Herniated Discs, Radiating Pain and Chiropractic

A report on the scientific literature 



80% of chiropractic patients reported excellent or good result in a 2 year study


By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP

 

 
Pain radiating down your leg secondary to a herniated disc is a common and often disabling occurrence. A disc in your spine is comprised of 2 basic components, the inner nucleus pulposis that is gelatinous in composition and the outer annulus fibrosis that is fibro-cartilaginous and very strong. When a person experiences trauma and the forces are directed at the spine and disc. The pressure on the inside of the disc is increased (like stepping on a balloon) and the internal nucleus pulposis creates pressure from the inside out. It tears the outer annulus fibrosis causing the internal material to go beyond the outer boundaries of the disc. This has often been misnamed a “slipped disc” because the disc doesn’t slip or slide, it is torn from the trauma allowing the internal material to escape.
 
Conversely, a bulging disc, which gets confused with a herniated disc, is a degenerative “wear and tear scenario” that occurs over time with the annulus fibrosis degenerating. This can also be a “risk factor” allowing the disc to herniate with less trauma due to the degeneration or thinning of the disc walls. This, however, is a conversation for another article.
 
Lifetime prevalence of a herniated disc has been estimated to be 35% in men and 45% in woman and it has been estimated that 90% of all leg pain secondary to herniated discs occurs at either the L4-5 or L5-S1 levels. It has also been reported that average duration of symptoms is 55.9 weeks, underscoring the critical necessity for finding a viable solution for these patients.1
 
Although many of these are surgical cases, it has been estimated that only 2-4% have actual surgical indications.Therefore, most patients need to be treated non-surgically and until recently, there have been few metrics affording guidance to the healthcare profession and public alike directing them to the right care. In a 2009 research report, culminating a 2 year study, a clear direction is now available for patients that suffer with radiating pain from herniated discs.
1 The results of the study show that as a result of chiropractic care, “clinically meaningful improvement in pain intensity was seen in 73.9% of patients (Murphy, Hurwitz, & McGovern, 2009, p. 728). "'Good' or 'excellent' improvement was reported by 80% of patients" (Murphy, Hurwitz, & McGovern, 2009, p. 723).
 
Chiropractic treatment protocols utilized were 2-3 times per week tapering down to 2 times per week and less until the patients were released from care. The reports go on to state that there were no major complications with any patient. The results of the study also suggest that patients with cervical radiculopathy (neck pain radiating in to the arms), lumbar spinal stenosis, pregnancy related lumbo-pelvic pain and chronic work related neck-arm pain may also benefit from non-surgical treatment such as chiropractic care.1
 
This study clearly shows that chiropractic is not only an alternative for disc related radiating pain, but would be the most logical place to begin care, as 80% of the patients studied got well and without being exposed to drugs, their side effects or the added burden to the healthcare system with more costly treatments. In practice, the balance of the patients who need necessary drugs or more complicated intervention would be referred to the appropriate specialist as is the standard of care within chiropractic.
 
This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions for disc and radiating pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.uschirodirectory.com and search your state.




References:

1.  Murphy, D. R., Hurwitz, E. L., & McGovern, E. E. (2009). A nonsurgical approach to the management of patients with lumbar radiculopathy secondary to herniated disk: A prospective observational cohort study with follow-up. Journal of Manipulative and Physiological Therapeutics, 32(9), 723-733.

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Published in Herniations

Balance, Chronic Pain and Chiropractic

A report on the scientific literature 




The results showed decreased pain and increased balance; helping to avoid falls

By

William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP

 

When we age, it seems that there are more and more challenges to our health and well being.  Falling and chronic pain are most likely fighting to be #1 on that list.  Whether there was a prior injury, decades of hard labor, years of inactivity or just simple daily wear and tear, chronic pain is difficult to manage.  Our societal tendencies are to medicate to “make the pain go away,” but the TRUTH is, it is still there, we just feel it less.  What happens to our bodies when year after year, we continue to work through it?  Well, the problem gets worse and we take more pills! 

