My previous posts
3rd June 2017
My new book chapters
I have been fortunate to have been invited to collaborate as a co-author with some of the leading authors in the chiropractic world in two new books just released in the last few months!
Check them out here;
The Praeger Handbook of Chiropractic Health Care
Evidence-Based Practices
by Cheryl Hawk, DC, PhD, CHES, Editor
Foreword by John Weeks
Chiropractic is the second largest physician-level U.S. health profession, providing care to at least 20 million patients annually. Even so, members of the general public and other health care providers are often unaware of the scientific evidence proving the benefits of chiropractic health care.
Careers in Chiropractic Health Care
Exploring a Growing Field
by Cheryl Hawk, DC, PhD, CHES, Editor
Foreword by John Weeks
The U.S. Bureau of Labor Statistics projects that chiropractor employment will increase by 17 percent in the period from 2014 to 2024—more than double the projected growth average (7 percent) for all U.S. jobs.
4th March 2017
Could back pain could be an early warning sign of premature death?
For years we have been told that back pain is insignificant and self-limiting. Usually this opinion did not come from chiropractors who have long recognised that back pain is often recurrent, debilitating and associated with poor quality of life, especially if it becomes chronic or persistent.
So the message now is; "ignore your bad back at your own risk!" Back pain is a common problem and it can have grave consequences. New research suggests that sufferers are actually 13 percent more likely to die early from any cause, and this follows findings that painkillers are ineffective in treating it. The researchers from the University of Sydney assessed the link between death rates and spinal pain in 4,390 twins over the age of 70 and found there is a clear link between back pain and mortality although we don’t know yet why this is so. Back pain is ranked as the highest contributor to disability in the world and may affect four in five people at some point in their lifetime. Studies have shown paracetamol or ibuprofen is ineffective against back pain, and more powerful opioid painkillers are both ineffective and highly dangerous.
18th Feb 2017
Things that work for back pain… and those that don’t
The mainstream medical media recently included spinal manipulation on a list of things that work for back pain. Chiropractors have always maintained that our non-pharmacological, non-surgical approach makes logical sense and should be tried in conjunction with active care such as lifestyle modification to include physical activity as a first option for both acute and chronic spinal pain.
What works:
Exercise; Tai chi; Yoga; Mindfulness-based stress reduction and other psychological therapies, Spinal manipulation and massage, Acupuncture.
What doesn’t work: Passive physical therapies (interferential therapy, short-wave diathermy, traction, ultrasound, lumbar supports, taping, electrical muscle stimulations), Opioids, Paracetamol, Benzodiazepines, Systemic corticosteroids, Tricyclic and SSRI antidepressants, (Insufficient evidence for gabapentin/pregabalin).
4th Feb 2017
NSAIDS no better than a sugar pill for back pain
A new study published in the highly respected journal Annals of the Rheumatic Diseases, has concluded "Compared with placebo, non-steroidal anti-inflammatory drugs (NSAIDs) do not provide a clinically important effect on spinal pain".
Researchers found six patients had to be treated with anti-inflammatory drugs for one patient to achieve a clinically important benefit in the short-term and the drugs come with side effects. Their safety analysis revealed NSAIDs increased the risk of gastrointestinal side effects by 2.5 times, compared to placebo.
This study follows on ‘the back’ of previous findings by the same expert team in the George Institute in Sydney which found that Paracetamol is also no better than placebo for back pain. These studies are really interesting because they appear to bring into question the current clinical practice guidelines that suggest these over the counter (OTC) medications as first line treatments for back pain.
So where does that leave people who have back pain and want relief? Well the best advice appears to be; 1) stay active 2) avoid bed rest 3) remember that avoiding the pain may not help, in other words even if it hurts to move it’s probably not causing harm, and 4) consider getting spinal manual care.
While the guidelines do already recommend that spinal manipulation be considered for pain relief and functional restoration if pain persists, it looks as though the guidelines should now be reconsidered in light of this new evidence to suggest spinal manipulation as the first option.
Other reference: Williams CM, Maher CG, Latimer J, et al. Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial. Lancet. 2014.
WA Health Department Spinal Pain Model of Care
Media
31st Jan 2017
Relieving spinal pain might also help mental and emotional well-being
I recently published a paper with some colleagues that reported the results of a controlled study looking at responses to chiropractic care among residents of a therapeutic community who had spinal pain. The results were interesting because we found that people who obtained relief from their spinal pain did better in the mental and emotional domains as well.
There is a lot of discussion around at the moment about the effects of chronic pain on a persons' overall sense of well-being. While it is something that chiropractors often notice anecdotally, ie; when people get relief from back pain, they often feel better mentally and emotionally as well, it was interesting for us to measure the extent of these effects in this group of people.
This study was also important in the context of realizing why people end up in a Therapeutic Community at all. Most people go there as a result of alcohol problems and illegal drugs, but a significant proportion are there as a result of getting hooked on prescription drugs sometimes prescribed initially for relief of spinal pain. While they are in the community they are obviously not allowed to use the strong types of drugs like opiates that got them there in the first place, so being able to get drug-free pain relief from chiropractic care is something these people really value.
If you want a full copy of the paper for your own use please contact me.