Surgery for Back Pain?

Think Again If you or someone you know is suffering from back pain, don't rush off to get surgery. There is considerable evidence supporting the value of conservative, nonsurgical treatments for back pain; further, a study in The New England Journal of Medicine asserts that surgery is overused for the treatment of back pain.

The study in question, which served to defined guidelines for low back pain (LBP) treatment, states that intervention is only recommended for back pain that persists beyond three weeks. Among the treatments recommended to minimize the recurrence of chronic LBP were intensive strengthening exercise and aerobic conditioning. Also, the study states that radiography and more advanced imaging procedures (i.e., MRI) are overused and should be considered only in cases of severe nerve pain, loss of function, or suspicion of underlying systemic disease. And here's the most important point: Surgery should only be considered after all conservative methods have failed.

Among these alternatives to medical intervention, the report finds chiropractic care to be effective and massage therapy to show promise. The study does not recommend bedrest for chronic LBP or pain from nerve involvement. The main recommendation, based upon this study's new guidelines, is a rapid return to normal activities, which includes a regular regiment of exercise to keep the back and leg muscles conditioned. For more information, consult your doctor and access online information at http://www.chiroweb.com/tyh/backpain.html.

Reference: Deyo R, Weinstein J, et al. Low back pain. The New England Journal of Medicine 2001:344(5), pp363-369.

DASH Toward Good Health

High blood pressure (hypertension) is dangerous because it causes the heart to work harder. When the heart works too hard, the strain can contribute to life-threatening conditions such as a heart attack or stroke. High blood pressure also damages arteries, leading to arterial disease.

It's well-established that sodium reduction is useful for people with hypertension, and for those trying to avoid it. But how much of a reduction is enough? A recent study published in The New England Journal of Medicine reports that salt reduction might have a greater effect on your blood pressure than you might think. In the study, 412 subjects were randomly assigned to consume a diet typical of the normal American diet, or the DASH (Dietary Approaches to Stop Hypertension) diet. The DASH diet is rich in fruits, vegetables and low-fat dairy. Within each group, subjects ate foods with high, intermediate and low levels of salt for 30 days.

The researchers discovered that reducing sodium intake from the highest to the intermediate level reduced average systolic blood pressure in the control group and the DASH group. The greatest reduction occurred in subjects who consumed the low-salt DASH diet.

Do you have too much salt in your diet? Chances are, the answer is yes. Talk to your doctor about the fundamentals of a low-sodium, low-fat diet rich in vitamins and minerals. Information on high blood pressure can also be found on the American Heart Association's website: http://www.americanheart.org.

Reference: Sacks F, Svetkey L, Vollmer W, et al. Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet. The New England Journal of Medicine January 2001:344, pp3-9.

For Otitis Media, Try Patience Before Drugs

Otitis media is an inflammation of the inner ear characterized by fluid buildup. The condition is one of the most common acute respiratory conditions managed in primary care, most frequently affecting children. In fact, otitis media ranks second to the common cold as the most common health problem in children.

espite its prevalence, treatment options for otitis media remain controversial. Most children are prescribed antibiotics, although considerable evidence suggests that the results are minimal at best. While antibiotics may have important benefits, there is little evidence suggesting that these prescriptions create positive differences in alleviating pain and distress associated with otitis media.

A study in the British Medical Journal investigated the utility of a 72-hour "wait-and-see" approach vs. antibiotics in managing otitis media in 315 children six months to 10 years of age. Children were randomly assigned to one of two protocols: antibiotics prescribed immediately, and prescriptions withheld for 72 hours. Results showed only minimal differences between the two groups, with no significant difference in school absence, pain or distress.

It's important to note that waiting for 72 hours while monitoring symptoms is safe, but a blanket approach of nonintervention may have dangers. However, these findings add to the considerable evidence espousing the value of conservative care in achieving positive health benefits. For more information on pediatric health, talk to your doctor and visit http://www.chiroweb.com/tyh/childhood.html.

Reference: Little P, Gould C, Williamson I, et al. Pragmatic randomized controlled trial of two prescribing strategies for childhood acute otitis media. British Medical Journal February 2001:322, pp336-342.

Fiber-licious

Although fiber is not considered an essential nutrient, numerous nutritional experts and organizations recommend consuming 25-30 grams of dietary fiber daily as part of a sensible diet. Despite such recommendations, and previous research suggesting the role of fiber in reducing the risk of several types of cancer, the average American consumes only about 10-15 grams per day.

