Mid Back-Chest Problems

Mid Back-Chest Problems (5)

US Chiropractic Directory Presents:

Mid Back-Chest Problems


Mid back and chest problems are a significant issues that people worldwide suffer from. Chiropractic has been safely and effectively helping patents with pain in the neck for over 100 years and The US Chiropractic Directory has create a forum of information involving the entire healthcare and scientific community to bring the public evidenced and researched based answers on how and why chiropractic works to help those with mid back and chest pain/problems.

The Effects of Chiropractic Spinal Adjustments on Heart Rates

A report on the scientific literature 


 

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

 
"Heart rate is the number of heartbeats per unit of time - typically expressed as beats per minute (bpm) - which can vary as the body's need for oxygen changes, such as during exercise or sleep. The measurement of heart rate is used by medical professionals to assist in the diagnosis and tracking of medical conditions. It is also used by individuals, such as athletes, who are interested in monitoring their heart rate to gain maximum efficiency from their training...Heart rate is measured by finding the pulse of the body. This pulse rate can be measured at any point on the body where an artery's pulsation is transmitted to the surface - often as it is compressed against an underlying structure like bone - by pressuring it with the index and middle finger. The thumb should not be used for measuring another person's heart rate, as its strong pulse may interfere with discriminating the site of pulsation" (Wikipedia, 2010, "Heart rate").
 
"The autonomic nervous system (ANS or visceral nervous system) is the part of the peripheral nervous system that acts as a control system functioning largely below the level of consciousness, and controls organ functions. The ANS affects heart rate, digestion, respiration rate, salivation, perspiration, diameter of the pupils, micturition (urination), and sexual arousal. Whereas most of its actions are involuntary, some, such as breathing, work in tandem with the conscious mind" (Wikipedia, 2010, "Autonomic nervous system").
 
For our conversation, it is this autonomic nervous system that largely controls the heart rate. Dr. I Kestin, Consultant Anesthesiologist, Derriford Hospital, UK, stated in 1993, “The heart will beat independently of any nervous or hormonal influences. This spontaneous rhythm of the heart (called intrinsic automaticity) can be altered by nervous impulses or by circulatory substances, like adrenaline. The muscle fibers of the heart are excitable cells like other muscle or nerve cells...This automatic rhythm of the heart can be altered by the autonomic nervous system. The sympathetic nervous system supply to the heart leaves the spinal cord at the first four thoracic vertebra, and supplies most of the muscle of the heart...There are nervous reflexes that effect heart rate. The afferents are nerves in the wall of the atria or aorta that respond to stretch. The aorta contains high pressure receptors. When the blood pressure is high these cause reflex slowing of the heart to reduce the cardiac output and the blood pressure. Similarly, when the blood pressure is low, the heart rate increases, as in shock. Similar pressure receptors are found in the atria. When the atria distend, as in heart failure...there is a reflex increase in the heart rate to pump the extra blood returning to the heart. When there is a sudden reduction in the pressure in the atria the heart slows" (
http://www.nda.ox.ac.uk/wfsa/html/u03/u03_011.htm).
 
Increased heart rate can lead to cardiomyopathy, damage of the heart muscle and according to Cook, Togni, Schaub, Wenaweser, and  Hess in 2006, “Since 1980, it is known that resting heart rate (RHR) is a prognostic factor in coronary diseased patients. Data from the Coronary Artery Surgery Study (CASS) published last year underline the prognostic importance of RHR for morbidity (time to rehospitalization), as well as total and cardiovascular mortality. Heart rate proves to be the best predictor after myocardial infarction, in patients with congestive heart failure, as well as in patients with diabetes mellitus or hypertension. In addition, it was found that elevated RHR is also strongly associated with mortality in the general population” (
p. 2387).
 
It has been the independent clinical observation and conclusion over the course of 30 years by Dr. Mark Studin, one of the author's of this article, that post chiropractic adjustment patients have experienced lowering heart rates and subsequent high blood pressures. Dr. Studin states, “Many patients have reported that their increased heart rates have abated for long periods of time.”
 
Budgell and Polus reported in The Journal of Manipulative and Physiological Therapeutics (2006) that chiropractic adjustments of the thoracic spine were associated with significant heart rate values and influenced the autonomic output of the heart, meaning that heart rates generally lower with the chiropractic adjustments because of the shift in the neurological communication of the autonomic nervous system (to the parasympathetic nerves) causing the heart to slow or normalize.

