LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Natural Pain Relief

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.

MASSIVELY LOWER YOUR RISK OF ARTHRITIS

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Arthritis is a pretty darn common finding as we start to get older.  I’ve seen it present in the spine of an 18 year old football player and the knees of 90 year olds, with everything in between.  Trauma clearly plays a role, but does not answer everything.  Turns out there are some pretty powerful ways to lower our risk of developing arthritis in the future.

One of the newer hormones on the scene of body composition and risk of diabetes is adiponectin.  Adiponectin is produced by the adipose (fat) cells.  Despite its origins, this hormone packs a wallop when it comes to making our bodies handle glucose better, keeping us leaner and pushing us away from diabetes.  Higher is better.

So what does the hormone adiponectin have to do with arthritis?  Above and beyond anything else, a good healthy lifestyle will protect against arthritis, especially of the spine.  In this study, those with the highest levels of adiponectin had a massive 70% lower risk of having hand arthritis, that was already present, from progressing.

Forget glucosamine and start addressing the rest of your lifestyle.

http://ard.bmj.com/content/70/7/1282.abstract

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

DO NOT DO THIS FOR A WORK INJURY!!

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As a chiropractor, I can tell you that taking advantage of more complicated and “high tech” treatments for many, if not most, musculoskeletal complaints is bad news.  Study after study shows that things like getting an MRI leads to higher chance of receiving an epidural.  Receiving an epidural leads to a higher chance of having surgery.  It becomes a cascade effect.

Most studies looking at chiropractic care for musculoskeletal complaints find that our care is at least as effective and definately cheaper.  Especially when you focus on less medication, less imaging and certainly less surgery.  Which always makes it difficult when someone tries to cut out chiropractic benefits to “save money.”  Math wasn’t my strong point, but sure seems to make sense to keep chiropractic in the picture.

This particular study, while not looking at chiropractic care, did look at the opposite end of the spectrum.  Researchers looked at patients with a herniated lumbar disc diagnosed in a hospital setting.  Almost 42% of them did not return to the workforce full time.  42%!!  The odds were worse if surgery was performed.

The bottom line is to seek chiropractic care FIRST.  Care will be simpler, less costly, and your odds of returning to work will be highter.

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I’VE HAD NECK PAIN EVER SINCE THAT ACCIDENT…

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The statistics on the persistance of neck pain following a whiplash-type injury are pretty disheartening.  Depending on the study you read, up to 90% of patients may experience some type of symptoms 10 years later.  This leads to a few comments from me.

First, I think this stresses just how important it is to address both the soft tissue AND the articular components of any type of injury.  Physical therapists stress exercises to strengthen the muscles injured.  Chiropractors generally address the movement of the joints in the neck following the injury.  Quite frankly, as someone who addresses the fascial, muscular and tendonous as well as the joint problems that occur after an injury, I feel that almost all cases are not treated with a comprehensive approach that addresses all aspects.  If all a chiropractor does is adjust, you miss the soft tissue component.  If all that is done is strengthening, you miss the articular component as well as the soft tissue pathology that occurs!!  (strengthening does NOT address the problems that develop in the fascia as a result of the injury).

The other aspect of this is that you should never, ever wait to get treatment after an injury.  The longer you wait, the more difficult that problem is going to be to fix.

This particular study confirms what anyone that deals with residual problems from a car accident.  If you do the right tests, you do indeed find problems.  Researchers found increased activity in the area of the 2nd cervical vertebrae that indicated inflammation was present.  This was years after the injury.

If you’ve had an injury recently, or have been dealing with a problem that started years ago, find a chiropractor that has a strong

MAKE SURE YOU TAKE THIS TO PROTECT YOUR JOINTS

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There has been much controversy over the use of joint support supplements like glucosamine, chondroitin and methysulfonylmethane (MSM) and their effectiveness for osteoarthritis.  Some studies find a protective effect, some do not.  This is yet another article supporting the use of chondroitin sulfate in osteoarthritis, demonstrating a protective effect on bone cartilage loss and bone erosions within 6 months of use for the knee.

The bottom line is that these supplements are very safe to try on a trial basis.  There is a wide variation in price, however, and, as the adage goes, you get what you pay for.  I always recommend to patients that they start with the more expensive brands, and one that contains a combination of all three compounds mentioned above.  After at least 3 months, if you find that it is effective for you, then you can try to substitute for a less expensive brand.  This way, you have established that it works for you and it was not a matter of quality.

And of course, couple this supplementation with an evaluation by a chiropractor that has a strong soft tissue focus–many times “arthritis” pain is NOT coming from the joint, but rather the soft tissues surrounding the joint itself.  Address this aspect of the problem and the pain goes away or gets significantly better.

http://ard.bmj.com/content/70/6/982.abstract