Healthy Life Newsletter July 2017

 


Chronic Pain Damages Your Brain
 
Chronic pain is front and center these days now that the opioid crisis – the wrong way to manage pain – has been exposed and opportunities to prevent and treat pain instead of medication (a key example: chiropractic) jump into the spotlight.
 
The reason for this increased emphasis isn't just because opioids have been proven often unnecessary and frequently dangerous, if not deadly, for treating pain – it's also because pain, particularly chronic pain, can be just as dangerous / deadly if not addressed. In fact, recent research suggests chronic pain may be so damaging as to cause brain changes that lead to cognitive decline and dementia.
 
In a study involving more than 10,000 elderly adults, researchers reviewed more than a decade of surveys that tracked pain levels and cognitive abilities. While cognitive function (memory, attention, etc.) tends to decline with age, those declines occurred significantly more rapidly in people who reported ongoing moderate to severe pain compared to people with little to no pain. What's more, the risk of suffering dementia (Alzheimer's is the most common cause) was also slightly higher in people with chronic pain.

This is a great example of how pain can impact areas of your body and life that aren't directly tied in to the source of the pain. And that's where chiropractic care can be so important, because chiropractors look for the cause of the pain and then work to resolve it, rather than just treating the symptom with a dangerous opioid or other medication. If you're suffering from chronic pain, talk to your chiropractor; your body and mind will thank you for it.

 

----------------------

 
Self-Care for Back Pain: Exercises to Help the Healing Process

By Marc Heller, DC
 
When it comes to back pain, your first thoughts may be to take over-the-counter pain medication and rest whenever possible. Two bad options. First, medication is only going to temporarily relieve the pain, if at all, and may be accompanied by various unpleasant side effects attributable to drugs. Second, rest may actually hurt more than help. While you're seeing your chiropractor, there are a few things you can do at home to help the healing process. Believe it or not, it's based on the simple principle of movement.
 
Whenever I see a patient with back pain, I always ask, "What do you do when you are in pain? What exercises help your pain?" I am continually surprised that very few patients know what self-care to do when they have an acute episode of pain. That includes motivated patients and patients I have seen before and carefully shown the right exercises. Maybe it is because when you hurt, you stop thinking clearly; or maybe it is fear that the pain will get worse. Both are valid excuses. Most of them just rest, ice the area, and use non-steroidal anti-inflammatory drugs (without realizing that NSAIDs actually block healing). Many of them say, "I hurt too much to exercise."

Why Movement Matters
 
The problem with this is that when you stop moving, when you are still, everything tightens up, circulation slows down, and pain chemicals accumulate in your muscles and joints. It's like waking up after sleeping in a cold room on a lousy mattress with a draft. If you get moving, you'll typically start to feel better.
 
So, here's the number-one rule to remember: Don't stop moving when you hurt. I know, you are in pain and afraid to move, and sudden movements may cause your back to "grab" or spasm. I am not telling you to ignore the pain. What I am saying is that you need to find movements that will ease your pain. In many cases, the most important thing to do when you hurt is to keep moving. The body often tightens up and limits your motion. If you find a motion that doesn't hurt you, it will probably help you. When you are hurting, you may not be able to do your usual activities, but you must keep moving. Try walking slowly, especially on flat and even ground. Try walking up a hill (you can walk up a hill without walking down, on a treadmill). Try swimming or simple motions in chest-deep water. Try basic pelvic tilts, staying within a pain-free range.
 
Here are some basic principles. The movement should be pain free (or at least cause minimal pain while being performed). When you have finished doing the exercise, your pain should be somewhat diminished. You should feel that you can move more freely. Your back should feel straighter and less "kinked."
 