In a recent study from the University of California’s Geriatric Primary Care lecture, the presenter stated, “Ambulatory elderly fill between 9-13 prescriptions a year...”
(Johnston, 2001, slide 3 ).She goes on to state, “Surveys indicate that elders take average of 2-4 nonprescription drugs daily” (Johnston, 2001, slide 5).  Adding additional “pills” to the mix for pain is often not a very good idea.  Although necessary medications are clearly indicated and needed, what are the options for those medications that are optional and potentially dangerous when taken over a long period of time? 

In a recent study published in a chiropractic research journal, the authors stated, “The purpose of this study was to collect preliminary information on the effect of a limited and extended course of chiropractic care on balance, chronic pain, and associated dizziness in a sample of older adults with impaired balance" (Hawk, Cambron, & Pfefer, 2009, p.438). The results showed decreased pain and increased balance (helping to avoid falls).

The authors finally reported, "Another interesting finding in this study that warrants further investigation is that it appeared that for the group on the extended care schedule, pain and disability decreased and remained at a lower level than for the limited care schedule, for the year we followed patients.  This provides preliminary support for chiropractic maintenance care for older adults with chronic pain”
(Hawk, Cambron, & Pfefer, 2009, p.445).

This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions for pregnant patients with balance disorders and chronic pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.uschirodirectory.comand search your state.


References:

1. Johnston, C. B. (2001, May). Drugs and the Elderly: Practical Considerations. PowerPoint presentation presented at the UCSF Division of Geriatrics Primary Care Lecture Series.
2.  Hawk, C., Cambron, J. A., & Pfefer, M. T. (2009). Pilot study of the effect of a limited and extended course of chiropractic care on balance, chronic pain and dizziness in older adults. Journal of Manipulative and Physiological Therapeutics, 32(6), 438-477
.

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Published in Balance

Comparing the Satisfaction of Low Back Pain Patients Receiving Medical vs. Chiropractic Care: Results from the UCLA Back Pain Study
 

A report on the scientific literature 



By
William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
 

The relationship between a patient and a doctor is a very important aspect of healthcare.  Many patients call this “bedside manner." Researchers call it “patient satisfaction.”  In a recent study published in the peer reviewed journal, American Journal of Public Health, and produced by the UCLA School of Public Health, the authors reported on the results of a comparison of patient satisfaction between patients that received chiropractic care and those that received medical care for lower back pain.  The authors stated, “Results from observational studies suggest that back pain patients are more satisfied with chiropractic care than with medical care” (Hertzman-Miller et al., 2002, p. 1628).

“Our study was conducted in a large managed care organization in Southern California...for approximately 100000 members”
Hertzman-Miller et al., 2002, p. 1628).  They go on to report, “Of the 681 randomized, 340 were assigned to the 2 medical groups and 341 were assigned to the 2 chiropractic groups” (Hertzman-Miller et al., 2002, p. 1630). Interestingly, the paper goes on to show “Chiropractic patients reported receiving more self-care advice than did medical patients, were more likely to report an explanation of their treatment, and visited their primary providers [their assigned chiropractor in this study] more often" (Hertzman-Miller et al., 2002, p. 1630).  The results showed, “In this randomized trial, chiropractic patients were more satisfied with their back care providers after 4 weeks of treatment than were medical patients” (Hertzman-Miller et al., 2002, p. 1631).  It should also be noted, “No deaths or serious adverse events occurred during the 4-week period” (Hertzman-Miller et al., 2002, p. 1630).

This paper in no way minimizes the importance of the medical physician as part of the team necessary to care for patients, understanding that there are diagnoses that mandate the services exclusively of the MD and other circumstances where concurrent care is required. However, when there is a choice based on overlapping care, common sense dictates a drugless treatment first, treatment involving drugs second and surgery last. Those patients, according to this study, who have chosen the chiropractic, drugless approach first, have reported a very high level of satisfaction with chiropractic care with no adverse events.
 
