Healthy Life Newsletter May 2017


Consumer Reports article about the recent review in the Journal of the American Medical Association demonstrating that chiropractic care is a safe and effective treatment for back pain...
Spinal Manipulation Can Ease Your Aching Back
A new analysis finds that the hands-on technique works as well as pain drugs and is safer, too
When you wrench your back, your first impulse may be to rummage through the medicine cabinet for an over-the-counter pain drug or even ask your doctor to prescribe a strong opioid painkiller such as Percocet or Vicodin.
But an analysis published April 11 in the Journal of the American Medical Association finds that spinal manipulation can ease your backache and get you moving again without the risk of medication side effects.
A new Consumer Reports survey of more than 3,500 back-pain sufferers reached similar conclusions: Nearly 90 percent of people who tried spinal manipulation found it helpful.  
Spinal manipulation involves a healthcare provider applying controlled forces to the spine to improve alignment and allow the muscles and joints to move more easily. While it’s usually done by a chiropractor, some doctors of osteopathic medicine (D.O.) and physical therapists also use the technique.
For the JAMA analysis, researchers from the Department of Veterans Affairs and elsewhere combined results from 26 studies involving more than 3,000 patients with low-back pain lasting six weeks or less. Patients treated with spinal manipulation were able to move through daily activities with less pain than people who didn’t get the therapy.

NOTE from Dr. Mha Atma:  The studies reviewed in the JAMA article show a "modest" benefit for back pain from chiropractic care.  But these studies were limited to chiropractic low back adjustments only.  A comprehensive approach to back pain, like we use in our office, includes soft tissue work, back stabilizing exercises, and dietary changes with anti-inflammatory supplements.  When all of these are used to complement the chiropractic adjustment, results are often significantly better than "modest."  As the chiropractic doctor interviewed in the article says at the end, “Spinal manipulation is just one part of an overall treatment strategy to get you actively engaged in taking care of yourself to get past this episode and prevent future recurrences.”

Is Today’s Technology a Pain in Your Neck?
Mobile devices such as cell phones, iPads, laptops and electronic readers have made our lives easier in many ways…but the increased time we spend in front of these screens can adversely affect our health. This doesn’t mean you have to stop using these devices, but you should learn how to use them in a more mindful manner as a way to minimize health risks, such as back, neck and even elbow pain.

When using technology devices, remember to:
  • Sit upright with your ears over your shoulders.
  • Look down with your eyes, and if you wear glasses, make sure you also can scan the entire screen without moving your head.
  • Never pinch a handheld phone between your ear and shoulder. Use a headset or even headphones to reduce shoulder strain.
  • When sitting at a device, make sure your feet are firmly flat on the floor or footrest with your knees lower than your hips. Make sure you can use the device without reaching.
  • When texting, bring your arms up in front of your eyes so that you don’t need to look down to see the screen.
  • Minimize the time you bend your elbows to hold the phone or device up to your face.
  • Take breaks! Get up and move around.

If you find yourself in pain despite your best efforts, your doctor of chiropractic can treat injuries and provide additional advice on using technology safely.


Chiropractic for Chronic Pain: A Key Piece of the Puzzle
Chronic pain is a major issue these days, and finding solutions that don't cause even more pain and misery (read: opioid abuse / addiction) is an even bigger issue. So, it's refreshing when we get a glimpse of nondrug approaches that are working. And boy is this one working.
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Since 2012, Rhode Island Medicaid "Community of Care" enrollees suffering from chronic pain have participated in an integrated chronic pain program designed to "reduce pain levels, improve function and overall health outcomes, reduce emergency room costs, and through a holistic approach and behavioral change models, educate members in self-care and accountability."
The program features holistic nurse case management with referrals to complementary and alternative medicine (CAM) providers including chiropractors, massage therapists and acupuncturists; and patient education including stress-reduction tips and more.
Community of Care enrollees "have significant economic challenges as well as bio-psycho-social disorders." CoC enrollees, as might be expected, tend to make more visits to emergency rooms compared to other patients.

