By ANAHAD O'CONNOR
Tony Cenicola/The New York Times, January 3, 2012,
What’s the best treatment for neck pain?
Seeing a chiropractor or engaging in light exercise relieves neck pain more effectively than relying on pain medication, new research shows.
The new study is one of the few head-to-head comparisons of various treatments for neck pain, a problem that affects three quarters of Americans at some point in their lives but has no proven, first-line treatment. While many people seek out spinal manipulation by chiropractors, the evidence supporting its usefulness has been limited at best.
But the new research, published in The Annals of Internal Medicine, found that chiropractic care or simple exercises done at home were better at reducing pain than taking medications like aspirin, ibuprofen or narcotics.
“These changes were diminished over time, but they were still present,” said Dr. Gert Bronfort, an author of the study and research professor at Northwestern Health Sciences University in Minnesota. “Even a year later, there were differences between the spinal manipulation and medication groups.”
Moderate and acute neck pain is one of the most frequent reasons for trips to primary care doctors, prompting millions of visits every year. For patients, it can be a difficult problem to navigate. In some cases the pain and stiffness crop up without explanation, and treatment options are varied. Physical therapy, pain medication and spinal manipulation are popular options, but Dr. Bronfort was inspired to carry out an analysis because so little research exists.
“There was a void in the scientific literature in terms of what the most helpful treatments are,” he said.
To find out, Dr. Bronfort and his colleagues recruited a large group of adults with neck pain that had no known specific cause. The subjects, 272 in all, were mostly recruited from a large HMO and through advertisements. The researchers then split them into three groups and followed them for about three months.
One group was assigned to visit a chiropractor for roughly 20-minute sessions throughout the course of the study, making an average of 15 visits. A second group was assigned to take common pain relievers like acetaminophen and — in some cases, at the discretion of a doctor — stronger drugs like narcotics and muscle relaxants. The third group met on two occasions with physical therapists who gave them instructions on simple, gentle exercises for the neck that they could do at home. They were encouraged to do 5 to 10 repetitions of each exercise up to eight times a day. (A demonstration of the exercises can be found at www.annals.org).
After 12 weeks, the people in the non-medication groups did significantly better than those taking the drugs. About 57 percent of those who met with chiropractors and 48 percent who did the exercises reported at least a 75 percent reduction in pain, compared to 33 percent of the people in the medication group.
A year later, when the researchers checked back in, 53 percent of the subjects who had received spinal manipulation still reported at least a 75 percent reduction in pain, similar to the exercise group. That compared to just a 38 percent pain reduction among those who had been taking medication.
Dr. Bronfort said it was a “big surprise” to see that the home exercises were about as effective as the chiropractic sessions. “We hadn’t expected that they would be that close,” he said. “But I guess that’s good news for patients.”
In addition to their limited pain relief, the medications had at least one other downside: people kept taking them. “The people in the medication group kept on using a higher amount of medication more frequently throughout the follow-up period, up to a year later,” Dr. Bronfort said. “If you’re taking medication over a long time, then we’re running into more systemic side effects like gastrointestinal problems.”
He also expressed concern that those on medications were not as empowered or active in their own care as those in the other groups. “We think it’s important that patients are enabled to deal with as much control over their own condition as possible,” he said. “This study shows that they can play a large role in their own care.”
Showing posts with label neck pain. Show all posts
Showing posts with label neck pain. Show all posts
Thursday, January 5, 2012
Friday, December 9, 2011
Should I see a Massage Therapist or a Chiropractor?
“How do I know if I need to see a Massage Therapist or a Chiropractor?” I am asked this question from time-to-time by prospective patients. It is a good question, and worth taking some time to look at a number of considerations.
Massage Therapists (MT) in Georgia are licensed professionals who graduate from a 9 month course of study. Prerequisites include a High School diploma or equivalent.
Massage is a system of structured touch, pressure, movement or holding of the soft tissues of the body, which has the primary intent to enhance or restore health and well-being.
Doctors of Chiropractic (DC) are licensed healthcare professionals who graduate from a 4-year course of study, and pass 4 National Board Exams. Prerequisites include an undergraduate degree or equivalent. DC’s may examine, use x-rays and other diagnostic testing, diagnosis and prescribe a course of treatment or refer.
