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Chronic low back pain causes countless days of work lost and health insurance dollars spent, yet the causes of this long-term condition remain elusive. Why do some people recover quickly from back pain while others suffer for years? A recent study in the journal Spine adds to the growing body of information that helps us understand the causes of recurring back pain and injury.

Low back pain is known to cause sufferers to utilize their back muscles differently, or substitute the wrong muscles for lifting tasks. Added force could in turn hasten spinal disc degeneration. This study investigated the force during lifting on the spines of 22 back-pain patients and 22 healthy individuals in two phases: one measuring spinal forces while participants lifted in a specific posture, and the other allowing individuals to personalize their posture to lift comfortably. The researchers wanted to determine how back-pain patients might compensate for their pain.

The researchers found that patients tended to compensate for back pain and injury by substituting inappropriate back, side, and abdominal muscles for lifting, rather than the correct muscles that hurt. The resulting force on the spine was significantly increased in back-pain patients as uninjured muscles were used to compensate for injured muscles. By guarding the injured muscles, back-pain sufferers imposed twice as much twisting force and 1.5 times more compressive force on their spines as healthy people, when lifting the same object in a controlled fashion. Also, lifting more slowly, as those with back pain tended to do, only prolonged and intensified the force on the spine.

If you suffer from chronic low back pain, talk to your doctor of chiropractic about treatment options like exercise and stretching to help you avoid substituting the wrong muscles while lifting.

Reference: Marras WS, Davis KG, Ferguson SA, et al. Spine loading characteristics of patients with low back pain compared with asymptomatic individuals. Spine 2001:26(23), pp. 2566-2574.

For more information on back pain, click here.

Preventing Youth Baseball Injuries

Elbow and shoulder pain are some of the most widespread injuries in youth baseball, and can be caused by pitchers overusing their throwing arms. The number of pitches thrown per game and the types of pitches thrown may be directly related to pain and injury.

To determine the frequency of elbow and shoulder complaints in youth baseball pitchers and to evaluate possible causes, the authors of a recent study in Medicine & Science in Sports & Exercise followed approximately 300 pitchers for two consecutive seasons. The 9- to 12-year-old children conveyed arm complaints following each game, and the authors related this to the number of pitches per game or per season and to types of pitches thrown.

Children who threw over 75 pitches per game were 50% more likely to suffer elbow pain than children throwing less than 25 pitches per game. Every 10 pitches per game increased the odds for elbow pain by 6%; this pain was present in more than a quarter of the games played. Shoulder pain occurred in one-third of the games, while elbow pain occurred in one-quarter of games. Both types of pain were also associated with throwing less than 300 pitches over the season, most likely due to underuse of a pitcher's throwing arm.

The authors of this study recommend limiting young pitchers to 75 pitches per game, and advocate consistent pitching to maintain strength and conditioning. The origins of elbow and shoulder pain differ, so be sure that methods for preventing pain at one location don't increase your child's risk for pain elsewhere.

Reference: Lyman S, Fleisig GS, Waterbor JW, et al. Longitudinal study of elbow and shoulder pain in youth baseball pitchers. Medicine & Science in Sports & Exercise 2001:33(11), pp. 1803-1810.

For more information on pediatric health issues, click here.

Beans, Beans, the Magical Fruit

Over 1 million Americans develop some form of heart disease every year, largely attributable to high cholesterol levels in the blood. Soybean protein and dietary fiber have been shown to reduce a person's cholesterol levels. Although other peas, beans, and peanuts contain high levels of the proteins and water-soluble fiber found in soybeans, their influence on cholesterol, heart disease, and cardiovascular disease is unknown.

The data obtained in the First National Health and Nutrition Examination Survey were reviewed in a study of almost 10,000 people, published in the Archives of Internal Medicine. Participants had initially answered questions indicating how often they consumed all types of legumes (dried beans, peas, peanuts, and peanut butter) over a three-month period, and were divided into categories based on legume intake levels. Researchers followed the participants over two decades, documenting cases of heart disease, cardiovascular disease, and resulting deaths as they occurred.

People who consumed an average of four or more servings of legumes per week were less likely to develop heart disease and cardiovascular disease than those who consumed legumes less than once per week. Those with higher legume intake also had lower average blood pressure and cholesterol, and decreased odds for developing diabetes and high blood pressure.

