative treatments (chiropractic adjustments) performed by chiropractors. They compared quality of life and disabilities of the patients in the study.

The study was limited to patients with distinct one-sided lumbar disc herniations as diagnosed via MRI and had associated radicular (nerve root) symptoms. Based upon the authors’ review of available MRI studies, the patients participating in the study were all initially considered surgical candidates. Both the surgical and chiropractic groups reported no new neurological problems and had only minor post-treatment soreness. 60% of the patients who underwent chiropractic care reported a successful outcome while 40% required surgery and of those 40%, all reported successful outcomes. This study concluded that 60% of the potential surgical candidates had positive outcomes utilizing chiropractic as the alternative to surgery.

Let's do the math. If we take the 400,000 disc surgeries (adding cervical surgeries to the equation) done each year as discussed in the opening paragraph and apply McMorland et al.'s (2010) findings that 60% of surgical candidates had successful outcomes with chiropractic as an alternative to surgery, 240,000 patients yearly could avoid needless surgery if they sought chiropractic care.

According to Sherman, Cauthen, Schoenberg, Burns, Reaven and Griffith in 2010, the 2010 inflation adjusted amount per case in Medicare dollars is $13,243.82 per patient once you take into consideration the complications, but exclude many other variables such as repeated MRI's, myelograms, and many hospital charges. Allen and Garfin (2010), taking into account total charges, including mean hospital charges for a single level, uncomplicated, minimally invasive surgery, reported the cost to be $70,159 for all payors. They also went on to report that for 2-level disc surgeries the complication rate increased by 25% with significantly more costs.

If you consider 240,000 preventable surgeries at $70,159 per patient, that equates to $16,838,160,000 healthcare dollars that did not have to be spent. MEDSTAT, as reported by Chiropractic Lifecare of America (2009), estimated that the average cost of chiropractic care per patient per case is $3,918 (2011 inflation adjusted dollars.) If you take this amount and apply it to the 240,000 unnecessary surgeries, you have a net savings of $66,241 per patient. The net savings to the Medicare system and private insurers is $15,897,840,000.

According to Fayssoux, Goldfarb, Vaccaro, James (2010) who studied the indirect costs associated with surgery for low back pain, the average lost productivity related to absenteeism resulted in lost wages of $2,884 per patient for the first postoperative year. "The findings demonstrate the significant, though not surprising, impact of spinal disability on productivity, and the importance of including measurement of lost productivity and return to work..." (Fayssoux et al., 2010, p. 9). This equals an additional $692,160,000 in wages to Americans per year by taking the necessity of absenteeism out of the equation with no surgeries to recover from.

Chiropractic offers solutions to the federal government, local government, and public and private insurance companies by avoiding unnecessary surgeries. Chiropractic offers solutions to the economy of local, state and federal governments by increasing the tax base and productivity in the marketplace as a result of keeping workers at work and circulating money into local economies with increased paychecks at the end of the year. The research is conclusive and chiropractic has solutions to many of the economic and societal problems in the United States and worldwide.

References:

1. Zigler, J. (2002). Lumbar artificial disc surgery for chronic back pain. spine-health. Retrieved fromhttp://www.spine-health.com/treatment/artificial-disc-replacement/lumbar-artificial-disc-surgery-chronic-back-pain

2. Allen, R. T., & Garfin, S. R. (2010). The economics of minimally invasive spine surgery: The value perspective. Spine, 35(Suppl. 26), 375-382.

3. Mayer, H. M. (Ed.). (2006). Minimally invasive spine surgery: A surgical manual. Germany: Springer.

3. McMorland, G., Suter, E., Casha, S., du Plessis, S. J., & Hurlbert, R. J. (2010). Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. Journal of Manipulative and Physiological Therapeutics, 33(8), 576-584.

4. Sherman, J., Cauthen, J., Schoenberg, D., Burns, M., Reaven, N. L., & Griffith, S. L. (2010). Economic impact of improving outcomes of lumbar discectomy. The Spine Journal, 10(2), 108–116.

