Healthy Life Newsletter September 2017


Study shows shoe orthotics and chiropractic care can give long term relief from chronic low back pain
Can't seem to get rid of that low back pain? Your chiropractor can help in multiple ways. In fact, a new study suggests custom orthotics (shoe inserts) are an effective treatment option, alone or in combination with chiropractic care, for relieving pain and improving function in patients with chronic low back pain.
Researchers randomized 225 adult subjects with symptomatic LBP for three months or more into three groups for comparison.
Pain and disability were assessed at baseline and re-assessed after six weeks. The shoe orthotic group received custom-made orthotics; the "plus" group received custom orthotics plus chiropractic care (spinal manipulation, hot or cold packs and manual soft-tissue massage); and the "waitlist" group received no intervention until week six of the study, at which time they also received custom orthotics.
After six weeks, shoe orthotic and "plus" patients had experienced significant improvements in pain and function compared to patients receiving no intervention until week six (waitlist group). Comparing the orthotics-only and "plus" groups, the latter achieved greater improvements in function, but similar pain relief as the orthotics-only group.
Perhaps most notably, decreased pain and functional improvement remained significant for up to 12 months in all three groups (even the waitlist group, which received orthotics only at week six), suggesting orthotic intervention, alone or in combination with chiropractic care, can have a lasting impact on chronic LBP. As the authors stated:
"It is noteworthy that for most time points after week 6, the MCID [minimal clinically important difference] data remained relatively stable, with no large decreases in the proportion of subjects who had at least 30% improvement in pain or disability compared with baseline, potentially demonstrating a lasting effect of care with the orthotic treatment."

Talk to your chiropractor to learn more about how a comprehensive chiropractic care plan including spinal manipulation and custom orthotics can help relieve your low back pain and help minimize the chances it will return.
Source: Cambron JA, et al. Shoe orthotics for the treatment of chronic low back pain: randomized clinical trial. Arch Phys Med Rehab, 2017 (in press).
(Note from Dr. Mha Atma: We  do have the capacity in our office to cast and order custom made flexible orthotics through the Foot Levelers company.)




Antidepressants: A Real Downer for Alzheimer Patients?
Evidence suggests antidepressants, while potentially effective in reducing depression symptoms, can also have major side effects – including an increased risk of suicide / suicidal thoughts in younger patients.
Now that's not what an antidepressant's supposed to do, is it? Unfortunately, taking an antidepressant if you suffer from Alzheimer's (which usually affects people at age 65 or older) doesn't mean you're out of the woods, either.
Seniors are already at increased risk of falls due to balance / stability issues and general frailty associated with old age (and antidepressant use, by the way). Now, research implicates antidepressants as a potential risk factor for head injuries, particularly among people with Alzheimer's disease. The elevated risk for injury commonly occurred within the first 30 days of use and persisted for up to two years. Researchers are particularly concerned by these findings because Alzheimer's patients often use antidepressants and are already at risk of injury from falling.
Click here to learn more about the potential side effects of antidepressant use and here for information on the dangers of use by children / adolescents. Always talk to your doctor about the side effects of medication and possible nondrug alternatives prior to filling any prescription.
(Note from Dr. Mha Atma: For some folks anti-depressants can literally be a life-saver.  However it is good to keep in mind that non-drug approaches to mild to moderate depression have been shown to be as effective as medication with only positive side effects.  These include exercise, an anti-inflammatory diet, Vitamin D and fish oil supplements.  Combine all of these for the best chance of success!)


5 Common Causes of Neck Pain (and How Chiropractic Can Help)

Neck pain can be acute (short term) or chronic (recurring or persisting for months and even years), but regardless, when you're in pain, relief is the first thing on your mind. Just as important as relief, of course, is finding the cause and ensuring you avoid the behavior / action that brought the pain on in the first place.
Here are five common causes of neck pain – and why doctors of chiropractic are well-suited to relieve the pain and determine the underlying cause.
1. Poor Posture: Leaning over a desk all day or slouching in your office chair? You're bound to develop neck pain eventually, if you haven't already. Do this quick test: In an upright or seated position, round your shoulders and back (poor posture). Does it impact your neck as well? Exactly!
2. Monitor Madness: Staring at the computer screen for hours at a time? That's not good for your health (or sanity), but from a neck pain perspective, it's madness, particularly if the screen height forces you to crane your neck up (too high) or extend it down (too low).
3. Sleep Issues: Ideally, we spend a third of our day sleeping, so your sleep habits – for better or worse – can have a dramatic effect on your health. With regard to neck pain, anytime you sleep in an uncomfortable position, particularly one that stresses your neck musculature (think about side-sleeping while grabbing your pillow tightly, sleeping on your stomach with your arms out in front of you, or even sleeping on your back, but with a pillow that doesn't adequately support your neck), you risk neck pain.
4. Technology Overload: We may spend a third of our day sleeping, but we increasingly spend the other 16 hours typing, texting, tapping and otherwise interacting with our smartphones, tablets, etc. Bottom line: bad for your neck. One doctor has even coined the phrase, "text neck," to describe the neck pain that can result from this constant technology interaction.

