LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Chiropractic Care

THE “WAR ON DRUGS” WAS LOOKING AT THE WRONG DRUGS

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In 1971, President Nixon declared a war on drugs.  Unfortunately for our country, that war was limited to illicit drugs.  For the next several decades, drug overdose deaths were largely attributable to these drugs.  However, beginning just after this century, these statistics began to take a scary turn.

In this recent report from the CDC’s report looking at data in Florida from 2003-2009, the numbers of drug overdose deaths increased 61%.   NONE of this increase was from cocaine or heroin.

 The death rate for prescription drugs increased 84.2%, with the greatest increase from oxycodone (264.6%), followed by alprazolam (233.8%) and methadone (79.2%).

By 2009, the number of deaths involving prescription drugs was four times the number involving illicit drugs.  Four times.  Were exactly is the “war on drugs” when it comes to prescription medications?  Glaringly absent.

Notice that these drugs are primarily used for pain control.  While some cases may be for intractable pain from situations like cancer, pancreatitis or kidney stones, I frequently see patients coming into my office on Oxycodone for a condition that would’ve been gone had they seen a chiropractor first.

So long as mainstream medical providers like PCPs, orthopedic surgeons, neurosurgeons and physiatrists are seen as the first point of entry for musculoskeletal complaints, the risk of getting drugs prescribed and aggressive procedures performed will remain high.  In general, for at least one of the larger insurers in the US, chiropractors provide about a 30% cost savings when they are seen first.

Other studies confirm that imaging, surgery and, most importantly for this study, pain medication use are much lower under chiropractic care.

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HAD A SPINAL FUSION? WAS THIS MATERIAL USED?

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I would have to say that in all but the most astute, few dug deep enough into their surgical procedure of fusion to find out how the surgeon was going to help the bones fuse together.  As a chiropractor, obviously the idea of fusion scares the heck out of me and I fear that far to few of spinal fusion patients have undergone a solid course of chiropractic care.

Back in 2002, the FDA approved the use of a type of cement in spinal surgeries.  This cement, called recombinant human bone morphogenetic protein-2 (rhBMP-2), was designed to cause your body to produce more bone to allow a faster and more complete fusion between the vertebrae that we being fused. 

Sounds great, right?  Unfortunately, in most of the studies conducted on this compound (the manufacturer was Medtronic and the product was called Infuse (R)) they left a little something out.  Adverse effects.

Of 13 studies done by Medtronic, not a single one reported adverse effects related to the use of this compound.  In this particular study, the authors took a new look at the data and found an adverse effects in 10 to 50% of the patients that received the compound.  Additionally, there were very strong financial ties between the researchers of these studies and Medtronic.  The authors of this current study call the original research “biased and corrupt.”

Wow.  I have had a select few patients in my office who, quite frankly, we tried everything possible to keep them from having surgery and we not successful.  I see a need in the right time and place for spinal fusion when EVERYTHING else has failed.

But what about the patients that were steered into spinal fusion far too soon (it is well documented that those who see a surgeon or primary care doctor first instead of a chiropactor, are more likely to have surgery)?  And what if these patients had a surgery that used this compound and they were in the percentage that experienced adverse effects?

All too often in medical research the story is the same.  The data is manipulated to favor the funding biotech or pharmaceutical company.  The doctor or surgeon places false benefit on the product leading to recommendation to patients.  It is ultimately the patient that may pay for this transgression.

The bottom line is that we need to always, always, always do our due diligence with anything being done to our bodies if it was not in the original plan by Mother Nature.

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SPINAL ARTHRITIS – DO I NEED SURGERY?

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Pretty much every day I address this question from patients.  They come in after having an X-ray or MRI done after a few weeks of untreated back pain and may even have their orthopedic surgeon appointment set up.  The problem remains that there is very little correlation between what we see on imaging and pain levels of a patient.

As a matter of fact, this is probably one of the bigger educational challenges I have in my practice because society has brainwashed into thinking that all the answers lie in the MRI or X-ray and they are infallible.  I can’t tell you how many times I have had patients come in with knee pain due to “arthritis.”  However, after 2 or 3 visits they are greatly improved.  We obviously did nothing to magically get rid of the arthritis, but the arthritis was not the pain generator for this patient.

This particular article reinforces this same concept for back pain, with a specific focus on those over 60 years of age.  The researchers found a very high level of arthritis of the spine (75.8%), but only a small portion (28.8%) had back pain.  And again, referring back to the knee example above, how many of these patients with back pain would still have symptoms after a solid course of chiropractic care coupled with soft tissue treatment?

The bottom line is that arthritis is something we see on X-rays or on MRI, but it is merely the canvas on which your symptoms may be painted.  Only rarely is surgery in these cases a good idea with a good outcome.  Without a doubt, your best first option for any type of pain is a Mesa chiropractor.  And this is NOT my bias, but rather, strongly supported by claims data from insurance companies and clinical studies.

http://ard.bmj.com/content/68/9/1401.abstract

TAKING A SHORT COURSE OF STEROIDS FOR PAIN?

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Medrol dose packs are commonly used to calm down inflammation and pain in musculoskeletal injuries.  This pack starts with a high dose of steroids that tapers down over the next 6 days.  Doesn’t fix the injury or restore the mechanics of an injury, but it sure curbs the inflammation associated with the injury.  So what could be wrong with that?

For starters, any diabetic can tell you that steroids wreak havoc on blood sugar.  They should–one of the jobs of cortisol in the body is to break down muscle to make glucose.  That may be fine when you skip a single breakfast, but with time you lose muscle mass and head towards diabetes.

But what about healthy patients?  A short course of steroids won’t do any harm, right?

Other than the aforementioned fact that it does nothing to actually heal an injury and will actually weaken the tissues leading to increased concern for future injuries, but, in this particular study, a single week of low dose prednisone in healthy males worsened the way insulin worked in the body by 33%.

This is NOT a good thing given that the effectiveness of the way our bodies use insulin is a (if not THE) critical component to a long, disease free life.  As usual, my bent as a chiropractor here in Mesa is that ANY musculoskeletal problem should be treated without medications first.  Anything less may produce greater harm than benefit.

TAKING THIS COMMON PAIN MED JUST ONCE CAN KILL YOU

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The data coming out of non-steroidal anti-inflammatory drugs (like ibuprofen) and the risk of heart attacks is downright scary.  All of this was precipitated by the lawsuit against Merck because of their suppression of data that the blockbuster drug Vioxx was causing heart attacks.  This prompted researchers to look at other NSAIDs and the data is very consistent.

In addition to bleeding ulcers, dementia, liver damage, kidney damage, joint damage and impotence, this class of drugs is absolutely, positively NOT to be used in anyone with heart disease.  This would include the >50% of the population that is prediabetic.

But this is, of course, only for people who use these drugs for months and years at a stretch, right?  According to this study, DAY ONE was soon enough to cause a heart attack or death in patients who had pre-existing heart disease.  Day one.  The particular NSAIDs that was the worst was diclonfenac, a drug that I see given to patients for simple musculoskeletal problems far too often.

Bottom line is that there are no safe drugs for pain, either prescription or over the counter.  Being somewhat biased towards chiropractic care, I would have to strongly suggest that a visit a chiropractor in Mesa is warranted even before you pop that ibuprofen or Tylenol.

http://circ.ahajournals.org/cgi/content/abstract/123/20/2226