5. Chiropractic Lifecare of America. (2009). The MESTAT Project. Learning. Retrieved from http://www.clahealthcare.com/learning/index.html

6. Fayssoux, R., Goldfarb, N. I., Vaccaro, A. R., & Harrop, J. (2010). Indirect costs associated with surgery for low back pain—A secondary analysis of clinical trial data. Population Health Management, 13(1), 9-13.

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Older American Utilization of Chiropractic Care

*Persons 65 Years and Older

A report on the scientific literature 


by

Mark Studin DC, FASBE(C), DAAPM, DAAMLP
 

5,372,280 Americans over 65 years old utilize chiropractic
 

According to the US Census Bureau (n.d.), the population in 2008 of persons over the age of 65 was 36,800,000. This represents a significant percentage of the total population and with the "baby-boomers" aging, the number is increasing yearly. As we get older, our bodies start to "break down" and experience signs of "wear and tear" along with other problems. The signs of "wear and tear" are called degenerative joint disease, spondylosis or arthritis as they all mean the same thing. In addition, we get accentuated curves in our spines either from side to side or forward and are both a form of scoliosis and are both unsightly and cause many other problems.

Many of these maladies can either be prevented or mitigated with regular exercise and/or chiropractic care throughout our lives to re-align the spine so that it stays straight. However, once we get older, many of these maladies have a side effect of pain and/or loss of function. In response to this, many older Americans seek solutions to improve function and reduce pain.

One solution that many Americans take is chiropractic care because it is a safe and effective means toward accomplishing the goals of getting well. As far back as 1993, according to Mange, Angus, Papadopoulos, and Swan, chiropractic was deemed safe and effective. This continues to 2010 where the safety of chiropractic was questioned regarding risks of stroke have been also been proven statistically rare with chiropractic care; therefore certifying chiropractic safe 

Weigel et al. (2010) reported that from 1993-2007 there were 14.6% Americans using chiropractic based on respondents in the Survey on Assets and Health Dynamics Among the Oldest Old (AHEAD) and their Medicare claims. Based upon the 2008 census report, that would be 5,372, 800 older American using chiropractic. In addition to the Medicare report, there are also countless others under chiropractic care who choose not to go through the Medicare system. The conclusion is a simple metric; older Americans are choosing a drugless solution to their problems and utilizing chiropractic care.

 

REFERENCES

1. U.S. Census Bureau. (n.d). Table 34. Persons 65 years old and over-characteristics by sex: 1990-2008, Current Population Reports, Retrieved from http://www.census.gov/compendia/statab/2010/tables/10s0034.pdf

2. Mange, P., Angus, D. E., Papadopoulos, C., & Swan, W. R. (1993). A study to examine the effectiveness and cost-effectiveness of chiropractic  management of low-back pain. The Manga Report, Retrieved from http://www.chiro.org/LINKS/GUIDELINES/Manga_93.shtml

3. Weigel, P., Hockenberry, J. M., Bentler, S. E., Obrizan, M., Kaskie, B., Jones, M. P., Ohsfeldt, R., Rosenthal, G. E.,  Wallace, R. B., & Wolinsky, F. D. (2010). A longitudinal study of chiropractic use among older adults in the United States. Chiropractic & Osteopathy, 18(34) Retrieved from http://www.chiroandosteo.com/content/18/1/34

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Monday, 06 December 2010 16:54

Dizziness in Older Adults and Chiropractic Care

Written by

Dizziness in Older Adults and Chiropractic Care

A report on the scientific literature 


by

Mark Studin DC, FASBE(C), DAAPM, DAAMLP

83% of dizziness sufferers showed improvement or eradication under chiropractic care

 

According to Maarsingh , Dros, Schellevis, van Weert, Bindels, and van der Horst in BMC Family Practice (2010), dizziness in older patients is a very common occurrence as reported by family medical practitioners. They reported that an 8.3% one-year prevalence of dizziness was reported in patients over the age of 65, with females having a higher incidence. It was also reported that the number could be higher as this is a symptom reported by the patient.