These studies along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions for patients with low back pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.



References:

1.  Hertzman-Miller, R. P., Morgenstern, H., Hurwitz, E. L., Yu, F., Adams, A. H., Harber, P., & Kominski, G. F. (2002).  Comparing the satisfaction of low back pain patients randomized to receive medical or chiropractic care: Results from the UCLA low-back pain study. American Journal of Public Health, 92(10),1628-1633.
 

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Carpal Tunnel Syndrome and Chiropractic

A report on the scientific literature 



By
William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP

 

When people experience pain in the wrist, the common assumption is that it is carpal tunnel syndrome.  The wrists are made of 2 rows of 4 bones called the carpal bones.  When you flip your hand over with the palm facing the sky, there is a covering over those bones at the wrist.  To the side of this covering is where you can take your pulse.  One of two major nerves that go to the hand travel between this covering and the carpal bones. The nerve travels with the tendons, which connect muscle to bone, of nine muscles that flex the wrist or bring your fingers toward you.  The nerve is named the median nerve, so carpal tunnel syndrome is the compression of the median nerve between the carpal bones and the covering of the tunnel at the wrist.  This causes numbness and tingling in the thumb, index finger and ½ of the middle finger because that is where the median nerve goes.  Numbness or tingling in any other finger or the palm is not due to carpal tunnel and may be coming from the elbow, shoulder or neck.

There are a few common reasons for carpal tunnel syndrome, the primary one being  inflammation or swelling in the tunnel.  This can be due to direct trauma like a wrist injury or a result of a car accident involving your hands twisting on the steering wheel.  Other causes can be overuse, like typing too much on a keyboard, fine movements at work or weakness and overuse of the forearm muscles.  The mild and moderate symptoms can generally be controlled and treated with conservative therapy. More severe cases often require surgery and can only be quantified with a neurological test. Surgery, although necessary in some cases, is a last resort since scar tissue can result from the surgical incision and over time can result in the return of compression of the median nerve in the carpal tunnel.  In the cases of the mild or moderate symptoms, they may be due to improper mechanics of the 8 bones of the wrist.  In these cases, chiropractic management, using the chiropractic adjustment administered to this area, has been shown to be effective in a recent study. 

In this study the authors stated, “From a mechanistic viewpoint, manual therapy techniques designed to release tissue adhesions and increase the range of motion (ROM) of the wrist may alleviate the mechanical compression of the median nerve without the need for surgical interventions"
(Burke et al., 2007, p. 51).  They also state, "Interventions were, on average, twice a week for 4 weeks and once a week for 2 additional weeks" (Burke et al., 2007, p. 50). "The improvements detected by our subjective evaluations of the signs and symptoms of CTS and patient satisfaction with the treatment outcomes provided additional evidence for the clinical efficacy of these 2 manual therapies for CTS. The improvements were maintained at 3 months for both treatment interventions” (Burke et al., 2007, p. 50).

The authors related the following statistic, “The American Academy of Neurology and 40% of neurologists in the Netherlands recommend conservative management of CTS before surgical intervention" (Burke et al., 2007, pp. 50-51). An important perspective to have on surgical intervention was also included and the authors stated, “In addition, of patients with failed primary surgical interventions, up to 12% may require a secondary surgical procedure.  Persistent symptoms after a secondary surgical procedure ranged from 25% to 95%" (Burke et al., 2007, p. 51). Therefore, we see that the American Academy of Neurology recommends holding off on surgery until other options are explored. 

In conclusion, the paper reports, “Although the clinical improvements were not different between the 2 manual therapy techniques, which were compared prospectively, the data substantiated the clinical efficacy of conservative treatment options for mild to moderate CTS"
(Burke et al., 2007, p. 59). In the end, it was the management of carpal tunnel syndrome by a doctor of chiropractic that was the most important factor; the individual techniques did not matter. 
 
