Lifecare Chiropractic
James Bogash, DC
Amy Strock, DC

1830 S. Alma School Rd
Bldg 7, Ste 135
Mesa, AZ 85210
(480) 839-CARE (2273)

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April 2005 Newsletter

 

In this issue of To Your Health:

Bed Rest: Still Unadvisable for LBP

Considerable evidence in the past decade shows that bed rest has not been beneficial to patients suffering from low back pain (LBP). A recent review by the Cochrane Collaboration Back Review Group analyzed all randomized studies up to March 2003, yielding two new trials comparing advice to rest in bed with advice to stay active for patients with LBP. In total, six trials compared bed rest with staying active for the management of LBP.

Results found that advice to rest in bed was clearly less effective than advice to stay active for patients with acute simple LBP. High-quality evidence shows small but consistent differences in favor of staying active for pain and functional status at 3-4 weeks and 12 weeks follow-up, respectively. Additionally, in patients with acute simple LBP, evidence shows that bed rest will increase length of sick leave in the first 12 weeks, compared to advice to stay active. For patients with sciatica, evidence shows that bed rest has little or no effect on pain and functional status, compared to staying active at 3-4 weeks and 12 weeks.

All in all, it appears that LBP sufferers should not count on bedrest to help decrease their recovery time or stave off pain. If you suffer from LBP, talk to your Doctor of Chiropractic about an appropriate treatment plan to include staying active. And For more information on chiropractic care for back pain, visit www.chiroweb.com/find/archives/musculoskeletal.

Reference: Hagen KB, Jamtvedt G, Hilde G, Winnem MF. The updated Cochrane Review of bed rest for low back pain and sciatica. Spine, March 1, 2005;30(5):542-46.

Caffeine Increases Risk for Chronic Daily Headache

Before your reach for your next "cup-o'-jo," consider the consequences of excessive caffeine consumption. Caffeine has been shown to cause withdrawal headache, which may contribute to the development of chronic daily headache (CDH), or headache occurring at least 15 days per month.

To confirm such a hypothesis, researchers recruited population-cases and control subjects from three U.S. metropolitan areas as part of a study designed to address caffeine’s potential involvement in CDH. Control subjects reported two to 104 headache days annually (average: 30 days), while population-cases reported 180 or more headache days per year (average: 260 days). Current and past caffeine consumption was assessed by way of self-report.

Results: High caffeine exposure, defined as being in the upper quartile of dietary consumption or using a caffeine-containing over-the-counter medication as a headache treatment, was associated with onset of CDH. Approximately one-fourth of case subjects reported taking pain medication of any type daily for headache in the previous three months.

According to the authors, “High medicinal or dietary caffeine consumption at the time of CDH onset (e.g., pre-CDH consumption) was a modest risk factor for CDH onset. Secondary analyses revealed that pre-CDH caffeine consumption might be an initiating factor in a subset of CDH sufferers, with the high-risk groups being women and those younger than age 40."

Still need a "pick-me-up" in the morning, but want to wean off caffeine? Try drinking green tea instead, which contains substantially less caffeine than coffee and has been shown to have a host of health benefits, including antioxidant and anti-cancer properties. For more information on health and nutrition, visit www.chiroweb.com/find/archives/nutrition.

Reference: Scher AI, Stewart WF, Lipton RB. Caffeine as a risk factor for chronic daily headache. A population-based study. Neurology, Dec. 14, 2004;63(11):2022-27.

Study Shows Exercise May Help Reduce Depression

In 1997, a study found that mild to moderate major depressive disorder (MDD) ranked second behind heart disease in terms of years of life lost due to premature death or disability. National estimates indicate that fewer than one-fourth of individuals with MDD seek treatment, and only one in 10 receive adequate treatment. A recent study was designed to test whether exercise is beneficial in treating mild to moderate MDD, and to determine the dose-response relation of exercise and reduction in depressive symptoms.