According to Web MD in 2009, "Dizzinessis a word that is often used to describe two different feelings. It is important to know exactly what you mean when you say 'I feel dizzy' because it can help you and your doctor narrow down the list of possible problems.

Lightheadedness is a feeling that you are about to faint or 'pass out.' Although you may feel dizzy, you do not feel as though you or your surroundings are moving. Lightheadedness often goes away or improves when you lie down. If lightheadedness gets worse, it can lead to a feeling of almost fainting or a fainting spell (syncope). You may sometimes feel nauseated or vomit when you are lightheaded.

Vertigo is a feeling that you or your surroundings are moving when there is no actual movement. You may feel as though you are spinning, whirling, falling, or tilting. When you have severe vertigo, you may feel very nauseated or vomit. You may have trouble walking or standing, and you may lose your balance and fall.

Although dizziness can occur in people of any age, it is more common among older adults. A fear of dizziness can cause older adults to limit their physical and social activities. Dizziness can also lead to falls and other injuries" (http://www.webmd.com/brain/tc/dizziness-lightheadedness-and-vertigo-topic-overview).

As reported by Hampton (2005), dizziness has become such a prevalent problem that in spite of rising health care costs, in 2003, Medicare introduced that routine screenings to new beneficiaries for hearing loss, balance disorders and dizziness would be covered. The reason is that the government is looking long-term to save money; something that rarely happens, but in this case is the best solution.

According to Lynn, Schuster, and Kabcenell (2000), Medicare creates "RUG," a classification of patients in nursing facilities grouped by disability and other care needs, for the purpose of determining coverage and rates in the Medicare system. Dizziness is one of the criteria in determining the reimbursement rates for skilled nursing facilities. The costs for a skilled nursing home depending upon the RUG score ranges from $424.97 to $155.66 per day and the variable is the documented impairment of the resident and the amount of care needed to support that population of residents. From a financial perspective, the Federal Governmental and Medicare have a very high stake in ensuring that hearing and dizziness is cared for and corrected at as early an age as possible to save the system significant money.

In 2009, Hawk and Cambron studied the relationship between chiropractic care and dizziness over an 8 week course of manipulative care (chiropractic spinal adjustments). The patients having a "dizziness handicap inventory" baseline score indicating significant dizziness reported an 83% improvement or eradication of the dizziness as a direct result of chiropractic care. Hawk and Cambron reported that this was a pilot study and more research is needed, but their findings could encourage others to find solutions to a growing problem among older adults in American and could positively impact both the lives of Americans and the financial burden of our economy.

These studies along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions for patients with dizziness. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.

  


References

1. Maarsingh, O. R., Dros, J., Schellevis, F. G., van Weert, H. C., Bindels, P. J., & van der Horst, H. E. (2010). Dizziness reported by elderly patients in family practice: Prevalence, incidence, and clinical characteristics. BMC Family Practice, 11(2), Retrieved from http://www.biomedcentral.com/1471-2296/11/2
2. WebMD (2009). Dizziness: Lightheadedness and vertigo-topic overview. Retrieved from http://www.webmd.com/brain/tc/dizziness-lightheadedness-and-vertigo-topic-overview

3. Hampton, D. (2005). New medicare benefit includes screening for hearing loss and dizziness. Hearing Review, Retrieved from http://www.hearingreview.com/issues/articles/2005-03_07.asp
4. Lynn, J., Schuster, J. L., & Kabcenell, A. (2000). 9.1.2 Skilled nursing facilities. In Improving care for the end of life: A sourcebook for healthcare managers and clinicians. Retrieved from http://www.mywhatever.com/cifwriter/content/66/4332.html
5.  Hawk, C., & Cambron, J. (2009). Chiropractic care for older adults: Effects on balance, dizziness, and chronic pain. Journal of Manipulative and Physiological Therapeutics, 32 (6), 431-437.

