LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Chiropractic Care

TRY CONSERVATIVE, NON-INVASIVE METHOD FIRST (02-23-09)

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The Relationship Between Repeated Epidural Steroid Injections and Subsequent Opioid Use and Lumbar Surgery

While the results of this study may have surprised the authors, as a practicing chiropractor I can tell you that it comes as no surprise. The authors evaluated within the VA system whether the use of epidural injections would reduce the use of opioid pain medication use and lumbar surgery. Well..they actually increased the frequency of patients being on medication and increased the likelihood that they would need surgery. This coincides with other research that epidurals do not have evidence of long term improvement.

As a chiropractor, I would look at two potential pathways. First, the culture surrounding the use of ESIs is one of outside intervention and fosters an attitude of helplessness in the patient–that the answer will come from outside help, not inside recovery. This attitude would lead to further interventions. Secondly, it is entirely possible that the sanctity of the spinal canal is intruded in this procedure, leading to some degree of localized inflammatory response and fibrotic healing, further confounding the initial presenting complaint.

The bottom line is that every possible conservative, non-invasive method should be tried first and the quick jump to interventions like ESIs will likely lead to a worse outcome.

Read entire article here

THE ADVANTAGE SEEDING TRIAL – (5-11-09)

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The ADVANTAGE Seeding Trial: A Review of Internal Documents

A seeding trial is a trial done under the guise of research, but is actually created and administered by the marketing department. This particular study was run and published purely to get doctors used to writing prescriptions for Vioxx when it was first released.

Really. I’ve said it before that if the public truly knew how they were manipulated by drug companies with drugs with marginal effectiveness and frequent side effects for conditions THEY DON’T EVEN FIX–Chiros would be on the top of the health care pile. This also makes you wonder, if the physicians in these studies are so easily manipulated, are they truly acting as “physicians” or more like technicians being trained to give drug A for condition A?

Read entire article here

HOW DO WE SAVE MASS AMOUNTS OF MONEY FOR MEDICARE??

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HOW DO WE SAVE MASS AMOUNTS OF MONEY FOR MEDICARE??  We make sure that the surgeries we do on seniors with lumbar spine arthritis are not merely to make money for the surgeons.

In a study spanning 5 years on seniors with lumbar spinal stenosis (an advanced degenerative condition of the lumbar spine), the number of complex (multilevel) fusions went up FIFTEEN times!! Sounds great if this was a better surgery than a simpler one, but unfortunately this is not even close–there was triple the risk of life threatening complications with the complex fusion.  The price tag for this fiasco?  $50,000 more for the complex surgery.  Wow.

Good thing they need to hammer down on chiropractic claims.  Wouldn’t want some evil chiropractor to rip Medicare off for $250…especially since our office uses Flexion Distraction which can be very successful for treatment of stenosis.

Read entire article here

POOR BLOOD FLOW IN THE BRAIN LINKED TO CHIROPRACTIC CONDITION

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Can we all agree that more blood flow to the brain is a good thing?  I’m sure anyone experiencing a blood choke in ju-jitsu would agree-it’s NOT the best feeling in the world.

Increased blood flow to the brain means more nutrients, more oxygen and more removal of waste products.  These are all ideal situations and lead to increased brain health.  The converse is equally as bad.

We already know of several things that increase blood flow to the brain, such as exercise and whole body vibration.  In addition to increasing blod flow, increasing the availability of nutrients that improve the production of ATP in the mitochondria such as choline, CoQ10, Vitamin E (as mixed tocopherols–NOT straight alpha tocoperol) and alpha-lipoic acid will also result in very positive improvements in brain function and will likely lead to reductions in the risk of Alzheimer’s, Parkinson’s, dementia, hearing loss, migraines and seizures.

So what’s missing from this list?

Based on this particular study, chiropractic treatment.

Researchers looked at the effect of chronic neck and upper back pain on the blood flow in the brain (cerebral perfusion).  They found that these patients with pain had less blood flow into their brains when compared to those who did not have chronic pain.  In the worst case, those with the most severe pain had 45% less blood flow to the parietal and frontal regions of the brain.  The parietal region functions heavily in evaluation the spatial relationships within our bodies and environment, while the frontal lobe is involved in higher mental functions like personality and decision making.

Given how important these regions of the brain are, I’m thinking that 45% sounds like way too much of a loss.  Now this does not mean that you run up to your favorite dolt and poke them in the upper trapezius muscle and ask if it hurts, but certainly entertains the additional value of chiropractic care to address pain in these regions.

If the combination of soft tissue treatment, at home stretches / yoga and chiropractic adjusting can help to increase movement in this region and reduce pain, it would make sense that blood flow to the brain would improve.  This would make chiropractic care an integral component of the treatment of the above mentioned conditions like seizures, migraines and dementia.  But that’s my biased opinion…

COULD CHIROPRACTIC SAVE YOUR LIFE?