DC’s may utilize spinal and extra-spinal adjustments, physiotherapy, therapeutic exercises, nutritional/dietary supplements and lifestyle modification.
It is very common for health insurance plans, motor vehicle accident insurance and Medicare to cover Chiropractic exams, x-rays and treatment. It is less common for insurance to cover Massage Therapy, but when it does, their must be a diagnosis and examination by a DC, MD or other doctorate level healthcare provider.
A typical first-time Massage Therapy client will have mild stiffness and stress in the neck or back, and they are looking for temporary relief and relaxation. The client comes back to the MT when they want more temporary relief.
A typical first-time Chiropractic patient will have more intense symptoms that interfere with some aspect of their daily life (sleep, work, mood, recreation, chores). They are looking for an understanding of their condition, relief from their pain or other symptoms and how to avoid future problems without drugs or surgery.
The patient follows a recommended schedule of care to get a desired result.
Over the years I have had new patients come to my practice who were told by a Massage Therapist that they needed a Chiropractor, and I have told patients that they needed to get massage more than they needed to be adjusted. Many of our patients who are under my care see our MT as well as me because the two working together is of more benefit than each alone.
What are your thoughts on when to see a Massage Therapist or a Chiropractor?
Massage Therapists (MT) in Georgia are licensed professionals who graduate from a 9 month course of study. Prerequisites include a High School diploma or equivalent.
Massage is a system of structured touch, pressure, movement or holding of the soft tissues of the body, which has the primary intent to enhance or restore health and well-being.
Doctors of Chiropractic (DC) are licensed healthcare professionals who graduate from a 4-year course of study, and pass 4 National Board Exams. Prerequisites include an undergraduate degree or equivalent. DC’s may examine, use x-rays and other diagnostic testing, diagnosis and prescribe a course of treatment or refer.
DC’s may utilize spinal and extra-spinal adjustments, physiotherapy, therapeutic exercises, nutritional/dietary supplements and lifestyle modification.
It is very common for health insurance plans, motor vehicle accident insurance and Medicare to cover Chiropractic exams, x-rays and treatment. It is less common for insurance to cover Massage Therapy, but when it does, their must be a diagnosis and examination by a DC, MD or other doctorate level healthcare provider.
A typical first-time Massage Therapy client will have mild stiffness and stress in the neck or back, and they are looking for temporary relief and relaxation. The client comes back to the MT when they want more temporary relief.
A typical first-time Chiropractic patient will have more intense symptoms that interfere with some aspect of their daily life (sleep, work, mood, recreation, chores). They are looking for an understanding of their condition, relief from their pain or other symptoms and how to avoid future problems without drugs or surgery.
The patient follows a recommended schedule of care to get a desired result.
Over the years I have had new patients come to my practice who were told by a Massage Therapist that they needed a Chiropractor, and I have told patients that they needed to get massage more than they needed to be adjusted. Many of our patients who are under my care see our MT as well as me because the two working together is of more benefit than each alone.
What are your thoughts on when to see a Massage Therapist or a Chiropractor?
Monday, October 17, 2011
Avoid Neck and Nerve Trouble with Smart Use of Phones
Mobile technological devices, such as digital
personal assistants (PDAs) and smartphones
have made our lives more convenient. We can
now send e-mails, access the Internet, manage
our schedules, and use spreadsheets and other
office software from our phones. While this
makes it easier to accomplish tasks without
being tethered to an office, it has also increased
the amount of time we spend using these
devices, which is not without risks.
Before these advances in technology, our bodies
moved as we used the phone and the computer,
we walked to the fax machine, and we flipped
through our calendars. Now we slump over a
small screen with little change in our position.
Our bodies are made to move—not to maintain
the same posture for long periods of time. This
doesn’t mean you have to sacrifice these modern
conveniences for your health, but you
should be aware of the risks and what you can
do to minimize them.
Protect Your Neck
The bent-forward position common among
mobile device users increases disc pressure. It
also increases loads on the muscles. This is
similar to the faulty forward position often used
when working on the computer. Remember
these tips:
• Sit upright, keeping your ears over your
shoulders.
• Look down with your eyes and gently
tuck your chin in, not forward.
• Never pinch the phone between your
ear and shoulder. Using a headset
reduces muscle fatigue and frees your
hands for typing or writing.