If you are experiencing numbness and tingling into hands or fingers, please discuss this with a doctor of chiropractic.  Conservative care is recommended by the American Academy of Neurology.
 


References:


1.  Burke, J., Buchberger, D. J., Carey-Loghmani, M. T., Dougherty, P. E., Greco, D. S., & Dishman, J. D. (2007). A pilot study comparing two manual therapy interventions for carpal tunnel syndrome. Journal of Manipulative and Physiological Therapeutics, 30(1), 50-61.

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Whiplash Disorders and Neck Pain

A report on the scientific literature 



By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
 

In car accidents and other trauma related causes, whiplash, formally known as WAD (Whiplash Associated Disorders), has the potential to create significant problems to the neck area or cervical spine. The treatment of these disorders ranges from rest or no care to non-invasive care such as chiropractic, acupuncture or physical therapy to invasive care starting with drugs and leading to surgery. Every one of these treatment modalities is indicated based upon the individual diagnosis of the condition and requires the care from a doctor who is experienced and credentialed in trauma related care.
 
The problem with whiplash is that it affects the ligamentous attachments that connect the bones to one another and creates hypermobility (too much movement or laxity). It often results in compression of the nerves causing pain and resultant premature degeneration. The biggest problem is that ligaments, as reported in a 2006 study, never heal or wound repair.1 They stay impaired for a lifetime, which affects different people in different ways.
 
Symptoms from whiplash include:2

  1. Neck pain and stiffness
  2. Headaches, most commonly at the base of the skull
  3. Dizziness
  4. Blurred vision
  5. Fatigue
  6. Difficulty concentrating
  7. Memory problems
  8. Ringing in the ears
  9. Sleep disturbances
  10. Irritability
  11. Pain spreading to your shoulders or arms
  12. Painful head movement
  13. Numbness, tingling or weakness in your arms

 
When analyzing and comparing non-invasive modalities for care, interventions involving mobilization (chiropractic) were more effective than usual care. Multimodal treatment including manual therapy, which included relaxation therapy, led to a quicker return to work and increased satisfaction with recovery.
3
 
With whiplash and resultant damage to ligaments, one the solutions is quick intervention where the joints are mobilized or put back in their normal position with a chiropractic adjustment before adhesions (internal scar tissue) can create a chronic (long term) problem. By getting the area “adjusted” after a conclusive diagnosis is one of the best approaches to treat whiplash disorders.
 
 
These studies along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions for pregnant patients with back pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at
www.uschirodirectory.comand search your state.



References:


1.  Tozer, S., & Duprez, D. (2005). Tendon and ligament; Repair and disease. Birth Defects Research (Part C) 75, 226-236.

2.  Mayo Clinic Staff. (n.d.). Whiplash, symptoms. MayoClinic.com. Retrieved from http://www.mayoclinic.com/health/whiplash/ds01037/dsection=symptoms
3.  Hurwitz, E. L., Carragee, E. J., van der Velde, G., Carroll, L. J., Nordin, M., Guzman, J., Peloso, P. M.,...Haldeman, S. (2009). Treatment of neck pain: Noninvasive interventions: Results of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders.  Journal of Manipulative and Physiological Therapeutics, 32(Suppl. 2), S141-S175.
 

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Published in Neck Problems

Pregnancy, Back Pain & Chiropractic

A report on the scientific literature 



By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP

 
"Back pain during pregnancy can be significant in terms of intensity and resulting disability" (Stuber & Smith, 2008, p. 447). It often exacerbates (magnifies) an underlying problem with the change in body mechanics as the pregnancy progresses and the fetus grows. One study found that 35.5% of woman had at least moderately severe back pain during 1 or more of their pregnancies. The pain scales of the pregnant woman (on the Owestry rating scale of 0-10, where 0 is no pain and 10 is the worst pain imaginable) ranged from 5.86 to 9.21.1
 
One of the problems with patients not seeking care during pregnancy is this can become a long- term chronic condition and inherently more difficult to resolve as muscles and connective tissue compensate to accommodate the increasing forward center of gravity. Over time, the tissue becomes "patterned" to the 9 month temporary state and abruptly changed, upon delivery. These multiple, sudden changes can cause a weakening of the supportive tissue, creating an abnormal chronic problem if not stabilized during pregnancy.
 