5. The Wrong Movement: Twisting, turning, stretching and stressing your neck is an easy way to cause neck pain. While the muscles in the neck are strong, they can be strained, sprained and even torn, just like any other muscle.
It's important to note that beyond these common causes, various other health issues can also contribute to or directly cause neck pain, including fibromyalgia, cervical arthritis or spondylosis (essentially spinal arthritis), spinal stenosis (narrowing of the spinal canal), infection of the spine, and even cancer. The good news is that a doctor of chiropractic can help identify which of these or the above causes is to blame.
When neck pain strikes, most people turn to a temporary solution first: pain-relieving medication. But that's not a permanent solution, of course, and it doesn't address the cause of the pain at all, which could be something relatively minor – or more serious. What's more, research suggests chiropractic spinal manipulation is actually more effective than over-the-counter and prescription medication for relieving both acute and subacute neck pain.
Suffering from neck pain? Then give your doctor of chiropractic a call. They'll help you relieve your pain and determine the cause so it doesn't return.
(Note from Dr. Mha Atma: Along with chiropractic adjustments, the same non-drug approaches to depression can also really help neck pain!  Again, these include exercise, an anti-inflammatory diet, Vitamin D and fish oil supplements.  Combine all of these for the best chance of success!)

Knee Osteoarthritis: Steroid Injections Aren't the Answer

Knee osteoarthritis can be painful and limit your activities, but corticosteroid injections aren't the answer, according to new research published in the May 16, 2017 issue of the Journal of the American Medical Association.
In the study, quarterly steroid injections actually increased cartilage loss over a two-year period without providing any benefit. That's a loss-loss situation if you ask us.
Patients suffering from knee osteoarthritis with synovitis were divided into two groups, with one group receiving the corticosteroid injections every 12 weeks for two years and a second group receiving a placebo (saline injections) at the same frequency and over the same time frame. Patients in the steroid group lost an average of 0.21 mm in cartilage thickness over the two-year period compared with only 0.10 mm, on average, in patients not receiving corticosteroids.

What's more, patients receiving steroid injections scored only 1.2 points lower on a 0-20 pain scale (0 = no pain, 20 = extreme pain), while patients not receiving steroid treatment scored 1.9 points lower following the intervention period. In other words, patients who received no steroids reported less pain at three-month follow-ups than patients who received steroids!
Osteoarthritis is the most common form of arthritis in the world, which makes finding effective treatment options paramount. Unfortunately (and as we've said repeatedly with other scenarios), drugs - in this case, injections - may not be the answer. If you suffer from osteoarthritis, talk to your doctor about nondrug alternatives to manage your pain and reduce other symptoms.
(Note from Dr. Mha Atma:  Other studies have shown that arthroscopic knee surgery does not help knee pain.  But guess what? Again, the same non-drug approaches to depression and neck pain can also help knee arthritis pain!  Once more, these include exercise--especially riding a stationary or regular bicycle, an anti-inflammatory diet, Vitamin D and fish oil supplements, and also ginger plus turmeric supplements.  And again, combine all of these for the best chance of success!)


Acid Suppressants Linked to Fracture Risk
Proton-pump inhibitors sound like something right out of Star Wars, but they're actually common - far too common, considering their potential risks - here in the real world.
This class of drugs, which includes Nexium, Prilosec and Prevacid, among others, is prescribed to treat digestive tract issues such as gastroesophageal reflux, chronic dyspepsia (indigestion) and peptic ulcer disease. These conditions are all characterized by excessive production of stomach acid. The intended mechanism of action of proton-pump inhibitors, as you might expect, is to reduce acid by blocking the gastric proton pump; a decidedly unintended mechanism of action is increased fracture risk.
Following a recent Food and Drug Administration (FDA) review of studies, the administration posted a "class labeling change"  notice on its Web site alerting health care professionals and consumers that proton-pump inhibitors will now feature a label warning regarding "a possible increased risk of fractures at the hip, wrist and spine" attributable to their use. According to the FDA, people ages 50 or older who had been taking the medication for one year or more, often in high doses, were at the greatest risk.
If your doctor tells you proton-pump inhibitors are in your immediate future, ask about the potential side effects and if you can avoid taking medication altogether.
(Note from Dr. Mha Atma: A true anti-inflammatory diet, which eliminates all sources of refined sugar, refined grains--including anything made from flour, and oils made from soybean, corn, safflower, and sunflower, and includes lots of fresh vegetables, fruit, and nuts along with (optionally) moderate amounts of animal protein, can greatly reduce the gastric reflux symptoms that lead to prescription of proton-pump inhibitors.)