• Support your forearms on a pillow
during extended texting to reduce the
strain on your neck and shoulder
muscles.
Prevent Elbow Injury
The ulnar, or “funny bone,” nerve wraps around
the inside of your elbow. Keeping your elbows
bent can compress the nerve. As the nerve
becomes irritated, you can experience pain,
numbness, tingling, and even weakness or muscle
atrophy. The nerve sits close to the surface
and is also damaged by external pressure. To
prevent injury:
• Minimize the time you bend the elbows
to hold the PDA screen up to see it.
• Instead of returning all your e-mails on
the phone, wait until you can use the
computer.
• Avoid leaning on the flexed elbow while
talking on the phone or in the car.
Like a Sore Thumb
Our thumbs are not made to quickly and forcefully
press the small keys on cell phones to text
and input data. Use the following tips to minimize
the risk of injury:
• Alternate among using your thumb,
index finger, and a stylus, if available.
• If your only choice is a stylus, change
how you hold it. Switch between holding
it like a pen and holding it between the
index and middle fingers.
• Several multi-tip pens are available at
office supply stores that enable you to
switch between pen and stylus tips. This
is a good option, as the barrel of the
pen is thicker than a standard stylus and
requires less force on the joints and
muscles.
• Minimize the use of scroll wheels as
they often cause inflammation of thumb
tendons.
As technology progresses, there will likely be
more tasks we can complete on our phones.
While this is convenient, remember to take
breaks and think about the effects on your
body.
Tips to Minimize PDA and Cell
Phone Use
• Return only urgent e-mails on the PDA.
Respond to other e-mails from your
computer.
• Use key shortcuts (cut, paste, etc.) and
abbreviations.
• Enter all contact info on the computer,
and synchronize the devices to transfer the
data to the PDA.
• Monitor the time spent on the phone or
PDA.
• Avoid, or at least minimize, using
word processing and spreadsheet programs
on your PDA.
• Take breaks to stretch and shake out
the hands.
• Turn the PDA off when possible! If it is
on all the time, it’s more likely to be overused.
For more information on injury prevention
and wellness, or to find a doctor of
chiropractic near you, go to the patient
information section on ACA’s Web site
at www.acatoday.org/Patients or call
800-986-4636.
This patient information page is a public service of the Journal of the American Chiropractic Association. The information
and recommendations appearing on this page are appropriate in most instances, but they are not a substitute
for a diagnosis by a specialist. For specific information concerning your health condition, consult your doctor
of chiropractic. This page may be reproduced noncommercially by doctors of chiropractic
personal assistants (PDAs) and smartphones
have made our lives more convenient. We can
now send e-mails, access the Internet, manage
our schedules, and use spreadsheets and other
office software from our phones. While this
makes it easier to accomplish tasks without
being tethered to an office, it has also increased
the amount of time we spend using these
devices, which is not without risks.
Before these advances in technology, our bodies
moved as we used the phone and the computer,
we walked to the fax machine, and we flipped
through our calendars. Now we slump over a
small screen with little change in our position.
Our bodies are made to move—not to maintain
the same posture for long periods of time. This
doesn’t mean you have to sacrifice these modern
conveniences for your health, but you
should be aware of the risks and what you can
do to minimize them.
Protect Your Neck
The bent-forward position common among
mobile device users increases disc pressure. It
also increases loads on the muscles. This is
similar to the faulty forward position often used
when working on the computer. Remember
these tips:
• Sit upright, keeping your ears over your
shoulders.
• Look down with your eyes and gently
tuck your chin in, not forward.
• Never pinch the phone between your
ear and shoulder. Using a headset
reduces muscle fatigue and frees your
hands for typing or writing.
• Support your forearms on a pillow
during extended texting to reduce the
strain on your neck and shoulder
muscles.
Prevent Elbow Injury
The ulnar, or “funny bone,” nerve wraps around
the inside of your elbow. Keeping your elbows
bent can compress the nerve. As the nerve
becomes irritated, you can experience pain,
numbness, tingling, and even weakness or muscle
atrophy. The nerve sits close to the surface
and is also damaged by external pressure. To
prevent injury:
• Minimize the time you bend the elbows
to hold the PDA screen up to see it.
• Instead of returning all your e-mails on
the phone, wait until you can use the
computer.
• Avoid leaning on the flexed elbow while
talking on the phone or in the car.