Backward bending is a great exercise when you're suffering from low back pain. Start on the floor or other stable surface (top picture), then slowly raise your upper body up while keeping your lower body stationary (bottom picture). The final step involves extending your arms up (much like a push-up). Basic Exercises for Low Back Pain
 
Here are two basic examples of self-care exercises that have stood the test of time. Many of my patients have found variations on these and other types of movements that act as "reset" buttons for their typical pain. You are the one living in your body; you are the most likely one to know what is working for you.
 
Lower back diagnosis is often very difficult and confusing. For the sake of this article, let's divide low back pain exercises into two categories: exercises that make your back feel better when you bend backward, and exercises that make your back feel better when you bring your leg toward your chest.
 
Backward Bending (extension of the lumbar spine). An exercise called the McKenzie extension is the first thing you should try if you have sciatica (pain running down your leg). If these exercises work, your pain will diminish and may centralize, which is a good thing. Centralize means your pain goes less far down your leg, and you may feel it closer to the spine. Bending backward may not feel good at first, but you should feel better immediately afterward. If you feel worse afterward or the pain goes farther down your leg, stop, as this is not the exercise for you.
 
How to Do It: Lie face-down on the floor, arms bent at your sides (sort of like a starting push-up posture). Straighten your arms up slowly, lifting your upper body off the floor as you do so.
 
Your legs and feet should stay on the ground. Hold for 3-5 seconds, then slowly lower your upper body back down. Repeat 10 times, as often as once per hour.
If your pain or restriction is on one side, a variation on McKenzie extension (lying on a raised surface with one leg on the floor, slightly bent) may be more comfortable (keep the elevated leg straight).
 
Flexion Exercises (bringing the leg toward the chest). People with lower back pain can also feel better with various types of leg flexion, bringing the bent leg toward the chest, or doing contract-relax and then bringing the bent leg toward the chest. These people usually have sacroiliac joint problems. (The SI joints are located on either side of the spine in the lower back.) These are also called Tigny exercises.
 
How to Do It: Lie on your back with one leg bent and then other flat on the floor. Bring the bent leg up toward the chest. Wrap your arms around the leg and then try to lower it toward the floor for 3-5 seconds, resisting with your arms. Relax, and then pull the bent leg up farther toward the chest. Repeat the entire process three times.
 
For pictures of exercises and more info go to http://www.toyourhealth.com/mpacms/tyh/article.php?id=1298&pagenumber=2

 

--------------------

Ginger Root for Migraines
by Michael Greger M.D.
 
Many successful herbal treatments start like this: Some doctor learns that some plant has been used in some ancient medical tradition, like ginger for headaches. Well, the physician has patients with headaches and so tries advising one with migraines to give it a try since it’s just some safe, common spice. At the first sign of a migraine coming on, the patient mixed a quarter teaspoon of powdered ginger in some water, drank it down, and poof! Within a half-hour, the migraine went away. It worked every time for them with no side effects. That’s what’s called a case report.
 
Case reports have played an important role in the history of medicine, though. AIDS was first discovered as a series of case reports. Some young guy walks into a clinic in Los Angeles with a bad case of thrush, and the rest is history. Reports of an unusual side effect of a failed chest pain drug led to the billion-dollar blockbuster, Viagra. Case reports may represent the weakest level of evidence, but they are often the first line of evidence, where everything starts. The ginger and migraine report isn’t helpful in itself, but it can inspire researchers to put the treatment to the test.
 
The problem is, who’s going to fund it? The market for migraine drugs is worth billions of dollars. A quarter teaspoon of powdered ginger costs about a penny. Who would fund a study pitting ginger versus the leading migraine drug?
 
No one… that is, until now. A double-blinded, randomized, controlled, clinical trial compared the efficacy of ginger to sumatriptan, also known as Imitrex, one of the top-selling billion-dollar drugs in the world in the treatment of migraine headaches. Researchers tried using only one-eighth of a teaspoon of powdered ginger versus a good dose of the drug.
 
They both worked just as well and just as fast.

