RSSGraston Technique in the News Again
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Will You Choose Supermarket or Science for Back Pain?
By admin, May 28, 2008 12:53 pm
Yet another review of back pain treatments and the evidence for and against many treatments has been published in The Spine Journal. Do we really need another one? Apparently we do because at this time chiropractors should be well integrated into the medical model, however, we are not.
Regarding back pain treatment the authors note, “The classical method of making health care decisions based on scientific evidence and expert consensus appears to have been replaced with a commercial and competitive model akin to shopping at a supermarket.”
“Only rarely do promotional material accurately present the scientific evidence, rarer still are there discussion of potential harms.”
Conclusions:
1. There are now more randomized controlled trials examining spinal manipulative therapy for back pain than any other intervention.
2. The overall evidence relative to efficacy and safety, “including recent high quality trials” support spinal manipulative therapy for the treatment of back pain.
3. “SMT is superior to usual medical care for patient improvement.”
4. For pain reduction, “High dose SMT is superior to low-dose SMT” in the short term.
5. SMT is superior to physical therapy and to home exercise in the long term.
Even more evidence to show chiropractic should be used as a first line treatment. Please call our office 415-566-7134 or contact us via our website Chiropractic San Francisco for a consultation.
Graston Technique Heals Ligaments 30% Faster
By admin, May 7, 2008 8:44 am
A recent study in the Journal of Orthopedic Sports Physical Therapy found treatment with Graston Technique healed ligaments 31% faster. In this study GT was used for one minute to the injured left medical collateral ligament of a knee three times a week for three weeks. ”the ligaments treated with Graston instrument-assisted cross-fiber massage were found to be 31% stronger and 34 percent stiffer than the untreated ligaments”.
To make an appointment for an assessment of your condition and to see if Graston is an appropriate treatment for your condition please call or email our office.
Pain After Motor Vehicle Accidents
By admin, March 18, 2008 4:49 pm
I’ve seen it so many times in the office. A new patient tells me they went to the ER after a car accident and was told nothing was broken, “you’ll be fine”. They continue to have pain and finally decided to seek care. This new research has a focus on auto accidents and suggests that people have ongoing pain years later. See the research synopsis here.
Additionally the author notes, “the focus up until now in a lot of our care is on whether you live or die, which is obviously important. But we can’t just stop there. And I think we need to look at what are the things we can do to improve people’s lives after serious illness or injury.
How about the only proven treatment for whiplash? Chiropractic.
Opioids Rarely Indicated For Acute Back Pain
By admin, March 18, 2008 3:11 pm
Although frequently prescribed for patients with lower back pain recent clinical guidelines by the American College of Physicians and the American Pain Society suggest that opioids should be reserved for the minority of individuals with severe disabling pain. In addition the guidelines warn clinicians of potential risks for abuse, addiction and other adverse events.
Another recent study by Webster et al. looked at 8443 worker’s compensation claims and found that opioids prolonged disability, “after controlling for age, gender, job tenure and injury severity, the findings indicate that receipt of higher amounts or morphine equivalent medications in early treatment was significantly associated with adverse outcomes, including higher medical costs and prolonged disability, higher risk for surgery and continued use of opioids.”
Graston Technique in the News Again
By admin, March 18, 2008 2:45 pm
The Graston Technique is in the news again, this time for the treatment of chronic pain. See the ABC news story here.
If you have any questions or would like to experience Graston Technique yourself, please call the office to schedule an appointment.
Prodisc Artificial Disk Replacement
By admin, March 18, 2008 1:54 pm
People often ask me about surgical treatments for lower back pain. One that has come up more recently is the Prodisc artificial disk replacement. One thing is for sure you have to be very careful about conflicts of interest in medicine these days.
According to a recent New York Times expose half of the surgeons who participated in the trial evaluating the artificial disk had direct financial stake in the success or failure of the product. ”Instead of serving as objective gatekeepers who can screen out potential harmful or ineffective new devices or drugs, some medical experts say, clinical researchers may have incentive to overstate the value of a new product for patients.”
The positive results of this study are very suspect and just another reason to use safe and proven effective chiropractic care. I wouldn’t subject myself to any unproven invasive medical procedure, you shouldn’t either.
7 Year Neck Pain Study Sheds Light on Best Care
By admin, March 7, 2008 9:56 am
Two weeks ago in Reno I had the opportunity to hear Scott Haldeman MD, DC, PhD discuss the findings of the The World Health Association’s Neck Pain Task Force. The task force was created to help neck pain sufferers and health professionals use the best research evidence to prevent, diagnose and treat neck pain.
The Neck Task Force recently released it’s findings after an exhaustive seven year study of neck pain treatments. They concluded that neck manipulation, acupuncture and massage are better than most of the treatments most utilized by the traditional medical system. It was found that steroid injections, surgery and neck collars show little evidence of benefit.
In addition to it’s comprehensive review of neck pain, the task for also took on the widely publicized incorrect notion that chiropractic manipulation causes stroke. They found that patients who visit the chiropractor are no more likely to experience a stroke than patients who visit their medical doctor.
Will the medical establishment take these guidelines and apply them to neck pain patients to ensure the best results. Doubtful, but the task force is going to do it’s best to get the word out.
