Working Your Way Through Back Pain

Most people experience loss when they miss work due to an injury. Sure, the first few days are fine, especially if you're being compensated for the time off, but eventually, a feeling of missing out sets in - many times accompanied by monetary concerns or a sense of reduced "job security." The longer you're out, the stronger the feeling can grow.

The occupational health services department of a major Dutch airline took part in a randomized, controlled trial comparing traditional spine care to behavior-oriented "graded" activity. Employees who had been absent from work due to low back pain were assigned to receive graded activity or usual care from their doctor for three months, or until they returned to work. The graded activity program showed impressive results, with patients missing an average of 58 days (over six months of follow-up), versus 87 days for those under usual care.

What exactly is "graded" activity? In this study, it consisted of aerobic exercise (i.e., rowing, cycling); strengthening exercises (i.e., sit-ups, leg presses, latissimus pull-downs); and those tailored to each worker's regular duties (such as lifting and setting down suitcases, e.g., for baggage handlers). This was combined with praise and consistent feedback from the treating physiotherapists, with attention paid more to "improvements rather than pain."

You have a choice: You can place your recovery in the hands of the "usual" care providers, who often rely on pain medications, or you can utilize the services of an expert in treating back pain and getting you back on the job as soon as possible: a doctor of chiropractic.

To learn more about back pain and the chiropractic approach to its prevention click here.

Reference: Staal JB, Hlobil H, Twisk JWR, Smid T, K

Ignore Me Now, Pay Me Later!

Perhaps the most important (yet most neglected) part of the human anatomy is the heart, but cardiorespiratory fitness is a factor in overall health. Reseachers conducted exercise tests over a 16-year period, factoring in a subset of 2,478 participants available to repeat the exercise tests conducted at the outset of the study.

Men and women 18 to 30 years of age were administered a maximal treadmill test (with increasing incline and speed until the subject reached physical exhaustion), gauging their overall health, and as late as 2001, given repeated tests and checked for their health status. Adjustments were made for age, race, sex, smoking, family history of diabetes, hypertension, and myocardial infarction.

Results: Those shown to be of "low fitness" were between three and six times more likely to develop diabetes, hypertension, and the metabolic syndrome than those espousing a "high-fitness" regimen. This study was performed in conjunction with another study, "Coronary Artery Risk Development in Young Adults", sponsored by the National Heart, Lung and Blood Institute; the subset repeating the exercise was a portion of a group of 5,115 participants from Chicago, Minneapolis, Birmingham and Oakland.

Ultimately, the study results confirm what your parents and doctors have told you: Your health habits today - good and bad - will affect your lifestyle years down the road. For more information on health and wellness click here

Reference: Carnethon MR, Gidding SS, Nehgme R, Sidney S, Jacobs DR, Liu K. Cardiorespiratory fitness in young adulthood and the development of cardiovascular disease factors. JAMA December 17, 2003:290(23), pp 3092-3100.

Is a "Mild" Concussion Really Mild?

Imagine an egg, with its contents rocked back and forth after being hit by an object not quite hard enough to break the shell. Compare this to the human skull and you have concussion: the result of a blow to the head or upper body that can manifest in disorientation, loss of consciousness, and other symptoms - or nothing at all.

Undiagnosed danger is the alarm sounded in a study by the University of Pittsburgh Medical Center (UPMC). Recent guidelines have suggested that high school athletes with mild or grade 1 concussions, could be returned to play if asymptomatic for 15 minutes, yet the study indicates much longer-lasting repercussions and a measurable decline in neuropsychological functioning from such injury during the first week of recovery.

Forty-three male and female high school athletes (a subgroup of 64 overall) tested with the "ImPACT" tool for neuropsychological performance prior to respective playing seasons; each was later tested two times during the first week of recovery. ImPACT, developed by UMPC researchers, includes assessment of attention, memory, reaction time and information-processing speed. It is also used by the NFL, NHL, MLB, several athletic organizations and approximately 250 high schools in the United States.

A dramatic decrease in memory and an increase in self-reported symptoms was visible in mildly concussed athletes 36 hours after an injury. The group with on-the-field symptoms lasting longer than five minutes retained a 500 percent chance of demonstrating a drop in memory performance.

The study also pointed out the 1.25 million high-school-age contact-sport athletes who incur an estimated 63,000 concussions per year, with mild concussion occurring most frequently. Research suggests - or rather, demands - that this type of injury be looked at more carefully. No longer should the words, "I'm fine," be acceptable to parents and school officials when coming from a "mildly concussed" high school athlete.