Here are some of the key findings from the pilot program thus far (2012-2015), showing average per-enrollee improvements post-referral into the integrated chronic pain program compared to pre-referral for enrollees with at least 12 months pre-referral data and 12 months post-referral data. Note that these improvements are also significant compared to the control group, consisting of CoC members who did not enroll in the chronic pain program.
  • Rx Scripts: Prescriptions declined from a whopping 70.42 pre-referral to 25.97 post-referral.
  • Opioid Scripts: Opioid prescription use declined from 7.69 pre-referral to 1.10 post-referral.
  • ER Visits: Emergency-room visits, a major issue for CoC enrollees, declined from 7.57 visits pre-referral to 2.98 visits post-referral.
  • Total Claims Costs: Average pre-referral claims costs approached $20,000 ($19,456.59) per enrollee pre-referral; post-referral, claims costs declined to $14,150.76, including CAM costs.
  • Patient Satisfaction: According to a third-party survey of program participants, 92 percent "agree or strongly agree their CAM provider reduced their pain level"; 82 percent "believe their quality of life has improved by participating"; and 96 percent "would recommend the program to friends or family suffering from chronic pain or fatigue."

Your doctor can tell you more about chronic pain, the opioid epidemic and how nondrug approaches such as chiropratic care are proving more effective and safer than medication.

Antibiotic Use and Childhood Obesity: A Clear Connection

While processed, empty-calorie foods and sedentary behavior usually take the blame for skyrocketing childhood obesity rates, a recent study suggests another culprit: antibiotics (AB).
According to the study,  antibiotic use within the first two years of birth was associated with a significantly higher risk of obesity at ages 2-5. The risk increased whether the child took any wide-spectrum (WS) antibiotic ("wide spectrum" or "broad spectrum" means the antibiotic acts against a wide range of bacteria), four or more antibiotics, or four or more antibiotics that included at least one AB of the wide-spectrum variety:
  • Any wide-spectrum AB: 11 percent increased obesity risk
  • Any AB (four or more): 11 percent increased obesity risk
  • Four or more AB (at least one WS): 17 percent increased obesity risk
By the way, the study also revealed that nearly seven in 10 infants (0-23 months of age) received at least one course of antibiotics before age 2, so don't think antibiotic use is an uncommon occurrence during this period of a child's development. Talk to your doctor about the association between infant antibiotic use and childhood obesity. It's part of a larger discussion you should always have with your medical provider before filling a prescription for any member of your family.


from the Science section of England's The Telegraph:

Ibuprofen for people with back pain has no significant effect - new study

By Henry Bodkin   2 FEBRUARY 2017

Common over-the-counter painkillers such as ibuprofen makes hardly any difference for people suffering from back pain, scientists have said.
A new study found that only one in six patients treated with non-steroidal anti-inflammatory drugs, known as NSAIDs, achieve any significant reduction in discomfort.
Back pain is a common complaint, affecting one in six people at any given time, although it usually improves within a few weeks.
Yet for some it persists and sufferers are advised by the NHS to stay as active as possible, try exercises and stretches, take anti-inflammatory painkillers and use hot or cold compression packs for short-term relief.
Professor Manuela Ferreira, who led the research at the University of Sydney, said the findings highlighted an urgent need to develop new therapies to treat back pain, which affects about four fifths of people during at some point during their lives.
"Back pain is the leading cause of disability worldwide and is commonly managed by prescribing medicines such as anti-inflammatories,” he said.
"But our results show anti-inflammatory drugs actually only provide very limited short term pain relief.
"They do reduce the level of pain, but only very slightly, and arguably not of any clinical significance.

"When you factor in the side effects which are very common, it becomes clear that these drugs are not the answer to providing pain relief to the many millions who suffer from this debilitating condition every year."
The study examined 35 trials involving more than 6,000 people, also found patients taking anti-inflammatories were 2.5 times more likely to suffer from gastro-intestinal problems such as stomach ulcers and bleeding.
Earlier research found paracetamol was ineffective and opioids provided minimal benefit compared to a placebo.
Most clinical guidelines currently recommend NSAIDs as the second line analgesics after paracetamol, with opioids coming at third choice.

Last July the American Heart Association warned that ibuprofen and other similar drugs can trigger heart failure, which occurs when the organ is unable to pump blood properly around the body.
The new study was published in the Annals of the Rheumatic Diseases.