Many studies show that vegetable proteins are much healthier than proteins found in meats, and legumes are also excellent sources of fiber and contain no harmful cholesterol. Be sure to minimize the amount of meat in your diet (especially fatty or red meat), and try to eat some form of peas or beans daily. Some of your other legume options include: lentils, black-eyed peas, red beans, and black beans.

Reference: Bazzano LA, He J, Ogden LG, et al. Legume consumption and risk of coronary heart disease in U.S. men and women. Archives of Internal Medicine 2001:161(21), pp. 2573-2578.

To find out more about the benefits of good nutrition, click here.

Irregular Menstrual Cycles May Predict Diabetes

Not all women have a regular four-week menstruation cycle; cycles can range from between 20 to 40 or more days, and in some women the cycle length changes regularly. Diabetes, a condition in which a person has higher than normal blood sugar, can cause damage to the heart, eyes, kidneys, nerves, and other organs. Unusually long, extremely irregular, or infrequent menstrual cycles may be linked to insulin resistance and the development of type 2 (or adult-onset) diabetes.

To assess the risk for type 2 diabetes in women with a history of irregular menstrual cycles, the authors of a recent study in the Journal of the American Medical Association followed over 100,000 women who had reported their menstrual cycle patterns from 18-22 years of age. A "usual" cycle was considered to be 26 to 31 days; weight, race, family history, cigarette use, and other factors were also examined.

Women with long (40+ days) or irregular menstrual cycles were more than twice as likely to develop type 2 diabetes over the 10-year study period than women with usual cycles. Women with very short cycles (21 days or less) were 1.5 times more likely to develop the condition than those with normal cycles. Overweight women had a significantly increased risk for type 2 diabetes as well, but obesity could not account for the increased risk in women with irregular cycles.

Unusual menstrual cycles may indicate metabolic changes that increase a woman's risk for insulin resistance. Insulin resistance hinders a woman's ability to process sugars and can cause type 2 diabetes over time. If you typically have very long or short menstrual cycles, especially if your menstrual cycle is highly irregular, take extra precautions to prevent the onset of type 2 diabetes. Talk to your doctor of chiropractic about diabetes prevention, and click here for more information on women's health.

Reference: Solomon CG, Hu FB, Dunaif A, et al. Long or highly irregular menstrual cycles as a marker for risk of type 2 diabetes mellitus. Journal of the American Medical Association 2001:286(19), pp. 2421-2426.

Let 'Em See You Sweat

Our skin provides a major line of defense against various environmental threats, including germs. Human skin produces antimicrobial agents for defense, which can limit germ growth after injury as a wound heals and reduce the inflammatory response to skin disorders. Does our sweat have anything to do with the infection-fighting properties of our skin?

A recent study in the journal Nature Immunology focused on the germ-fighting ability of the human skin. Researchers analyzed a new germ-fighting agent found in the human skin - and discovered that it was based in our sweat. The gene identified, deemed Dermcidin, was found to be excreted solely by the sweat glands, whereby it was transported by the sweat to the skin's surface. The gene could not be found in of the other major bodily organs tested.

The antibiotic ability of Dermcidin was maintained over wide pH (acidity) levels and salinity ranges that resembled the conditions found in human sweat. Dermcidin was "highly effective" against E. coli, fungi, and other bacteria that can be found in fecal matter and infected water supplies. These germs can infect your wounds and contaminate the food you eat.

You may not enjoy the sticky, wet feeling of sweat on your skin, but the next time you break a sweat while exercising, perhaps you'll appreciate this bodily response a bit more. Your sweat may be eliminating the harmful, invading microorganisms you come into contact with before they have a chance to get into your body.

Reference: Schittek B, Hipfel R, Sauer B, et al. Dermcidin: A novel human antibiotic peptide secreted by sweat glands. Nature Immunology 2001:2(12), pp. 1133-1137.

Charcoal: Not Just for Barbecues

The best treatment for accidental ingestion of toxic substances is activated charcoal (AC). AC, a different type of charcoal than you use for your barbecue, is especially effective if used within the first hour after poison ingestion. It has been suggested that AC should be administered in the home, but this idea has received a negative response from some people because of concerns that parents may not be able to properly administer AC to their children.

The Kentucky Regional Poison Center recently began advising parents with young children and pharmacies to have AC on hand in case of accidental poisoning. For 18 months, the authors of this study in Pediatrics followed the poison center and over 100 cases of home AC administration. Cases were followed until three days after poison ingestion; patients who were recommended home AC administration but treated in the emergency department instead were used for comparison.