If you haven't yet adopted a diet containing adequate amounts of fiber, perhaps these latest study results will do the trick. A recent study in the International Journal of Cancer compared 902 patients with cancer (271 with oral cancer, 327 with pharyngeal cancer, and 304 with esophageal cancer) with 1,950 control subjects. Results showed that individuals who consumed the most fruit, vegetables and whole-grain cereals (all high in dietary fiber) had a lower risk for cancers of the mouth and throat, compared with these on low-fiber diets. Soluble fiber, found in fruit, vegetables, and whole grain cereals, and insoluble fiber, found in seeds and the skin of fruit, were both protective. The results were also equal for both sexes.

The authors mention that high fiber intake may be a marker for a healthier lifestyle that includes lower intake of meat and other foods high in saturated fat and cholesterol, and higher intake of low-fat foods such as fruit and vegetables. Ask your doctor to help outline a comprehensive nutritional program suitable to your needs.

For more information on nutrition, go to http://www.chiroweb.com/tyh/nutrients.html.

Reference: Soler M, Bosetti C, Franceschi S, et al. Fiber intake and the risk of oral, pharyngeal and esophageal cancer. International Journal of Cancer January 2001:91, pp283-287.

Acupuncture for Migraines

According to the National Headache Foundation, as many as 28 million Americans suffer from migraine headaches each year. Migraines can be caused by a variety of physical and environmental factors, including diet, stress, allergens, menstruation, and changes in the weather.

In one of the largest studies of its kind to date, a team of investigators in Italy examined the effectiveness of acupuncture versus a variety of pharmacological therapies in treating migraines. Their results, published in a recent issue of the Journal of Traditional Chinese Medicine, revealed that patients given acupuncture experienced fewer migraine episodes, missed fewer days from work, and suffered no side effects compared to patients on conventional drug therapy. They also found acupuncture to be more cost-efficient, estimating a savings of hundreds of millions of dollars in private and social health expenditures if it were used to treat headaches alone instead of drugs.

"Up to now, there has been neither precise data about these savings to the public, nor about the lack of risks for the patients treated with acupuncture for common diseases with a social cost," the investigators noted in their conclusion. "Today, thanks to this study, we have precise data which prove the exceptional usefulness of acupuncture."

Reference: Liguori A, Petti F, Bangrazi A, Camaioni D, Guccione G, Pitari GM, Bianchi A, Nicoletti WE. Comparison of pharmacological treatment versus acupuncture treatment for migraine without aura - analysis of sociomedical parameters. Journal of Traditional Chinese Medicine 2000; Vol. 20, No. 3, pp231-40.

For more information on acupuncture and Oriental medicine, visit http://www.acupuncturetoday.com

A Conservative Approach to Treating Ankle Sprains

Ankle sprains, perhaps the most common injury in amateur and professional athletes, account for up to 10% of sports-related injuries. A recent study, published in the Journal of Manipulative and Physiological Therapeutics, was conducted to determine the value of chiropractic care in the treatment of ankle injuries.

Thirty individuals participated in the study, with 15 participants receiving five minutes of chiropractic manipulation (a specific adjustment) two times a week, and the remaining 15 patients receiving a placebo in the form of a sham ultrasound treatment. Patients were evaluated at the first treatment, at the final treatment, and at a one-month follow-up exam. Each participant received a maximum of eight treatment sessions spread over four weeks.

Results: Although both groups showed improvement, notable differences were observed in favor of the adjustment group with respect to reduction in pain, increased ankle range of motion, and ankle function. For more information concerning sport-related health issues, talk to your doctor, or visit http://www.chiroweb.com/tyh/sports.html.

Reference: Pellow J, Brantingham J. The efficacy of adjusting the ankle in the treatment of subacute and chronic grade I and grade II ankle inversion sprains. Journal of Manipulative and Physiological Therapeutics 2001:24(1), pp. 17-24.

Fighting Osteoarthritis with Glucosamine and Chondroitin

It has been suggested that the combination of glucosamine and chondroitin sulfate may aid in the management of joint pain, particularly knee pain. Among patients with knee osteoarthritis (OA), long-term use of glucosamine/chondroitin sulfate appears to prevent changes in joint structure and significantly improve arthritis symptoms.

In a recent study involving 93 patients with knee osteoarthritis, a treatment group received preparations of a glucosamine/chondroitin sulfate compound twice a day orally. A control group was given a placebo for comparison, and the two groups were evaluated at baseline and every two months for six months. In addition to physical examinations and functional status questionnaires, x-rays of each patient's knees were taken and evaluated.

A significant improvement was noted in patients with mild or moderate OA in the treatment group, although patients with severe OA did not show significant improvements. The authors note that this study is the first of its kind in the United States, and that their findings suggest that preparations containing glucosamine, chondroitin sulfate and manganese may be effective for the treatment of mild to moderate OA of the knee.