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Wednesday, 15 September 2010 21:30

Decreased Muscle Spasms and Chiropractic Care

Written by

Decreased Muscle Spasms and Chiropractic Care

A report on the scientific literature 


By

William J. Owens DC, DAAMLP

Mark Studin DC, FASBE (C), DAAPM, DAAMLP

 

There have been many discussions regarding the effects of the short and long term benefits of a chiropractic adjustment. The ultimate focus is a change in the biomechanics and therefore, the physiology surrounding the affected area of the spine. Although there is a significant amount of evidence showing the effects of spinal adjusting on the central nervous system, this study concentrated on the effects on the peripheral nervous system (outside of the brain and spinal cord) and paraspinal musculature, specifically of the effects of spinal adjusting on the paraspinal musculature in the mid-lower back (thoracic and lumbar spines).

The authors stated, "Many chiropractors palpate for tight muscle bundles in the paraspinal musculature as one indication of where to adjust. It seems reasonable to expect resting muscle activity, which can be monitored by an electromyogram (nerve test to determine muscle firing, and resultant spasm) to be abnormally high in the region of a tight muscle bundle" (DeVocht, Pickar, & Wilder, 2005, pp. 465-466). They went on to state, "In this descriptive study, we have further explored the phenomenon of reduced electromyogram (muscle firing and resultant spasms) activity after [spinal adjusting] to better understand the immediate effects of [spinal adjusting]" (DeVocht et al., 2005, p. 466).

The results of the study showed, "With electromyogram recordings obtained from 2 paraspinal muscle sites on each participant (except for one), 27 of the 31 pre-treatment resting electromyogram levels decreased after treatment. During the 5 to 10 minutes of the treatment protocol, distinct changes (both increases and decreases) in the level of muscle activity were often observed" (DeVocht et al., 2005, p. 470). Ultimately the study revealed, "… the reduction of resting electromyogram activity after [spinal adjusting that we observed in the greater majority of cases is consistent with and supportive of the commonly held perception that tight muscle bundles are associated with low back pain and that they can be alleviated by [a chiropractic spinal adjustment]" (DeVocht et al., 2005, p. 470).



Reference:

1.  DeVocht, J. W., Pickar, J. G., & Wilder, D. G. (2005). Spinal manipulation alters electromyographic activity of paraspinal muscles: A descriptive study. Journal of Manipulative and Physiologic Therapeutics, 28(7), 465-471.

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Thursday, 24 June 2010 23:55

Increased Sports Performance and Chiropractic

Written by

Increased Sports Performance and Chiropractic
 

A report on the scientific literature 



By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP

Allison Bonk BA
 

Strength training is a critical component of fitness for every athlete. Although coaches used to believe resistance exercises only added unnecessary bulk to the athlete, hindering their ability to execute skill, that notion has been proven false.1 The basic conecpts behind this training is to promote a steady and specific increase in strength and other abilities by customizing the routine to the needs of the sport and to the physical capacity of the individual. The rules and principles work hand in hand in order to try to obtain superior programs of strength.2

The benefits of strength training to an athlete's performance are numerous. It is a vital conditioning component for power atheletes and can also be a source for improvement in pure endurance events. However, much sport-specific resistance training requires a more cultivated approach than basic weight-lifting. Explosive power, muscular endurance, maximal strength or some combination of all three are often required in order for a sports participant to be superior. The focus is rarely on pure muscle bulk and even when it is, that does not eliminate the need for strength training.1

Over the past few years, the sport and fitness market has been inundated with products claiming to greatly improve athlethic performance. However, an understanding of biomechanics and exercise physiology reveals that few of these products actually do what they claim to, such as improve strength, speed and power.  In fact, many inhibit them. Rarely do these devices address the issues of anatomical and neuromuscular adaptation, key components for performance improvement.2
 
SPORTS SPECIFIC
 
Regardless of an athlete's sport of choice, stength training is included in the development of one's abilities. Stength training programs can be geared towards overall muscle strength, but many sports trainers focus on specific muscles needed to thrive in a particular area. Therefore, a golf strength training program will differ from that for baseball or tennis; any athlete's stregnth training will focus on the muscles used in their preferred sport. For example, the muscles used in golf need to be trained to work together as one unit. In order to hit the ball, the muscles must twist and turn during the swing and work together to provide a hit stronger hit. In other words, in the case of golf strength training, the focus is on the mucles as a group, rather than individually.3
 
In the case of football players, the benefit of strength and strength training is strongly supported by research. For example, De Proft and colleagues had one group of Belgian players engage in extra weight training during the season. When compared to a control group of colleagues who did no extra training, it was found that the players improved their kicking power and leg strength. In addition, British researcher Thomas Reilly demonstrated that stronger players outlasted weaker players in regards to a regular place in the team. They also had reduced injury risks. His recommendation is to develop leg strength in particular, especially in the quadriceps and hamstrings, in order to help stabilize the knee joint. That joint is the most frequently injured joint in these types of professionals.

