Very cool.  A new study from the Journal of Occupational and Environmental Studies did something I've been hoping they'd do.  They looked at 894 cases of low back pain that resulted in worker's compensation claims.  They compared the results in these cases based on whether the patients saw a medical doctor, a physical therapist, or a chiropractor.  The results were astonishing.  The people who saw the medical doctors were 60% more likely than the people who saw the chiropractors to have disability recurrence.  The people who were treated by the physical therapist were twice as likely to have a recurrence than the people who saw the chiropractors.  Please read that again!

Chiropractors receive more training in treating low back pain without surgery than anyone on earth.  This training, coupled with the incredible power of the chiropractic adjustment to help the body to heal itself provides patients with the best chance to obtain the best result in healing.  What blows my mind is that every person in the USA is not referred to a Chiropractor as a first contact when low back pain occurs.  I am not anti-MD or anti-physical therapist--I refer patient to both professions when its appropriate, but I do believe, and the facts support, that we'd have a healthier country if Chiropractic were the first treatment option for all musculoskeletal injuries.

Read the study.

New guidelines in the October edition of Annals of Internal Medicine make an excellent recommendation for treatment of low back pain:  "For patients who do not improve with selfcare options, clinicians should consider the addition of nonpharmacologic therapy with proven benefits—for acute low back pain, spinal manipulation; for chronic or subacute low back pain, intensive interdisciplinary rehabilitation, exercise therapy, acupuncture, massage therapy, spinal manipulation, yoga, cognitive-behavioral therapy, or progressive relaxation..."

Chiropractic patients can attest to the benefits of spinal manipulation, and scientific evidence has accumulated to the point where the medical profession cannot deny these benefits.  I truly hope that the medical profession will take the advice of the experts in their field who are now recommending chiropractic care for patients with low back pain...rather they will or not is another story!  Most of the patients who come to my clinic  after seeing a medical doctor report that chiropractic care was not even discussed and that they were prescribed narcotic medication and muscle relaxers.  These drugs are discouraged in all current medical guidelines...will treatment change with this new set of guides?

New research demonstrates the dramatic effects of chiropractic care for people with ankylosing spondylitis.  Ankylosing spondylitits, or AS, is a progressive inflammatory arthritis of the spine that eventually results in stiffness and fusion of spinal joints.  Researchers in this most recent study evaluated a 34 year-old male with a 10 year diagnosis of AS during an 18 week course of chiropractic treatment.  The results were profound, "There was a 90% improvement in the disease activity index and an 85% improvement in the functional index from the pre-treatment baseline..."

I have the privilege of seeing people's function returning with chiropractic care on a regular basis--people regaining the ability to walk, run, throw, and enjoy life pain free.  Read more about chiropractic here.

Read the study here. 

I am often asked by patients and doctors alike what research exists regarding chiropractic care, and how chiropractic works.  Below is a short overview of research on chiropractic and low back pain, as well as information on the mechanisms by which chiropractic works.  The second part is written in medical-ese, so the lay reader may want to skip it.  If your medical doctor is a "non-believer", tell him not to worry--belief is no longer required, we have research and mechanisms!   Have him give this article a read!...Read More...

Many studies have demonstrated how effective glucosamine and chondroitin sulfate (GS and CS) can be for arthritis (read more on treating arthritis).  A new paper shows that long-term use of GS and CS may actually repair degenerated discs in the spine.

Spinal discs lie between your vertebrae--they provide your spine with shock absorption and freedom of movement.  Discs degenerate primarily due to either trauma or faulty movement patterns (see your Chiropractor!)

This recent paper followed a 56 year-old man who had a disc hernia (this is where the "gooey" stuff inside the disc tears through the tough, fibrous outside of the disc).  The man supplemented with 2,000mg of glucosamine sulfate and 1600mg of chondroitin sulfate for 2 years.  Amazingly, the disc repaired itself significantly over the 2-year period--it actually gained back much of its height!  This is unusual--typically once a disc begins to degenerate the process continues.  