One study, in a retrospective review of 179 pregnant woman in 5 clinics regarding back pain during pregnancy and labor, found that 85% reported relief of their low back pain as a direct result of chiropractic care. In an unrelated study, 25% had complete remission of their back pain, 50% reported feeling very well and 15% were feeling better. Only 10% reported no changes
.1
 
In one study, the average pain scale prior to chiropractic care was 7.58 out of 10 and while they were under chiropractic care was 4.25. A second study revealed the average pain scale before chiropractic care was 5.9 and post chiropractic care 1.5 out of 10 on the Owestry scale.
 
This author, having practiced chiropractic for 30 years and cared for 100’s of pregnant patients during that time, has had similar results in the clinical setting. The primary reason these pregnant patients have sought chiropractic care has been that it is a drugless approach and it works. Beyond that, pregnant patients shouldn't spend 9 months in pain. They should be able to enjoy an active pregnancy and get the exercise needed to have a healthy, full-term labor and delivery.
 
This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions for pregnant patients with back pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.uschirodirectory.comand search your state.



References:


1.  Stuber, K. J., & Smith, D. L. (2008). Chiropractic treatment of pregnancy-related low back pain: A systematic review of the evidence. Journal of Manipulative and Physiological Therapeutics, 31(6), 447-454.

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Chronic or Acute (Non-Cardiac) Chest Pain and Chiropractic

A report on the scientific literature 



By
William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
 

Having chest pain can be a very scary experience and is a MAJOR cause for concern.  The obvious condition to evaluate and rule out is a heart attack.  There are many cases where the heart has been verified to be okay and there are no conditions related to blockage of the arteries in the chest, but the pain continues.  One common problem that is more benign, but can produce constant moderate/severe chronic pain, is chest pain of mechanical origin.  In other words, the bones and joints of the chest and middle back are not working properly and are causing irritation of the nerves.  This type of pain is actually quite common and related to posture, working activities (computer work) and trauma (car accidents, karate or even surgery).  YOU MUST BE RELEASED BY A CARDIOLOGIST WITH ANY TYPE OF CHEST PAIN prior to exploring treatment for mechanical chest pain.
 
Chiropractic continues to show up in the research as being effective for the treatment of mechanical chest pain.  In a recent paper published in conjunction with the New York Chiropractic College, the authors discuss such a case.   The clinical features of this case were “A 49-year-old man had chronic chest pain, dyspnea [trouble breathing] and anxiety for over 4 months.  The severity of the condition gradually progressed to the point of precluding the patient’s active employment and most physical activity.  Prior efforts to treat the condition were met with failure" (
Polkinghorn & Colloca, 2003, p. 108).
 
The authors went on to describe the treatment.  “The patient received mechanical force, manually assisted short-lever chiropractic adjustment
[the most common type of adjustment] of the thoracic spine and, in particular, the costosternal articulations [where the ribs meet the breast bone on the front of the chest]...Sustained chiropractic care rendered over a 14 week period resulted in complete resolution of the patient’s previously chronic condition, with recovery maintained at 9 month follow-up” (Polkinghorn & Colloca, 2003, p. 108).
 
Clinically, Dr. Studin (a co-author of this article) had a similar case this past month.  A 30-year-old painter had significant chest pain, chest tightness, shortness of breath and spontaneous perspiration.  He was rushed to the emergency room for an urgent cardiac work-up and subsequently released with a diagnosis of anxiety and a prescription for Xanax (anti-anxiety drug).  The next day, the patient still experienced the same signs and symptoms and began chiropractic care. After 1 chiropractic adjustment of both the sternum-rib complex and the spine, his entire symptom pattern was gone immediately and the patient was pain free.  It is now 4 weeks later and the patient is still symptom free.
 