Most patients started out in moderate or severe pain but, after taking the ginger or the drug, ended up in mild pain or completely pain-free. The same proportion of migraine sufferers reported satisfaction with the results either way. As far as I’m concerned, ginger won—not only because it’s a few billion dollars cheaper than the drug, but because there were significantly fewer side effects in the ginger group. People taking sumatriptan reported dizziness, a sedative effect, vertigo, and heartburn. The only thing reported for ginger was an upset tummy in about 1 out of 25 people. (As a note of caution, taking a whole tablespoon of ginger powder at one time on an empty stomach could irritate anyone’s stomach.)
 
An eighth of a teaspoon of ginger is not only up to 3000-times cheaper than the drug, but you’re also less likely to end up as a case report yourself of someone who had a heart attack or died after taking the drug—tragedies that have occurred due to sumatriptan.
 

-------------------------
 
 
The Cost of Medical Research; It’s Not What You Think
by Dr. James Bogash
 
The drug companies use the cost of drug development as a rationale for charging massive amounts for new drugs when they get brought to market under a patent.
 
The reality is that many of these drugs are priced far above what it cost to bring it to market and definitely beyond what it costs to produce.  In other words, it has nothing to do with what the drug company’s costs were or are; it instead has to do with how much the market will bear the costs.  This leads to massive profits.
 
But this is NOT where the true cost of these drugs lie for society.
 
The true cost lies with the fact that many of these drugs are a complete waste of money.  (This of course does not begin to account for the damage done from drugs that are later taken off the market or given black box warnings for safety reasons discovered after the drug was launched)
 
Sound a little extremist?
 
Before you judge me, you need to understand the concept of SURROGATE END MARKERS, which I have discussed many times before.  A surrogate end marker is used in drug research studies to basically save money and time.
 
The ultimate classic example is cholesterol lowering drugs.  Lipotor was initially approved and based on its ability to lower cholesterol levels.  What I usually point out is that no one really gives a hoot about his or her cholesterol levels, it’s just that no one wants to have a heart attack or stroke.  Using cholesterol as the surrogate end marker for heart attacks, the Pfizer did not need to run years-longer, more expensive studies to see if Lipitor actually lowered rates of heart attacks.
 
And that’s what happened.  It took YEARS before the studies on statins were done and published to see if cholesterol lowering drugs actually lowered rates of heart attacks.  When the dust finally settled on the topic, the results were less-than-stunning.  About a 1% absolute reduction in the rates of heart attacks.
 
The amount of money wasted (and continuing to be wasted) on this class of drugs is beyond most of our comprehension.
 
If this was an isolated example everything would be maybe OK, but it’s not.

Blood pressure medications for stage 1 hypertension (systolic <160 or diastolic <100) do not lower the risk of heart attack, stroke or death.  What the heck are we wasted BILLIONS of dollars on them then???  (I’d love an answer, but I fear the question is largely rhetorical)
 
Fancy new cancer drugs that improve “disease free survival” do not actually help cancer patients live longer but cost tens of thousands of dollars more per patient.
 
But we can’t leave diabetes medications out of the mix.  About a decade ago, there began a massive shift in research dollars towards a gut hormone called GLP-1 that happened after researchers found that a compound in Gila monster spit could act the same in our bodies.
 
Since that time, published research on this hormone and the class of drugs that could slow down our body’s own breakdown of GLP-1 (normally only last about 1-2 minutes in our own body) has dominated the diabetes medical journal landscape.  These two types of drugs (GLP-1 like drugs and drugs that slow down our body’s breakdown of this same hormone) hit the diabetes drug market at a full-on sprint with names like Byetta, Vicotoza, Januvia and Onglyza.

And they weren’t cheap (lots of variables, but on average $300+ / month)
 
But no one could argue that they did a better job of control blood sugar (if you can ignore those pesky side effects like acute pancreatitis and pancreatic cancer).  But one COULD argue that the lesson from the past about using surrogate end markers almost always ends up to be a bad plan.
 