Peter Apor, a Hungarian researcher who has been involved in long-term studies of Hungarian professionals, supports this idea, as he has found that the knee-extension torque has been associated with success in the game and that strong hamstring muscles in relation to quadriceps are crucial to knee injury prevention. Another common football injury is hernia. Developing strong abdominal muscles is the best prevention for this type of injury.4
 
RESEARCH
 
In 2006, a research study was performed to assess whether chiropractic adjustments increased muscle strength in leg muscles and the results were conclusive and imperative for any athlete, either professional or recreational. The implications go well beyond sports, as this also affects the workplace and manual labor of any kind.
 
Simply put, the brain has to communicate or talk to muscles in order to fully function or recruit all motor units (individual parts of the muscle) during a maximal voluntary contraction. The adjustment activates mechanoreceptors (parts of the nerve responsible for firing the muscle and causing contractions).
 
The study showed a significant (10%) increase in quadricept (leg muscle) strength in the treatment group after the chiropractic adjustment, while prior to the adjustment there was no statistical difference between treatment groups. This clearly indicates that chiropractic care increases muscle strength in any individual and has far reaching affects in every type of athlete as well as every other activity of daily living.5
 
This study along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions to increase muscle strength. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.comand search your state.




References

1.  Sports Fitness Advisor. (n.d.). Strength Training Section. Retrieved from http://www.sport-fitness-advisor.com/strengthtraining.html

2.  Lawrenson, D. (n.d.). The six basic rules of strength training for sports. Muscle and Strength. Retrieved from http://www.muscleandstrength.com/articles/six-basic-rules-of-strength-training.html
3.  Hubpages, Inc. (2010). Building specific group of muscles with golf strength training 64. Retrieved from http://hubpages.com/hub/Building-Specific-Group-Of-Muscles-With-Golf-Strength-Training
4.  BrainMAC. (n.d.) Strength training for football players. Retrieved from http://www.brianmac.co.uk/football/strength.htm
5.  Hillermann, B.,  Gomes, A. N., Korporaal, C., & Jackson, D. (2006). A pilot study comparing the effects of spinal manipulative therapy with those of extra-spinal manipulative therapy on quadriceps muscle strength, Journal of Manipulative and Physiological Therapeutics, 29(2), 145-149.
 

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Sunday, 06 June 2010 13:35

Muscle Pain, Trigger Points and Chiropractic

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Muscle Pain, Trigger Points and Chiropractic

A report on the scientific literature 



By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
 

"Myofascial pain syndrome is a chronic form of muscle pain. The pain of myofascial pain syndrome centers around sensitive points in your muscles called trigger points. The trigger points can be painful when touched and the pain can spread throughout the affected muscle" (Mayo Foundation for Medical Education and Research, 2009, http://www.mayoclinic.com/health/myofascial-pain-syndrome/ds01042)

Nearly everyone experiences muscle pain from time to time that generally resolves in a few days. But people with myofascial pain syndrome have muscle pain that persists or worsens. Myofascial pain caused by trigger points has been linked to many types of pain, including headaches, jaw pain, neck pain, low back pain, pelvic pain, and arm and leg pain" (Mayo Foundation for Medical Education and Research, 2009, http://www.mayoclinic.com/health/myofascial-pain-syndrome/ds01042).

"MPS may be related to a closer-studied complex condition known as fibromyalgia. By accepted definition, the pain of fibromyalgia is generalized, occurring above and below the waist and on both sides of the body. On the other hand, myofascial pain is more often described as occurring in a more limited area of the body, for example, only around the shoulder and neck, and on only one side of the body.