This study by Budgell and Polus offers potential answers to many as to why patients' heart rates spontaneously spike for no apparent reason. The spine, although a great influence the nervous system, has often been overlooked in the clinical arena as the prime cause for cardiac issues. The authors of this article want to emphasize that chiropractic care has a positive effect for many conditions, including cardiac, and should be considered in conjunction with all other health care specialists, as clinically indicated, as a conclusive diagnosis to rule out life-threatening illnesses must be rendered.





References:

1.  Wikipedia, The Free Encyclopedia. (2010, July). Heart rate. Retrieved from http://en.wikipedia.org/wiki/Heart_rate

2.  Wikipedia, The Free Encyclopedia. (2010, July). Autonomic nervous system. Retrieved from http://en.wikipedia.org/wiki/Autonomic_nervous_system
3.  Kestin, I. (1993). Control of heart rate, Physiology, 3(3), 1. Retrieved from http://www.nda.ox.ac.uk/wfsa/html/u03/u03_011.htm
4.  Cook, S., Togni, M., Schaub, M. C., Wenaweser, P., & Hess, O. M. (2006). High heart rate: A cardiovascular risk factor?, European Heart Journal, 27(20), 2387-2393.
5.  Budgell, B., & Polus, B. (2006, October). The effects of thoracic manipulation on heart rate variability: A controlled crossover trial. Journal of Manipulative and Physiological Therapeutics, 29(8), 603-610.

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Thursday, 27 May 2010 21:48

Pregnancy, Back Pain and Chiropractic

Written by

Pregnancy, Back Pain & Chiropractic

A report on the scientific literature 



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

 
"Back pain during pregnancy can be significant in terms of intensity and resulting disability" (Stuber & Smith, 2008, p. 447). It often exacerbates (magnifies) an underlying problem with the change in body mechanics as the pregnancy progresses and the fetus grows. One study found that 35.5% of woman had at least moderately severe back pain during 1 or more of their pregnancies. The pain scales of the pregnant woman (on the Owestry rating scale of 0-10, where 0 is no pain and 10 is the worst pain imaginable) ranged from 5.86 to 9.21.1
 
One of the problems with patients not seeking care during pregnancy is this can become a long- term chronic condition and inherently more difficult to resolve as muscles and connective tissue compensate to accommodate the increasing forward center of gravity. Over time, the tissue becomes "patterned" to the 9 month temporary state and abruptly changed, upon delivery. These multiple, sudden changes can cause a weakening of the supportive tissue, creating an abnormal chronic problem if not stabilized during pregnancy.
 
One study, in a retrospective review of 179 pregnant woman in 5 clinics regarding back pain during pregnancy and labor, found that 85% reported relief of their low back pain as a direct result of chiropractic care. In an unrelated study, 25% had complete remission of their back pain, 50% reported feeling very well and 15% were feeling better. Only 10% reported no changes
.1
 
In one study, the average pain scale prior to chiropractic care was 7.58 out of 10 and while they were under chiropractic care was 4.25. A second study revealed the average pain scale before chiropractic care was 5.9 and post chiropractic care 1.5 out of 10 on the Owestry scale.
 
This author, having practiced chiropractic for 30 years and cared for 100’s of pregnant patients during that time, has had similar results in the clinical setting. The primary reason these pregnant patients have sought chiropractic care has been that it is a drugless approach and it works. Beyond that, pregnant patients shouldn't spend 9 months in pain. They should be able to enjoy an active pregnancy and get the exercise needed to have a healthy, full-term labor and delivery.
 
This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions for pregnant patients with back pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.uschirodirectory.comand search your state.



References:


1.  Stuber, K. J., & Smith, D. L. (2008). Chiropractic treatment of pregnancy-related low back pain: A systematic review of the evidence. Journal of Manipulative and Physiological Therapeutics, 31(6), 447-454.