If you have disc problems I highly suggest 3 things:

1. See a chiropractor regularly--chiropractic manipulation can help with your pain, and more importantly, normalize movement in the joints around the disc.  The disc has very little blood supply and gets its nutrition through movement--as they are compressed old fluids are squeezed out, and as they expand new, nutrition laden fluids are drawn in.  This is necessary for a healthy disc!
2. Begin a stabilization program for your low back.  Instructions and videos of how to do this are available free here.
3. Supplement with Glucosamine and Chondroitin Sulfate!  I recommend using the same amounts outlined in the study above.
   

 Read the paper.

There was an excellent article in Forbes this month called "Dangerous Devices". The article primarily focuses on the folly of stents for heart disease. Newer medicated stents are actually causing heart attacks. Also mentioned in the article are some devices used to treat low back pain. "Now some doctors are flagging the potential dangers of new implantable gadgets to treat back pain, prevent stroke and soothe severe heartburn. Some doctors decry J&J's new metal disc, known as the Charite, which has been implanted in the spines of several thousand patients. It was approved by regulators after a trial involving only 304 patients--and only 36% of them fared well enough to get off narcotic painkillers."

This replacement disc surgery was approved recently, and I am bombarded with advertisements for it at my office--suprising since only 1/3 improve enough to get off narcotics! They also discussed spinal fusions: "Each year half a million people in the U.S. undergo spinal-fusion surgery, says research firm Frost & Sullivan. They get cages, screws and rods implanted in the spine, despite studies that show fusion is not very effective for lower back pain." Why are these devices successful despite a lack of evidence of efficacy? "Medtronic in July agreed to pay $40 million in fines to settle civil allegations that its spinal-devices unit paid kickbacks to doctors in the form of sham consulting agreements, shady royalty pacts and lavish trips; though the company paid up, it denies any wrongdoing." "UC, Irvine's Charles Rosen argues that scores of spine surgeons 'have basically become marketing men for these companies and earn huge consulting fees.'"

The article requires that you activate a free membership--it can be found here.

Chiropractic adjusments improve the ability to contract a stomach muscle called transversus abdominis, researchers say. The tranversus abdominus goes all the way around your trunk--from your low back all the way around to the front--much like a girdle. The significance of this muscle is that it gives a tremendous amount of support to the low back and pelvis. Weakness in this muscle group is a significant predictor of chronic low back pain. This study sheds more light as to why many people who have low back pain do not get better with an exercise program until they receive chiropractic care. By normalizing the function in the joints of the low back, chiropractic effectively "turns on" the muscles necessary for a healthy back! Link to the reference.

A new study evaluated the effectiveness of chiropractic care utilizing a flexion/distraction table versus physical therapy one year after treatment was completed. If you've been to my office you'll most likely have been on my flexion/distraction table--it’s the fancy table in room 2 that moves up and down. One year after treatment was completed, researchers found that "subjects who received chiropractic care (flexion distraction therapy) had significantly lower pain scores than subjects who received physical therapy (exercise program)." Chiropractic care improves functioning of the spine and the nervous system. Without proper function, no medication or exercise will provide lasting benefits. That is why time after time, chiropractic care provides superior results for spinal problems. If you know someone who has pain and has not tried chiropractic, do them a favor and refer them to a chiropractor! Link to J Altern Complement Med. 2006 Sep;12(7):659-68.

A very cool new study looked at the effect of meditation on brain reactivity to pain. Study subjects had MRI's of their brains performed while receiving "thermally induced pain" (they were burned!). The subjects were then taught to meditate and practiced meditation daily for 5 months. When the patients had their brains re-imaged while being subjected to the painful stimuli, their pain response decreased by 40-50%! This study showed that meditation has a profound effect on the effect of one's personal experience of physical pain. On my articles page there is an article caled Chronic Pain Shrinks Your Brain. That article reports on a study that showed how detrimental spinal pain can be on your brain--besides depression, anxiety, and fear, chronic pain can actually age your brain by decades! This study on meditation demonstrates a means by which I feel these negative changes can be halted and reversed. Link to the Study.

A new study in the journal Manual Medicine compared exercise only to exercise plus chiropractic adjustments for people suffering from low back pain. Astonishingly, patients doing exercise only were eight times more likely to get worse than patients receiving adjustments plus exercises! The reason for this is simple. Exercise with a dysfunctional back is like revving up your engine when there's a problem with your radiator--the added stress will bring out the problem, not solve it. Chiropractic restores the radiator!--then suitable exercises can do their job in strengthening the low back. Check out this awesome study here