Neither MPS nor fibromyalgia is thought to be an inflammatory or degenerative condition, and the best evidence suggests that the problem is one of an altered pain threshold, with more pain reported for a given amount of painful stimuli. This altered pain threshold can be manifest as increased muscle tenderness, especially in the certain areas, e.g., the trapezius muscle. These syndromes tend to occur more often in women than in men, and the pain may be associated with fatigue and sleep disturbances" (Wikipedia, 2010, http://en.wikipedia.org/wiki/Myofascial_pain_syndrome).

In 2009, a comprehensive study  by Vernon & Schneider reported that manual-type therapies (chiropractic care) have acceptable evidentiary support in the treatment of myofascial pain syndrome and myofascial trigger points. This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions for myofacial pain syndrome. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.uschirodirectory.comand search your state.
 

References:

1.  Mayo Foundation for Medical Education and Research. (2009, December). Mayofacial pain syndrome. Retrieved from http://www.mayoclinic.com/health/myofascial-pain-syndrome/ds01042

2.  Wikipedia, The Free Encyclopedia. (2010, July). Myofacial pain sydrome. Retrieved from http://en.wikipedia.org/wiki/Myofascial_pain_syndrome
3.  Vernon, H., & Schneider, M. (2009). Chiropractic management of myofascial trigger points and myofascial pain syndrome: A systematic review of the literature. Journal of Manipulative and Physiological Therapeutics, 32(1), 14-24.
 

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Comparing the Satisfaction of Low Back Pain Patients Receiving Medical vs. Chiropractic Care: Results from the UCLA Back Pain Study
 

A report on the scientific literature 



By
William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
 

The relationship between a patient and a doctor is a very important aspect of healthcare.  Many patients call this “bedside manner." Researchers call it “patient satisfaction.”  In a recent study published in the peer reviewed journal, American Journal of Public Health, and produced by the UCLA School of Public Health, the authors reported on the results of a comparison of patient satisfaction between patients that received chiropractic care and those that received medical care for lower back pain.  The authors stated, “Results from observational studies suggest that back pain patients are more satisfied with chiropractic care than with medical care” (Hertzman-Miller et al., 2002, p. 1628).

“Our study was conducted in a large managed care organization in Southern California...for approximately 100000 members”
Hertzman-Miller et al., 2002, p. 1628).  They go on to report, “Of the 681 randomized, 340 were assigned to the 2 medical groups and 341 were assigned to the 2 chiropractic groups” (Hertzman-Miller et al., 2002, p. 1630). Interestingly, the paper goes on to show “Chiropractic patients reported receiving more self-care advice than did medical patients, were more likely to report an explanation of their treatment, and visited their primary providers [their assigned chiropractor in this study] more often" (Hertzman-Miller et al., 2002, p. 1630).  The results showed, “In this randomized trial, chiropractic patients were more satisfied with their back care providers after 4 weeks of treatment than were medical patients” (Hertzman-Miller et al., 2002, p. 1631).  It should also be noted, “No deaths or serious adverse events occurred during the 4-week period” (Hertzman-Miller et al., 2002, p. 1630).

This paper in no way minimizes the importance of the medical physician as part of the team necessary to care for patients, understanding that there are diagnoses that mandate the services exclusively of the MD and other circumstances where concurrent care is required. However, when there is a choice based on overlapping care, common sense dictates a drugless treatment first, treatment involving drugs second and surgery last. Those patients, according to this study, who have chosen the chiropractic, drugless approach first, have reported a very high level of satisfaction with chiropractic care with no adverse events.
 
These studies along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions for patients with low back pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.



References:

1.  Hertzman-Miller, R. P., Morgenstern, H., Hurwitz, E. L., Yu, F., Adams, A. H., Harber, P., & Kominski, G. F. (2002).  Comparing the satisfaction of low back pain patients randomized to receive medical or chiropractic care: Results from the UCLA low-back pain study. American Journal of Public Health, 92(10),1628-1633.
 

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