Eighty adults diagnosed with mild to moderate MDD were randomized to one of four aerobic exercise treatment groups that varied total energy expenditure (7.0 kcal/kg/week or 17.5 kcal/kg/week) and frequency (three days/week or five days/week), or to a placebo control group that participated in flexibility exercises three days a week. Outcome was determined by the score on the 17-item Hamilton Rating Scale for Depression (HRSD).

Results: After 12 weeks, the group expending 17.5 kcal/kg/week (consistent with public health recommendations) had the lowest scores, while the placebo control group had the highest scores. The authors concluded that “Aerobic exercise in the amount recommended by consensus public health recommendations was effective in treating mild to moderate MDD. The amount of exercise that is less than half of these recommendations was not effective."

If you suffer from mild to moderate depression, try engaging in some type of physical activity. You'll experience a wide range of benefits in a short amount of time, including elevated mood, increased stamina and improved health, overall. For more information on the benefits of exercise, visit www.chiroweb.com/find/archives/sports.

Reference: Dunn AL, Trivedi MH, Kampert JB, et al. Exercise treatment for depression. Efficacy and dose response. American Journal of Preventive Medicine 2005;28(1):1-8.

RECOMMENDED READING: Keeping you aware of the latest resources that will provide the information you need to make wise decisions about your health.

This month's featured title is Golden Rules for Vibrant Health in Body, Mind and Spirit by Joseph J. Sweere, DC.

The answer to the common question, "How do you avoid having regret when it comes to your health and wellness?" comes in the form of Dr. SweereŐs Golden Rules for Vibrant Health in Body, Mind and Spirit, and the book provides just what it claims to: "golden rules" for living a healthy life and enjoying all that life has to offer. Chapter topics include Food: What and How You Eat; Water and Your Body; Medicinal Wonder Foods; and Structure and Function: Exercising and Maintaining Your Body, as well as several others designed to give readers a greater appreciation for the power of natural healing.

Click here to read the complete review.

Breast-Feeding and Rheumatoid Arthritis? Is There a Connection?

Rheumatoid arthritis (RA) is an autoimmune disorder that occurs up to four times more frequently in women than men. Evidence suggests that female sex hormones may be at least partially responsible for this trend in that RA appears to develop during times when these hormone levels fluctuate, such as after giving birth. Some studies have suggested that breast-feeding may increase the risk of RA, while other studies have suggested that breast-feeding may protect women from the condition.

To further assess this connection, researchers examined data from more than 121,000 female nurses relevant to the age of first menstrual period, number of children, age at first birth, duration of breast-feeding, smoking, body mass index, use of oral contraceptives, incidence of irregular menstruation, and use of hormones following the onset of menopause; 674 women were identified with incident RA.

After adjusting for specific variables, researchers found a significant decrease in the incidence of RA based on the incidence and duration of breast-feeding. Compared to women who did not breast-feed, women who had breast-fed between 12 months and 23 months were 30 percent less likely to be diagnosed with rheumatoid arthritis. Breast-feeding for at least 24 months resulted in a 50 percent reduction in RA risk. The researchers also discovered an increased risk of rheumatoid arthritis in women who had their first menstrual period at age 10 or younger and in young women with "very irregular" menstrual periods.

"In conclusion," note the authors, "we observed that breast-feeding was inversely associated with the risk of RA, with a strong trend for decreasing risk of RA with increasing duration of breast-feeding, and that early age at menarche is positively associated with seropositive RA. In addition, we identified a novel risk factor, irregular menstrual cycles, that increased the risk of subsequent RA … These findings suggest avenues for further research into the hormonal mechanisms involved in RA, because the complex relationships between RA and reproductive hormones clearly warrant further study."

For more information about this study, visit www.chiropracticresearchreview.com.