These clinical case reviews are a very common finding when the cause is a neuromuscular (spinal nerves and muscles) finding called a vertebral subluxation.  These cases also illustrate that the chiropractic subluxation complex can be found in many places in the body.  Although the spine is the most common area, we now know that it can be found anywhere two bones come together, including the chest.  A doctor of chiropractic is a very important part of your healthcare team, even when it comes to chest pain. 
 
This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions to chronic, non-cardiac chest pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.uschirodirectory.com and search your state.
 


References:

1.  Polkinghorn, B. S., & Colloca, C. J. (2003). Chiropractic management of chronic chest pain using mechanical force, manually assisted short-level adjusting procedures. Journal of Manipulative and Physioliological Therapeutics, 26(2), 108-115.

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Recurrent Low Back Pain and Chiropractic

A report on the scientific literature 




By
William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP

 

Low back pain is a very common occurrence in our society.  There are people that experience it once in their lives, but it is much more common to have back pain that reoccurs when you least expect it.  Chiropractic care has been show to be effective in eliminating it or in the cases of chronic recurrent lower back pain, in managing symptoms to allow chronic low back pain sufferers go through their days “pain free.” 
 
Although pain is the #1 reason someone would consult a doctor of chiropractic, the effects of chiropractic on people with recurrent pain are dramatic.  In a recent study published in a peer reviewed medically indexed article, the authors stated the objective was, “To investigate the recovery pattern in chiropractic patients being treated for long-lasting or recurrent low back pain…”
(Stig, Nilsson, & Leboeuf-Yde, 2001, 288).  A total of 158 people were included in the study.  The results of the research showed, “Approximately 50% of patients reported that they had ‘improved’ at the 4th visit and within 2 weeks...At the 12th visit...approximately 75% of the patients reported that ‘improvement’ had occurred” (Stig, Nilsson, & Leboeuf-Yde, 2001, 288).  “Improvement” was defined as a rating of 1-2/10 on a 10 point scale with 0 being no pain and 10 being the worst pain imaginable.1
 
The results of this study indicate that 75% of the population gets better in a short amount of time. Should those patients with low back pain have chosen a preventive regimen of chiropractic care, our clinical experience dictates those numbers would have been much higher. Some patients require care once monthly, while others once weekly depending upon their occupations and activity levels as risk factors in exposing the spine to stress. Stresses that affect the spine are physical, chemical or emotional and all three have significant causative values.
 
The research continues to grow, showing the effectiveness of chiropractic management of lower back pain and in this case, lower back pain that reoccurs.  The chiropractic adjustment is the primary method of treatment that produced these amazing results.  If you have lower back pain, please speak with a doctor of chiropractic today. Research has shown that improvement occurs without drugs or surgery. 
 
This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions to recurrent low back pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.uschirodirectory.com and search your state.
 


References:

1.  Stig, L-C., Nilsson, O., & Leboeuf-Yde, C. (2001). Recovery pattern of patients treated with chiropractic spinal manipulative therapy for long-lasting or recurrent back pain.
Journal of Manipulative and Physioliological Therapeutics, 24(4), 288-91.


 

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Published in Low Back Problems

Elbow Pain (Tennis Elbow, Golf Elbow) and Chiropractic

A report on the scientific literature 



By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP

 

Tennis elbow, golf elbow, shooter’s elbow "is a condition where the outer part of the elbow becomes sore and tender. It is commonly associated with playing tennis or other racquet sports, though the injury can happen to almost anybody. The condition is also known as lateral epicondylitis ("inflammation of the outside elbow bone"), a misnomer as histologic studies have shown no inflammatory process. Other descriptions for tennis elbow are lateral epicondylosis, lateral epicondylalgia, or simply lateral elbow pain...The peak incidence is between 30 and 60 years of age historically" (Wikipedia, 2010, http://en.wikipedia.org/wiki/Tennis_elbow).
 