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Chronic or Acute (Non-Cardiac) Chest Pain and Chiropractic

A report on the scientific literature 



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

Having chest pain can be a very scary experience and is a MAJOR cause for concern.  The obvious condition to evaluate and rule out is a heart attack.  There are many cases where the heart has been verified to be okay and there are no conditions related to blockage of the arteries in the chest, but the pain continues.  One common problem that is more benign, but can produce constant moderate/severe chronic pain, is chest pain of mechanical origin.  In other words, the bones and joints of the chest and middle back are not working properly and are causing irritation of the nerves.  This type of pain is actually quite common and related to posture, working activities (computer work) and trauma (car accidents, karate or even surgery).  YOU MUST BE RELEASED BY A CARDIOLOGIST WITH ANY TYPE OF CHEST PAIN prior to exploring treatment for mechanical chest pain.
 
Chiropractic continues to show up in the research as being effective for the treatment of mechanical chest pain.  In a recent paper published in conjunction with the New York Chiropractic College, the authors discuss such a case.   The clinical features of this case were “A 49-year-old man had chronic chest pain, dyspnea [trouble breathing] and anxiety for over 4 months.  The severity of the condition gradually progressed to the point of precluding the patient’s active employment and most physical activity.  Prior efforts to treat the condition were met with failure" (
Polkinghorn & Colloca, 2003, p. 108).
 
The authors went on to describe the treatment.  “The patient received mechanical force, manually assisted short-lever chiropractic adjustment
[the most common type of adjustment] of the thoracic spine and, in particular, the costosternal articulations [where the ribs meet the breast bone on the front of the chest]...Sustained chiropractic care rendered over a 14 week period resulted in complete resolution of the patient’s previously chronic condition, with recovery maintained at 9 month follow-up” (Polkinghorn & Colloca, 2003, p. 108).
 
Clinically, Dr. Studin (a co-author of this article) had a similar case this past month.  A 30-year-old painter had significant chest pain, chest tightness, shortness of breath and spontaneous perspiration.  He was rushed to the emergency room for an urgent cardiac work-up and subsequently released with a diagnosis of anxiety and a prescription for Xanax (anti-anxiety drug).  The next day, the patient still experienced the same signs and symptoms and began chiropractic care. After 1 chiropractic adjustment of both the sternum-rib complex and the spine, his entire symptom pattern was gone immediately and the patient was pain free.  It is now 4 weeks later and the patient is still symptom free.
 
These clinical case reviews are a very common finding when the cause is a neuromuscular (spinal nerves and muscles) finding called a vertebral subluxation.  These cases also illustrate that the chiropractic subluxation complex can be found in many places in the body.  Although the spine is the most common area, we now know that it can be found anywhere two bones come together, including the chest.  A doctor of chiropractic is a very important part of your healthcare team, even when it comes to chest pain. 
 
This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions to chronic, non-cardiac chest 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.  Polkinghorn, B. S., & Colloca, C. J. (2003). Chiropractic management of chronic chest pain using mechanical force, manually assisted short-level adjusting procedures. Journal of Manipulative and Physioliological Therapeutics, 26(2), 108-115.

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Sunday, 23 May 2010 15:48

Chronic Back Pain, Prevention and Chiropractic

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Chronic Back Pain, Disability, Chiropractic and Prevention

A report on the scientific literature 



For the disability scores only the group that was given spinal manipulations during the follow-up period maintained their postintensive treatment scores

By

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

Low back pain sufferers know all too well that constant vigilance is required when dealing with spinal pain.  There are frequent flare-ups occurring for seemingly benign reasons.  Chiropractic has been shown to be effective in treating lower back pain, but what about keeping it under control for the long term.  A recent study by Descarreaux, Blouin, Drolet, Papadimitriou, & Teasdale (2004) studied the effects of preventive spinal manipulation for chronic low back pain. 

The authors state, “Thirty patients with chronic nonspecific low-back pain were separated into 2 groups.  The first group received 12 treatments in an intensive 1-month period but received no treatment in a subsequent 9-month period...
The second group received 12 treatments in an intensive 1-month period and also received maintenance spinal manipulation every 3 weeks for a 9-month follow-up period” (Descarreaux et al., 2004, p. 509).   Pain and disability levels were measured and reported for both groups.