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COULD CHIROPRACTIC SAVE YOUR LIFE?  It’s far too common to have a patient come into my office that has been given some heavy duty pain meds, frequently among the opioid class (Vicodin, Oxycotin).

Recent studies have even shown that a large number of primary care doctors will even prescribe these on a patient’s first visit for acute low back pain, which is disturbingly against all the recommendations.  As a chiropractic physician, I can tell you that it is a major goal of the treatment of any patient to reduce, avoid or eliminate their need for any type of pain control.  It is rare that we are not successful.

Hopefully, this report from the CDC will enlighten you on just how dangerous this class of drugs is.  The number of annual deaths in 2006?  26,400.  And we spent billions of dollars on the swine flu????  What is sometimes frustrating as a chiropractor is that, when entities (like here in AZ for AHCCS or insurance companies) look at costs for our care, they only rarely look at cost SAVINGS for care.  They just look at chiropractic care as a line item expense, despite the fact that we save up to 30% on orthopedic costs alone.  These numbers do NOT take into account how many patients are able to go off of, reduce their usage or not go on prescription opioids in the first place.

LOW BACK PAIN AND BEST PRACTICE CARE

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PRIMARY CARE OFF THE LIST TO SEE FOR LOW BACK PAIN.  It doesn’t happen often, but I still have patients who ask if they should see their PCP before they see me.  Or who have seen their PCP before me.  Far too frequent the care and recommendations they receive are not in tune with the medical research.  Jumping on prescription pain meds and anti-inflammatories, no recommendation to stay active, jumping on X-rays or worse, MRIs, way too soon.  Epidurals before any conservative care is attempted.

This particular study confirms what I see in my office–PCPs are not aware of how to treat low back pain.  Heck–almost 20% in this study were given OPIOIDS for acute low back pain!!  The bottom line?  Much evidence points to the fact that chiropractors are the best, most effective and most cost-effective point of entry for any musculoskeletal problem.

WHAT ELSE CAN I DO TO HELP WITH MY SHOULDER PAIN?

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WHAT ELSE CAN I DO TO HELP WITH MY SHOULDER PAIN?  It’s still the prevailing opinion that chiropractic care is for patients with low back pain.  However, there is much research suggesting that manipulation is effective for a variety of other conditions.

This particular study found that the addition of manipulation to a standard course of care for shoulder pain was more effective.  In my office, the addition of unique soft tissue approaches like NMR and Graston to more completely effect the soft tissues (fascia, muscles, ligaments, tendons) means that shoulder pain will be a thing of the past for most patients.  And we rarely need to use anything beyond some simple elastic tubing home exercises for recovery.

DID YOU SEE A CHIROPRACTOR FOR YOUR NECK PAIN?

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Given the initials after my name, you can assume there’s going to be a bias in this post.  Let’s just go ahead and assume it’s going to be a big one.  The overall question, however, is–how many neck pain sufferers have not seen a chiropractor?

I’m sure the number is far too high.  I remember sitting in the ER with a friend about 4 years ago.  The ER was overcrowded and we were in the hall separated by a curtain.  I could clearly hear the clinician talking with the patient in the area next to us (so much for HIPPA, huh?) and it was all I could do to not step next door, step in and suggest that I would be better off handling this.

Can we just accept that mainstream medicine gets a very poor education in musculoskeletal problems?  Just like you wouldn’t want me removing your gallbladder or discussing whether you should take 10 or 80 mg of Lipitor (yeah–like THAT would even be on the discussion board…), we really need to accept that the average PCP does not have the training necessary to adequately manage most musculoskeletal problems.

I had a new patient in last week that has relatively straightforward non-specific low back pain.  I expect her to be doing much, much better within 3-5 visits.  The problem is she has been under medical care for a year which has included cortisone injections, an MRI and now Percocet, ibuprofen and gabapentin.  She then mentions to me that her family has always had somewhat of a fear of chiropractors, and this is why she has been hesitant to see one.

Huh?  Afraid of chiropractors?  Let’s look a little closer at her care:

  • She’s had maybe $5K-15K worth of services
  •  One YEAR of pain (which now has her unemployed and unable to work)
  • She has been told by the pain management doctor that there are no other options
  • She’s on a drug that the manufacturer paid $2.3 BILLION to the Justice Dept for offlabel promotion of gabapentin
  • The list of dangerous side effects of NSAIDs like ibuprofen is so long as to be its own blog post
  • Narcotic pain relievers (Percocet) now exceed illicit drugs in deaths and ER visits in this country

While her case is for low back pain, the clinical scenario with neck pain is not much different.  This particular study just confirms what every practicing chiropractor already knows–chiropractic manipulation, in both the short and long term, was more effective than the medications typically used to treat them.

And, to my knowledge, no one’s ever experienced their stomachs rupturing with subsequent internal bleeding following an adjustment…