Symptoms include pain on the outer part of the elbow (lateral epicondyle), point tenderness over the lateral epicondyle – a prominent part of the bone on the outside of the elbow, gripping and movements of the wrist hurt, especially wrist extension and lifting movements, activities that use the muscles that extend the wrist (e.g. pouring a pitcher or gallon of milk, lifting with the palm down) are characteristically painful, and morning stiffness.1
 
In December of 2008, a research article reported on the effects of chiropractic cervical manipulation (adjustment) on the pain pressure threshold, or the minimal amount of pressure to cause pain, along with grip strength, or the amount of strength in the hand. The results of the research concluded that the application of a cervical spine adjustment produced an immediate bilateral (both sides) increase in pain pressure threshold (decreased pain) and an immediate pain free grip on the affected side.2
 
This is one of the reasons that both professional golf and tennis organizations maintain chiropractors at high profile events as it is reported that the scores of the players have improved with chiropractic care. However, this also explains why chiropractic has been helping in work and at home in everyday life with a similar diagnosis.
 
This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions to elbow pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.uschirodirectory.com and search your state.



References:

1.  Wikipedia, The Free Encyclopedia. (2010, August). Tennis elbow. Retrieved from http://en.wikipedia.org/wiki/Tennis_elbow

2.  Fernández-Carnero, J., Fernández-de-las-Peñas, C., & Cleland, J. A. (2008). Immediate hypoalgesic and motor effects after a single cervical spine manipulation in subjects with lateral epicondylalgia, Journal of Manipulative and Physiological Therapeutics, 31(9), 675-681.

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Chronic Back Pain, Disability, Chiropractic and Prevention

A report on the scientific literature 



For the disability scores only the group that was given spinal manipulations during the follow-up period maintained their postintensive treatment scores

By

William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
 

Low back pain sufferers know all too well that constant vigilance is required when dealing with spinal pain.  There are frequent flare-ups occurring for seemingly benign reasons.  Chiropractic has been shown to be effective in treating lower back pain, but what about keeping it under control for the long term.  A recent study by Descarreaux, Blouin, Drolet, Papadimitriou, & Teasdale (2004) studied the effects of preventive spinal manipulation for chronic low back pain. 

The authors state, “Thirty patients with chronic nonspecific low-back pain were separated into 2 groups.  The first group received 12 treatments in an intensive 1-month period but received no treatment in a subsequent 9-month period...
The second group received 12 treatments in an intensive 1-month period and also received maintenance spinal manipulation every 3 weeks for a 9-month follow-up period” (Descarreaux et al., 2004, p. 509).   Pain and disability levels were measured and reported for both groups.

The authors report, “For both groups, the pain and disability levels decreased after the intensive phase of treatments.  Both groups maintained their pain scores at levels similar to the postintensive treatments throughout the follow-up period. For the disability scores, however, only the group that was given spinal manipulations during the follow-up period maintained their postintensive treatment scores.  The disability scores of the other group went back to their pretreatment levels”
(Descarreaux et al., 2004, p. 509). Finally it was concluded, “Intensive spinal manipulation (adjustments) is effective for the treatment of chronic low back pain.  This experiment suggests that maintenance spinal manipulations after intensive manipulative care may be beneficial to patients to maintain subjective postintensive treatment disability levels” (Descarreaux et al., 2004, p. 509).

This study is a great start. Now there will be larger populations of chronic back pain suffers and preventive chiropractic care.  Many thousands of people have gotten relief from chiropractic care; you may be one of them. If you are suffering and have not seen a doctor of chiropractic, please take to time to search the database on this site for a doctor close to you.



References:

1.  Descarreaux, M., Blouin, J.-S., Drolet, M., Papadimitriou, S., & Teasdale, N. (2004). Efficacy of preventive spinal manipulation for chronic low-back pain and related disabilities: A preliminary study. Journal of Manipulative and Physiological Therapeutics, 27(8), 509-514.

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