You see, most diabetics die of heart-related complications.  This means that any drug used to treat diabetes really has to have an impact on heart disease if it’s going to be worth squat.
 
I’m betting you can see where I’m going with this….
 
In  this particular study researchers evaluated any published studies done on the benefit of DPP-4 inhibitors (the drugs that block the enzyme that breaks down GLP-2 so quickly) and major adverse cardiovascular events (MACE).  Here’s what they found when they looked over 69 different trials with almost 68,000 patients:
 
Luckily, when compared to another class of diabetes drugs called sulfonylureas, DPP-4 inhibitors were associated with a 42% lower risk of MACE.
 
But when the DPP-4 inhibitors were compared to the newest class of drug for diabetes (SGLT2 inhibitors, which allow sugar to be lost through the kidneys) they were linked to a 89% higher risk of MACE.
 
When compared to placebo the expensive, heavily used, new class of drugs that mess with the GLP-1 pathway, there was no benefit on major cardiovascular events.
To sum this up, an entire new class of drugs designed to help diabetics manage blood sugar are pretty much worthless at preventing the major complication in diabetics.
 
With this in mind, it doesn’t matter squat what it cost to develop or what it costs to manufacture because the drug doesn’t really help diabetics in the long run.  This means that cost to society is equal to pretty much every dime spent by the healthcare system on this class of drugs PLUS the medical costs associated with the sometimes dangerous and fatal side effects from the drugs.
 
Good thing more people have access to drugs through the Affordable Care Act.
 

-------------------------

 
A War You Can Win: 9 Ways to Make Better Food Choices

By David Seaman, DC, MS, DABCN

The average American consumes approximately 60 percent of calories from sugar, flour and refined oils.1 A donut is a good example of a so-called "food" that represents these calorie sources.
 
We also consume a considerable number of calories from French fries and ketchup, each of which began as vegetation, but after refinement represents more sugar, flour and refined oil calories. Generally, Americans consume very little in the way of vegetables and fruit. The result is big business for the refined-food manufacturers and ultimately, Big Pharma. But what about us? Here's how you can fight back.
Unhealthy Food Is Big Business
 
The cost of producing foods made with sugar, flour and refined oil is modest when it comes to the price of these commodities. In other words, there is still an acceptable profit margin for "foods" made with these calorie sources. And companies that use these calorie sources are still doing very well financially. To confirm this, all one needs to do is look at the stock prices of companies that use huge amounts of these calories sources. For example, the stock price for Coca-Cola was $11 in 1995, $21 in 2009 and $39 in June 2015. For McDonald's, the stock price during those years were $15, $55 and $95.
 
Clearly, if one is involved in the selling of refined calories, there is a financial benefit. Refined calories are a good business. If you would have put all your money in Coca-Cola or McDonald's in 2009, you might be able to retire right now because you would have doubled your money. Imagine that – your retirement would be based on sugar, flour and refined oil.
 
What about the people who eat calories from sugar, flour and refined oils? I've labeled these folks "dietary crackheads" because these calories are addictive.2 To be fair, even if you eat few calories from dietary crack, you can still be a dietary crackhead. This is because almost everyone loves the taste of dietary crack, and most of us would like to eat a lot of it, which means we are either practicing or non-practicing dietary crackheads. (I have been mostly a non-practicing dietary crackhead for many years.)
 
But what about those who consume 60 percent of their calories from dietary crack? What happens to them over time? The answer is obvious: most gain weight and eventually develop the metabolic syndrome. Unfortunately, 34 percent of individuals 20 years and older in America have the metabolic syndrome.3 Clearly, the consumers of dietary crack do not benefit unless they simultaneously own stock in companies that distribute "dietary crack."
 