Reference: Karlson EW, Mandl LA, Hankinson SE, Grodstein F. Do breast-feeding and other reproductive factors influence future risk of rheumatoid arthritis? Results from the Nurses’ Health Study. Arthritis & Rheumatism, November 2004;50(11):3458-3467.

Medication Discrepancies Found During Hospital Admissions

An accurate medication use history is a key element of the patient assessment process on admission to a hospital; however, prior studies have shown that medication discrepancies at the time of hospital admission are common and that such errors have the potential to cause harm to patients.

To study these types of discrepancies, researchers examined 151 patients (average age: 77 years) over a three-month period who were admitted to a teaching hospital. A discrepancy was defined as "any difference between the medication use history and the admission medication orders" and included omissions or additions of medications; medication substitutions within the same pharmacologic class; and changes in dose, frequency or administration as part of the criteria. Patients were included in the study if they reported using a minimum of four prescription drugs prior to admission.

Results: Researchers found that 53.6 percent of study participants had at least one unintended discrepancy, the most common being the omission of a regularly used medication (46.4 percent). It was determined that 38.6 percent of the discrepancies "had the potential to cause moderate to severe discomfort or clinical deterioration."

The researchers noted study limitations that included "the absence of a gold standard for the identification of home medication use. We relied on the report of the patient or caregiver in conjunction with collateral information from medication vials or pharmacy contacts whenever possible. Previous research suggests that our study assessments provided the best available measure of patients’ actual home medication use." Nonetheless, they concluded, "Medication errors at the time of hospital admission are common, and some have the potential to cause harm. Better methods of ensuring an accurate medication history at the time of hospital admission are needed."

For more information on this and other health-related studies, visit www.chiropracticresearchreview.com.

References: Cornish PL, Knowles SR, Marchesano R, et al. Unintended medication discrepancies at the time of hospital admission. Archives of Internal Medicine 2005;165:424-429.

Childhood Weight May Predict Weight in Adulthood

It's no secret that obesity in America has reached epidemic proportions. Now, new research shows that children between the ages of 8-15 who are in the upper half of their normal weight range are more likely to become overweight or obese young adults than their leaner counterparts.

Researchers recorded the height, weight and blood pressure of 314 Massachusetts children, ages 8-15 years old at baseline, between 1978 and 1981. These values were measured in the same participants eight to 12 years later at follow-up. Participants averaged a mean body mass index (BMI) of 20 kg/m2 at the first childhood visit, with a "prevalence of at risk for overweight or overweight at the first childhood visit [at] 34 percent for girls and 32 percent for boys."

At follow-up, 48.3 percent of the boys and 23.5 percent of the girls were overweight or obese. High blood pressure was more prominent among the boys (12.3 percent) than girls (1.9 percent), as well. According to the authors, "children with a BMI between the national 85th and 95th percentiles for age and gender were classified as at risk for overweight, and those with a BMI > 95th percentile were classified as overweight." The authors considered BMI between the 50th and 84th percentile to be at the high end of a normal weight range.

The researchers concluded, "Although very lean children are unlikely to become overweight adults, we observed that children in the upper end of the healthy weight range (e.g., 50th to 84th percentiles) are at an elevated risk of becoming overweight or obese. Furthermore, boys in the upper end of the healthy weight range are at an increased risk of becoming hypertensive. These findings suggest that future interventions to prevent adult obesity and its complications should include not only overweight children but also children and adolescents as low as the 50th percentile of BMI for age and gender."

For more information on this and other health-related studies, visit www.chiropracticresearchreview.com.

Reference: Field AE, Cook NR, Gillman MW. Weight status in childhood as a predictor of becoming overweight or hypertensive in early adulthood. Obesity Research Jan 2005;13(1):163-69.

James Bogash, DC and Amy Strock, DC
1830 S. Alma School Rd, Bldg 7, Ste 135, Mesa, AZ 85210
(Alma School Road, just south of the Superstition Freeway/Highway 60)
Chiropractic Health Care for Chandler, Mesa and Tempe Arizona
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