LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Natural Pain Relief

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…

DOES ARTHRITIS MEAN I HAVE TO HAVE PAIN FOREVER?

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DOES ARTHRITIS MEAN I HAVE TO HAVE PAIN FOREVER?  In our office, the answer is almost always a strong “NO,” but it is a perception that many patients have, possibly because their PCPs don’t have many answers.  Keep in mind that the joint is surrounded by the soft tissues (fascia, ligaments, tendons, muscles) and, in most cases, these tissues actually create much more pain than the joint does.  Address the problems in the tissues surrounding the joint and the pain can go away.

In this particular study, the authors looked at what patients did after being given a diagnosis of knee arthritis.  75% percent of them took matters into their own hands by increasing activity levels, 33% turned to acupuncture, orthotics, braces and 36% started supplements.  The results were very encouraging–after 6 months,  the majority of patients in the study had found some relief from this approach.  I know that in our office, we strongly urge patients to increase their activity levels with very good results.

Read entire article here.

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…

 

STEROID INJECTIONS FOR LOW BACK PAIN? DID YOU GET AN MRI FIRST?

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Medicine has somehow managed to create a culture around low back pain.  Maybe it was unintentional.  Maybe it was ignorance.  Maybe it was willfully done to support the “system.”  Whatever the reason, it costs society massive amounts of money on waste.

Usually not a month goes by when some patient is told by their PCP that they should stop seeing a chiropractor (sometimes after only 1 or 2 visits) and see a PT or get an MRI or both.  Worse, there are many times that a chiropractor does not even become a part of the equation.  The costs when a chiropractor is NOT involved skyrocket.  Here in AZ, a patient seeing their PCP first may end up costing some 30% more.  If they manage to self refer to a PT, the costs are almost TRIPLE.

The reasons for this are multiple, but the bottom line is that we are experts at low back pain and are very good at controlling care.  This means that we infrequently order X-rays and rarely order MRIs.  I know that, in our office, if the patient’s low back pain and leg pain looks an awful lot like sciatica from a disc bulge, why the heck would I order an MRI if I already have a very good idea of what is going on?

This particular study has some interesting findings.  Researchers looked at patients getting an epidural for low back pain with leg pain (lumbosacral radiculopathy) and whether or not they actually needed an MRI before the procedure.  What???  Of course you need an MRI before someone sticks a very long needle into the most sacred of regions in your spine!!  Or do you..

Here are the findings when comparing 2 groups of patients, one group where the MRI was used to guide the epidural procedure and a second group where the MRI was NOT used:

  • Slightly less leg pain in the MRI group at 1 month
  • No differences in pain or function at 3 months
  • After 3 months, only 35% in group 1 and 41% in group 2 showed improvement
  • In non-MRI patients who received a different injection than that proposed by an independent physician (basically a 2nd opinion, but this doctor did actually look at an MRI of the patient), the outcomes were not quite as good as those whose procedure matched that the MRI findings
  • Collectively, 6.8% of patients did not (group 2) or would not have (group 1) received an epidural after the MRI was reviewed

So, the bottom line is that MRI made very little difference in the outcomes of the epidural.  Further, a little under 2/3 of the patients received no long term benefit from the whole process.  All for the price tag of around $10K.  Give a good chiropractor $10K to work with and we’ll have the vast majority of patients competing for the Ironman Triathlon in 6 months….

CONSIDERING SURGERY FOR YOUR KNEE PAIN?

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Knee pain is something we see commonly in our office. Unfortunately, I think these are many more cases because patients have been told that their knee pain is arthritis and there is nothing that can be done. This could not be further from the truth.

From a treatment viewpoint, the knee is really not a complex joint. Basically it is referred to as a ginglymus (“hinge”) joint with a slight degree of rotation. There are ligaments, meniscus, muscles, the joint itself and….most importantly…the fascia!

While it is difficult to describe, I generally refer to the fascia as the sheath that our joints and muscles are encased in. It is far more complicated than that, but it seems to get the point across. Many patients come in concerned that they may have torn a ligament in their knee and may even have an MRI to back up the idea.  However, current theories are actually debunking the idea that ligaments truly exist.

Rather, they are thickenings of the fascia along areas of a joint that provide increased stability. We have called them ligaments and have seen them on cadavers because anatomists have dissected out what they were looking for. In other words, they were looking for a ligament so, as they dissected out a region they actually created the ligament from the fascia surrounding that area. So, this thickening of tissue exists, but it is actually the continuation of the fascia from the area above and below it.

So what does this mean?

It means that the fascia surrounding a joint may be the most critical tissue that needs to be addressed for joint pain. This can be addressed with fascial manipulation, Graston technique or Rolfing. Laser, chiropractic adjusting, ultrasound, strengthening exercises and any number of other techniques are not going to address the problems that occur in the fascia and may not be as effective for relieving knee pain.

The fascia is also a major source of pain in the knee. Because of this, patients develop knee pain, their primary care doctors orders X-rays (or worse-an MRI) done before any treatment, and they are told they have arthritis. They try some pain meds, maybe a short course of physical therapy, but don’t notice much of a difference. At this point they are resigned to wait until the pain gets debilitating enough for a knee replacement. Sounds like a great plan, huh?

It is common for this patient to come into my office, only to leave 2 or 3 visits later with much less pain in their knees. Did the arthritis suddenly get fixed?  Of course not. Rather, the pain was not coming from the joint itself, but rather from the fascia surrounding the knee.

So what does all of this have to do with this particular study?

Because of the marked increase in the number of knee replacements being done in the US, researchers look to confirm that this increase was due to the increased obesity and the increasing age of the population. This was not what they found.  Rather, knee pain increased independently of age and BMI.

Of extreme importance is what they did NOT find.

They did NOT find an increase in arthritis of the knee. So, our country is performing more and more knee replacements. This is not due to obesity (obesity did play a role, but it was a smaller one) or age. And there was not more arthritis found. So basically, we are replacing perfecting good knee joints because of problems likely due to fascia surrounding the joint that was never effectively treated.

The bottom line is that anyone with knee pain should first be evaluated by a chiropractor that specializes in the treatment of the soft tissues that surround a joint (in this case, the knee). If pain persists after several visits, then an evaluation by a surgeon may be warranted, but certainly not before.