Like a Sore Thumb
Our thumbs are not made to quickly and forcefully
press the small keys on cell phones to text
and input data. Use the following tips to minimize
the risk of injury:
• Alternate among using your thumb,
index finger, and a stylus, if available.
• If your only choice is a stylus, change
how you hold it. Switch between holding
it like a pen and holding it between the
index and middle fingers.
• Several multi-tip pens are available at
office supply stores that enable you to
switch between pen and stylus tips. This
is a good option, as the barrel of the
pen is thicker than a standard stylus and
requires less force on the joints and
muscles.
• Minimize the use of scroll wheels as
they often cause inflammation of thumb
tendons.
As technology progresses, there will likely be
more tasks we can complete on our phones.
While this is convenient, remember to take
breaks and think about the effects on your
body.
Tips to Minimize PDA and Cell
Phone Use
• Return only urgent e-mails on the PDA.
Respond to other e-mails from your
computer.
• Use key shortcuts (cut, paste, etc.) and
abbreviations.
• Enter all contact info on the computer,
and synchronize the devices to transfer the
data to the PDA.
• Monitor the time spent on the phone or
PDA.
• Avoid, or at least minimize, using
word processing and spreadsheet programs
on your PDA.
• Take breaks to stretch and shake out
the hands.
• Turn the PDA off when possible! If it is
on all the time, it’s more likely to be overused.
For more information on injury prevention
and wellness, or to find a doctor of
chiropractic near you, go to the patient
information section on ACA’s Web site
at www.acatoday.org/Patients or call
800-986-4636.
This patient information page is a public service of the Journal of the American Chiropractic Association. The information
and recommendations appearing on this page are appropriate in most instances, but they are not a substitute
for a diagnosis by a specialist. For specific information concerning your health condition, consult your doctor
of chiropractic. This page may be reproduced noncommercially by doctors of chiropractic
Sunday, October 9, 2011
Best of the Best
Dr. James Cox, founder and developer of the Cox Technic system for spine pain, is one the most outstanding Doctors of Chiropractic in the world. I attended the Cox Symposium for Certified Cox Practitioners this weekend in Nashville, TN, receiving my re-certification status for another two years. I have been certified since 1994, and am one of the few DC's, out of 3,000 licensed chiropractors in Georgia, who carries the Cox certification. The Symposium keeps us up-to-date with the latest information and research documentation that we can apply to help patients who suffer from spine-related pain. The Cox Technic allows me to offer evidence-based non-surgical chiropractic protocols for the relief of spine pain due to disc herniations, stenosis and related conditions causing neck, upper back, shoulder, arm, low back and leg pain. The Cox Technic flexion-distraction protocols have been scrutinized in federally funded research projects. Flexion-distraction biomechanical effects have been documented- drop in intradiscal pressures, increase in spinal canal area and discal height-and clinical outcomes have been published- superior in pain relief for radiculopathy, better for relief of chronic low back pain, and more effective in reducing the need for healthcare visits for spinal pain in the year after treatment. I am proud to provide this specialized non-surgical solution for back pain relief in my Roswell practice. For additional information on Cox Technic, visit www.coxtechnic.com or our practice website www.leadingedgeatlanta.com.
Monday, May 10, 2010
Could chiropractic have helped save Tiger Woods' neck?
Tiger Woods dropped out of The Players Championship this weekend, complaining of neck pain that was interfering with his ability to play. Neck pain is second only to low back pain for spinal conditions affecting Americans. Considering the abuse we give our necks, this should not be surprising. We sleep with too many pillows. We scrunch our cellphones between our neck and shoulders. We hunch over computers all day. We fall asleep on the couch. All these positions put physical strain on our neck. From minor stiffness to a full blown herniated disk , many who suffer from neck pain could be helped with regular chiropractic care. A healthy neck should be supple, pain-free and properly aligned so that the nerve endings leading to the head and arms are free of impingement.
Chiropractors specialize in detection and correction of the most common cause of neck pain, vertebral subluxation. Vertebral refers to the spinal bones, and subluxation refers to a partial dislocation. Chiropractic doctors experts in helping the underlying cause of neck pain, and working with patients to help relieve pain, restore mobility and free-up impingement to nerves.
Tiger... see your chiropractor. An adjustment today, may keep the surgeon away!
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