The metabolic syndrome is an interesting condition because it is a pro-inflammatory metabolic state that can last for many years before an overt disease develops, which then requires a specific drug or surgical intervention. Here is example of conditions that develop after the metabolic syndrome state is achieved by eating dietary crack: acne, type 2 diabetes, cancer, cardiovascular disease, stroke, hypertension, polycystic ovarian syndrome, non-alcoholic fatty liver disease, gallstones, sleep apnea, myopia, male vertex balding, depression, low testosterone, and erectile dysfunction.4-5
 
Practically speaking, someone might take acne medication for several years before graduating to metformin for elevated blood glucose and a statin for elevated cholesterol. Eventually, by the time a man is 50 years of age, he may be taking medications for glucose, cholesterol, hypertension, depression and erectile dysfunction. And during this time, he has continued to eat 60 percent of his calories from dietary crack.
 
How does this man benefit beyond the temporary pleasure he gets from the taste of dietary crack? Clearly, there is no benefit for him – just suffering. And the suffering can continue if he develops vascular disease or cancer that requires surgical intervention.
 
Big Pharma Continues to Reap the Financial Rewards
 
In addition to the manufacturers of dietary crack, the pharmaceutical companies and the hospital system are also beneficiaries. While many drug companies had their peak stock price during the tech bubble days (2000), they are certainly not suffering. Their stock prices have a similar upward pattern as the refined food-producing companies. When you get a chance, check out the stock price patterns for Merck, Pfizer and AstraZeneca. Like the refined-calorie producers, drugs companies would have been a good investment over the past several decades.
 
How to Make Better Food Choices
 
Refined foods and drugs continue to be growing industries. They obviously have a good business model. Interestingly, people like to blame refined-food companies and drug companies for our bad health. In my opinion, this is completely incorrect and reflects a state of ignorance. If I eat dietary crack and take medications as a result, it is my fault. No one is forcing me to eat their refined calories or take their drugs and support industries that subsequently benefit. This is a voluntary choice made by the majority of Americans. Simply put, we need to make better choices.
 
The challenge, of course, is to avoid refined calories on a long-term basis. This can be complicated for many people, even if you're wellness-inclined. So, here is a list of things you can do:
  
  • Cultivate a proper eating mindset – this involves finding a reason to truly "care" about avoiding disease-promoting refined foods.
  • Understand that almost everyone will always like the taste of dietary crack. Do not feel guilty about wanting it or occasionally partaking. Just don't overdo it on a chronic basis.
  • Eat more vegetables during meals to create the sensation of fullness. In general, the feeling of gut fullness must be respected in spite of what food-eating thoughts one might have.
  • Keep dietary crack out of the house so there is no temptation at home.
  • Drink more water.
  • Build up to exercising at an aggressive-enough level that appetite suppression occurs.
  • Get adequate sleep, as less than six hours per night on a chronic basis can promote weight gain by various metabolic mechanisms.
  • Fight stress with exercise, not by eating excess / unhealthy food.
  • Mentally accept that steps #1-8 represent a process to utilize throughout life.
 
References
  
  • Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr, 2005;81(2):341-354.
  • Seaman DR. "Dietary 'Crackheads' and the Never-Ending Battle Against the Bulging Waistline." Dynamic Chiropractic, April 1, 2013.
  • Seaman DR, Palombo AD. An overview of the identification and management of the metabolic syndrome in chiropractic practice. J Chiropr Med, 2014;13(3):210-19.
  • Seaman DR. Body mass index and musculoskeletal pain: is there a connection? Chiropractic Man Ther, 2013;21:15.
  • Wang C, Jackson G, Jones TH, et al. Low testosterone associated with obesity and the metabolic syndrome contributes to sexual dysfunction and cardiovascular disease risk in men with type 2 diabetes. Diabetes Care, 2011;34:1669-75.
 
David Seaman, MS, DC, DACBN, is the author of Clinical Nutrition for Pain, Inflammation and Tissue Healing. He has a master's degree in nutrition from the University of Bridgeport, Conn., and lectures on nutrition for Anabolic Labs (www.anaboliclabs.com).