If you suffer from osteoarthritis, talk to your doctor about the most effective ways to manage your condition. For further information on nutritional supplements and nutrition, visit http://www.chiroweb.com/tyh/nutrients.html.

Reference: Das A, Hammad T. Efficacy of a combination of FCHG49 glucosamine hydrochloride, TRH122 low molecular weight sodium chondroitin sulfate and manganese ascorbate in the management of knee osteoarthritis. Osteoarthritis and Cartilage, September 2000:8, pp343-350.

Preventing Hip Fractures with Plant Foods

Remember the classic Popeye cartoons? Did you notice that Popeye never seemed to age? Sure, he was only a cartoon character, but there's more to the story. Chances are, if Popeye had been a living, breathing human being, he would have faced injury and aging better than many of us do.

What could account for this youthful vitality? Perhaps it's the fact that Popeye ate his spinach. Dark green leafy vegetables, like spinach and broccoli, are rich in vitamin K, which may help reduce hip fractures as we age. In a recent study in the American Journal of Clinical nutrition, individuals with the highest daily vitamin K intake had a significantly lower risk of hip fracture compared with those with the lowest intake. Bone mineral density (BMD) was not influenced by vitamin K intake, suggesting an independent protective effect on bone strength from vitamin K.

We're subject to a variety of physical changes as we get older, and to a point there's not much we can do about it. However, considerable evidence (including this study) points to the value of proper nutrition and exercise in delaying or minimizing the consequences of aging. Talk to your doctor about the essentials of good health. You can also access additional information on line at http://www.chiroweb.com/tyh/nutrients.html

Reference: Booth S, Tucker K, Chen H, et al. Dietary vitamin K intakes are associated with hip fracture but not with bone mineral density in elderly men and women. The American Journal of Clinical nutrition 2000: Vol. 71, pp1201-1208.

Too Much Static for Students

Unless you're superhuman, you've probably experienced more than a few neck pains and headaches. The source of these conditions remains unclear, although evidence suggests a potential connection between the two. Evidence also hints at the maintenance of static postures, such as with prolonged reading, writing, or computer work, and stress as contributing factors for neck and headache pain.

Students subject themselves to hours of prolonged reading, writing and computer work, which may make them a high-risk group for neck pain and headaches. To test this hypothesis, a recent study published in the Journal of the Neuromusculoskeletal System evaluated the effect of neck pain and headache pain on the academic performance of 118 college students. A survey gathered data on head and neck pain, which were then correlated with student grade-point averages (GPA), an indicator of academic performance.

Results showed that a high incidence of neck pain (51.3%) and headaches (73.7%) within the student population; many students also reported problems with concentration as a result of such conditions. Moreover, academic performance diminished in 17.9% of patients suffering from neck pain and 39% of students with headaches.

If these conditions affect student performance, it's a distinct possibility that the general population is likewise affected - work that requires extensive concentration or focus. To find out more about what you can do to ease the pain and frustration of headaches and neck pain, go to http://www.chiroweb.com/tyh/headaches.html and http://www.chiroweb.com/tyh/neckpain.html.

Reference: Rose KA. The effect of neck pain and headaches on the academic performance of college students. Journal of the Neuromusculoskeletal System 2000:8(4), pp118-122.

Treating Post-traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) can occur after exposure to any frightening or threatening event involving potential or actual physical harm.It's been estimated that nearly one million Vietnam veterans developed PTSD. Tens of thousands of veterans with PTSD receive treatment from the VA in the form of medication and/or talk therapy, but with limited results. Many others continue to live without treatment for their condition.

A program sponsored by the renowned Upledger Foundation in Palm Beach Gardens, Florida, may provide a glimpse into the effective treatment of PTSD. The "Vietnam Veteran Intensive Treatment Program," as it was called, initially involved 24 veterans recruited for 10-day intensive programs; 22 patients completed the program.

CranioSacral Therapy involved using a soft touch generally no greater than five gramsRabout the weight of a nickelRto test and release restrictions in the craniosacral system (the membranes and cerebrospinal fluid that surround and protect the brain and spinal cord) to improve the functioning of the central nervous system. SomatoEmotional Release, an expansion on the principles of CranioSacral Therapy, involved the integration of manual techniques with verbal processing skills and other creative methods.

Overall, statistically significant improvements were noted in all of the variables, suggesting that results were a direct consequence of the treatments delivered. One of the most impressive findings demonstrated a shift in subjects' attitudes from hopelessness to optimism.

For additional information on the benefits of massage therapy, visit http://www.massagetoday.com.