The authors report, “For both groups, the pain and disability levels decreased after the intensive phase of treatments.  Both groups maintained their pain scores at levels similar to the postintensive treatments throughout the follow-up period. For the disability scores, however, only the group that was given spinal manipulations during the follow-up period maintained their postintensive treatment scores.  The disability scores of the other group went back to their pretreatment levels”
(Descarreaux et al., 2004, p. 509). Finally it was concluded, “Intensive spinal manipulation (adjustments) is effective for the treatment of chronic low back pain.  This experiment suggests that maintenance spinal manipulations after intensive manipulative care may be beneficial to patients to maintain subjective postintensive treatment disability levels” (Descarreaux et al., 2004, p. 509).

This study is a great start. Now there will be larger populations of chronic back pain suffers and preventive chiropractic care.  Many thousands of people have gotten relief from chiropractic care; you may be one of them. If you are suffering and have not seen a doctor of chiropractic, please take to time to search the database on this site for a doctor close to you.



References:

1.  Descarreaux, M., Blouin, J.-S., Drolet, M., Papadimitriou, S., & Teasdale, N. (2004). Efficacy of preventive spinal manipulation for chronic low-back pain and related disabilities: A preliminary study. Journal of Manipulative and Physiological Therapeutics, 27(8), 509-514.

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Thursday, 22 April 2010 12:48

Chest Pain, Mid Back Pain and Chiropractic

Written by

Chest Pain, Mid-Back Pain and Chiropractic

A report on the scientific literature 


By
William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
 
Chiropractic care is targeted to reducing the Vertebral Subluxation Complex and associated neuro-muscular conditions after more serious medical conditions have been ruled out with chest pain. Vertebral Subluxation Complex is the most common reason for pain in the middle back and chest that is not the result of a heart problem or acid reflux. In cases of non-cardiac (not involving the heart) middle back and chest pain, Chiropractic has been shown to have significant results in reducing or eliminating pain and discomfort. Many people experience pain between the shoulder blades, over the breast bone or the collar bones. In today’s society of increasing demands in the office setting, endless hours in front of a computer or all day commutes in our vehicles the stress on the thoracic spine (middle back)and chest continues to increase. Unfortunately when we sit and slouch forward, the brunt of the forces are condensed to the area just below our shoulder blades and our breast bone. We have all been cautioned to “have good posture”, but anyone that has worked a full day knows, once you are tired there is really not much you can do about your posture.
A recent study stated that “Traditionally, patients with chest discomfort are admitted to a cardiology ward because the heart is under suspicion as the pain source; however, the etiology of pain may be non-cardiac in up to 50% of cases”1 (p654). The authors continue on to say “Although patients with non-cardiac chest pain have an excellent prognosis for survival and a future risk of cardiac morbidity [complications] similar to that of the general population, approximately 3 quarters of these patients continue to suffer from residual chest pain, one half remain or become unemployed, and one half report being significantly disabled”1 (p 654)
 
The most important aspect of this study states “There is a broad agreement among clinicians that the musculoskeletal system is a potential source of pain in non-cardiac chest discomfort, but very few studies have addressed this issue systematically despite the compelling issues discussed above.”1 (p 654)   This study found that there was a significant reduction in the anxiety associated with the patient’s chest pain, the patients had a better understanding that the musculoskeletal system was the source of their discomfort and 96% of patients believed that chiropractic treatment had helped.1
 
In a case study published in 2003, the authors discovered that after the possibility of cardiac involvement was considered, Vertebral Subluxation Complex located at the junction of the breast bones and ribs in the front of the chest was the cause. Reducing the Vertebral Subluxation Complex with Chiropractic techniques had resolved this patients symptoms. 2
Chiropractic interventions into managing and/or eliminating chest and middle back pain have been shown to be safe once cardiac causes have been ruled out. Doctors of Chiropractic are trained to not only evaluate for non-musculoskeletal conditions, but to work as part of your healthcare team. 3
1.       Henrik W. Christensen, DC, MD, PhD, Werner Vach, PhD, Anthony Cichangi, Claus Manniche, MD, DMSc, Torben Haghfelt, MD, DMSc, and Poul F. Hilund-CaHsen, MD, DMSc. Manual Therapy for Patients with Stable Angina Pectoris: A Nonrandomized open prospective trial. J Manipulative Physiol Ther 2005;28:654-661
2.       Bradley S. Polkinghorn, DC, Christopher J. Colloca, DC. Chiropractic management of chronic chest pain using mechanical force, manually assisted short-lever adjusting procedures. J Manipulative Physiol Ther 2003;26:108-15.

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