All children treated in the home were successfully given a sufficient amount of AC, and no complications developed in any cases. The average time for home ingestion was 38 minutes - half the average treatment time in emergency-department cases (73 minutes). Mushrooms and medications were the most likely poisons ingested, while yogurt, fruit, milk, and water were likely to be offered with the charcoal to make it palatable.

The authors of this study add that over 200 more children were administered AC in their home by recommendation of the same poison center after the conclusion of this study; again, in all cases the treatment was successful. You should be able to successfully administer AC in your home if your child ever ingests poison, which can reduce the treatment time and make the treatment more effective. Keep AC in your medicine cabinet as a precautionary measure - you should be able to find it at your local pharmacy.

Reference: Spiller HA, Rodgers GC. Evaluation of administration of activated charcoal in the home. Pediatrics 2001 (online):108(6), p. e100.

For more information on pediatric health issues click here.

Commercials Worth Watching

In the 4.3 million inhabitants of Victoria, Australia, back pain is the condition responsible for one-quarter of all workers' compensation claims and half the costs of all compensation claims. Due to convincing evidence that psychological factors may be associated with back pain more than any other factors, the Victorian WorkCover Authority started a broad-based public health campaign in 1997 to alter widespread misconceptions about back pain and reduce disability costs in the state. The campaign encouraged patients with low back pain to stay active, exercise, remain at work, and avoid prolonged rest.

The study, published in the journal Spine, was conducted in Victoria, using the neighboring state of New South Wales as a control. Telephone surveys were carried out in both states before, two years into, and two-and-a-half years into the mass-media campaign, which involved prime-time television commercials and radio and billboard advertisements. Questionnaires on back-pain knowledge, such as how to avoid it, were used to determine the success of the campaign. General practitioners' beliefs and attitudes toward back pain were also recorded in a similar fashion.

The questionnaires were completed by almost 5,000 respondents in the general population and approximately 2,500 general practitioners. In Victoria, where the campaign was conducted, accurate knowledge about back pain increased significantly on the back-pain knowledge questionnaires. The population of New South Wales, which had no media campaign, showed no improvement in the questionnaire scores. In addition, general practitioners showed an increase in treatment knowledge in Victoria only.

This study shows that a broad-based media campaign may successfully improve society's knowledge about back pain. Back pain can be highly debilitating, yet is often avoidable through proper lifting techniques, strength training, good flexibility, etc. Ask your doctor of chiropractic about methods for avoiding low back pain.

Reference: Buchbinder R, Jolley D, Wyatt M. 2001 Volvo Award winner in clinical studies: Effects of a media campaign on back pain beliefs and its potential influence on management of low back pain in general practice. Spine 2001:26(23), pp. 2535-2542.

Wake Up and Smell the Sesame

Irritated, painful, and dehydrated sinuses are fairly common in dry climates. If you suffer from dry sinuses, you know that symptoms are most pronounced in dry environments: on airplanes, in air-conditioned rooms, and during the winter months. Saline solution nasal spray has traditionally been used to treat dry sinuses, yet pure sesame oil spray has been offered as an alternative form of treatment. So which is better?

To compare the effectiveness of saline spray to sesame oil spray in the treatment of dry nasal passages, the authors of a recent study in the Archives of Otolaryngology - Head and Neck Surgery examined approximately 80 people who had suffered from the condition for an average of 13 years. The study was conducted in the winter in Sweden, during low outside relative humidity. The subjects were divided into two groups: One group used saline spray for two weeks, followed by sesame oil spray for two weeks, while the other group used the sprays in opposite order. Patients rated their symptoms (dryness, stuffiness, crusting) each evening.

Sesame oil won the contest. Eight of 10 using sesame oil reported improved symptoms after two weeks, while only three of 10 using saline reported improvement. Pure sesame oil spray was significantly more effective than saline for treating nasal dryness, and was somewhat better at relieving stuffiness and crusting. Although negative side effects occurred in both groups, including possible upper respiratory tract infection or nosebleeds, the authors write that these infections were consistent with infections that commonly occur in the population during winter in Sweden.

If you suffer from dry sinuses, consider using sesame oil spray as treatment. It offers a natural, drug-free option for eliminating this irritating condition. For information on other herb and botanical remedies click here.

Reference: Johnsen J, Bratt BM, Michel-Barron O, et al. Pure sesame oil vs. isotonic sodium chloride solution as treatment for dry nasal mucosa. Archives of Otolaryngology - Head and Neck Surgery 2001:127(11), pp. 1353-1356.