Chiropractic More Effective Than Usual Medical Care
By admin, February 13, 2008 3:35 pm
Numerous international guidelines have endorsed the use of spinal manipulation as a treatment for acute back pain, however family physicians have been slow to adopt these guidelines. No wonder it was reported in the latest JAMA that the cost of back and neck care has ballooned yet people reported increased disability. Basically we are spending more and more for less results.
This latest study, Chiropractic Hospital Based Interventions Research Outcomes Trial or C.H.I.R.O. for short found that evidence based care including chiropractic was far superior to usual care including physical therapy, bed rest and excessive use of narcotic analgesics. It is not surprising that when given evidence based care patients improve more rapidly and have less disability in the long and short term. Unfortunatly physicians in the United States rarely if ever follow evidence based care and guidelines for back pain. If this continues look for costs to skyrocket even more and increasing disability in our population.
Back Pain and Sex
By admin, October 5, 2007 8:45 am
From www.spine-health.com
For many of the millions of Americans who suffer with back pain, trying to maintain a healthy sex life can be frustrating. But back pain doesn’t have to mean no sex, though it may mean taking a different approach to lovemaking. And that can be a good thing. As the saying goes, “Where there’s a will, there’s a way.” The first step is to get a sound diagnosis from a doctor or therapist. Remember that sexuality is an integral part of normal, healthy relationships. So be sure to ask how a specific back condition might affect it, and follow the advice received. Ideally, both partners should be present so both hear the same advice.
Emotional and psychological issues
Understandably, the limitations brought about by back pain may produce stress that can damage a relationship. The person who doesn’t have the pain often finds it difficult to understand what his or her partner is experiencing. The negative effects that pain has been causing in a couple’s sex life can sometimes spill over into other aspects of the relationship.
Good communication is critical. Otherwise, one partner may mistakenly interpret a reluctance to engage in sexual activity as an excuse for not wanting to be close, which can lead to feelings of rejection and resentment.
To reduce the tension, try to create an atmosphere in which neither partner will feel rushed. Be patient with each other. Many therapists suggest setting the stage with a gentle massage, a hot bath or shower, or the application of a pain cream – any of which can relax the muscles and ease pain. Even under the best of circumstances, back pain may occur during sex. Knowing this, couples should plan how they’ll respond ahead of time, so they can avoid becoming angry or frustrated.
Positions and approaches
For people with lower back pain there may be a preference either for bending forward, or standing straight / bending backwards.
Bending backwards/standing straight. For some people with degenerative disc disease or a disc herniation, standing up straight or bending backwards tends to feel better, and bending forward tends to make the pain worse. These people are usually most comfortable when the spine is straightened or bent backward slightly (basically stand more upright, not slouched). Bending backwards is called “extension”.
Bending forwards. For some people with spinal stenosis, they feel better when they bend forward, and worse when they stand more upright. People with spinal stenosis may resist standing upright and may slouch or tip their shoulders forward to feel more comfortable. Bending forward is called “flexion”.
These differences must be taken into account when deciding which sexual positions might work best.
When standing up straight and/or bending backwards (extension) feels better
For example, if a man with lower back pain prefers “extension” then he can use the missionary position, with the woman bending her knees toward her chest. For this to work, the man has to support himself on his hands so his back is extended or bent backwards more. Or she can straddle him (facing away or towards him) while he lies on his back with a pillow under his lower back or he may sit in a sturdy armless chair.
A woman with this type of lower back pain may want to lie on her stomach with a pillow under her chest, allowing her partner to enter her from behind. Or she can straddle him – facing toward him or away – as he sits in a chair, which lets her control both the position of her lower back and her movement. She can also use the missionary position, supporting her lower back with a rolled up towel or flat pillow and being careful not to bend her legs up too far, or perhaps bend one leg towards her shoulder and to the side slightly. Do not pull too much for this may flatten the low back and cause more flexion.
When bending forward (flexion) feels better
A man with lower back pain who prefers flexion may be more comfortable entering his partner from behind as they both kneel on the bed. Or, the woman can kneel on the edge of the bed, facing in, while he enters from behind, allowing him to bend forward as he stands. Also, they can lay in a side-lying position with him entering from behind (sometimes called the fetal position or spooning).
A woman with this kind of lower back pain may want to try the missionary position, keeping her knees bent and pulled towards her armpits. The more she brings her knees upward, the more the spine will bend. If she opts to straddle the man, she should bend forward and put her chest against his.
Anyone who suffers from severe back pain should lie on his or her back on a relatively firm surface with pillows supporting the knees and head, with a small rolled up towel placed under the lower back. A position where both partners are on their sides may also work.
For some people, positions that allow genital intercourse may simply be too painful. In this case, partners can try other options that are less taxing on the back, such as massage, gentle touching or oral sex.
As a rule, the partner with lower back pain should take a passive role in lovemaking, with the other partner introducing stimulation in a very relaxed manner. Just remember to take it slow. And identify as specifically as possible which movements are comfortable and which ones hurt and should be avoided.
Brave new world
Trying new positions can be a rewarding journey of exploration that leads to a new intimacy between partners. Just because back pain may limit one’s physical abilities, it doesn’t have to limit sensuality. Never underestimate the power of candlelight and soft music. And as an added benefit, restoring healthy sexual relations will lower stress, and lower stress often leads to less pain.