For more information on sports and fitness click here

Reference: Lovell MR, Collins MW, Iverson GL, Johnston KM, Bradley JP. Grade 1 or "ding" concussions in high school athletes. American Journal of Sports Medicine 2004:32, pp47-54.

Don't Be a Cereal Killer!

Parents: Before you crack down too hard on your kids' daily consumption of the latest sugary breakfast cereal, you may want to consider a study culled from the December issue of Journal of the American Dietetic Association.

From February 1998 through February 1999, more than 2,000 households in the United States kept a two-week food diary. Included in the study were 603 children ages 4 to 12 years, divided into three groups: those ingesting ready-to-eat cereal eight or more times within two weeks; those consuming cereal four to seven times; and those eating three or fewer servings. The results were evaluated in terms of the notoriously "unforgiving" body mass index (BMI), which for the first group (those eating cereal the most frequently) showed 80 percent falling within appropriate standards.

Contrary to this, only 52.6 percent of the children who consumed relatively little cereal for breakfast maintained an appropriate BMI. Now of course, Dr. Albertson represents the Bell Institute of Health and Nutrition (formed by General Mills, one of the world's leading cereal companies), but the message is still clear: Cereal - or any breakfast food containing even the minimum of nutritional ingredients - is better than nothing at all.

Have you taken your children to see your doctor of chiropractic yet? In addition to starting them on the road to health with regular chiropractic adjustments, your chiropractor can discuss nutritional strategies to keep you and your kids fit in an increasingly unfit world.

For more on pediatric health click here.

References: Albertson AM, Anderson GH, Crockett SJ, Goebel MT. Ready-to-eat cereal consumption: Its relationship with BMI and nutrient intake of children aged 4 to 12 years. Journal of the American Dietetic Assocation December, 2003:103(12).

Nine Things Your Back Hates

Since 1948, residents of Framingham, Mass., have been subjected to all manner of inconveniences in the name of science. The Framingham Heart Study (FHS) has examined volunteers there every two years, and data used during examination #22 (1992-1993) were used for a first-ever study on the contribution of back symptoms to overall physical disability in older adults.

Of the 1,710 surviving members from the original 5,209 taking part in the FHS, 1,007 contributed data on back symptoms. Subjects ranged in age from 70 to 100, and were surveyed regarding pain, aching and stiffness. Researchers then asked subjects about their difficulty in standing in place for 15 minutes; walking half a mile; stooping, crouching or kneeling; lifting a 10-pound object; entering and exiting an automobile; pushing or pulling a large object; putting on socks or stockings; extending arms above shoulder level; and writing, handling or manipulating small objects. Any of these activities was classified as a "functional limitation" if it could not be performed or performed with difficulty.

In all subjects, 18 percent to 34 percent of all functional limitations were attributable to back problems; moreover, women seemed particularly affected by these limitations. Don't let back pain limit you! Your doctor of chiropractic can help your spine "make friends" with the nine activities listed above.

To learn more about the benefits of chiropractic click here.

Reference: Edmond SL, Felson DT. Function and back symptoms in older adults. Journal of the American Geriatrics Society December 2003:51(12), pp1702-1709.

Taking it to Heart

The term "broken-hearted" may be as literal as it sounds. Subclinical depression (characterized by persistent negativity, irritability, easy anger, and a general dissatisfaction with life), often goes undiagnosed and/or untreated, posing an increased risk for cardiovascular disease (CVD). Recently, A Women's Health Initiative (WHI) observational study followed 93,676 older or postmenopausal female subjects for an average of 4.1 years to gauge depression.

Approximately 16 percent of the subjects showed depressive symptoms; those individuals had a 50 percent greater risk for heart disease (or death from it) compared to women without depressive symptoms. For depressed women, the risk of death from any cause was shown to be 30 percent higher than nondepressed women. Does that mean that heart disease and depression are connected?

Lead author of the study, Dr. Sylvia Wasserthiel-Smoller, speculated, "It could be that people really have some kind of subclinical disease [and] maybe the first place it manifests itself is in the depressed mood," suggesting that a depressed mood itself may influence other variables that lead to disease.

Regardless, neither heart health nor depression should be taken lightly. For more information, visit the American Heart Association at www.americanheart.org/presenter.jhtml?identifier=3017091 and the American Psychological Association at www.apa.org/ppo/issues/pwomenanddepress.html.

For more information on women's health click here.

Reference: Wassertheil-Smoller S, Shumaker S, Ockene J, Talavera GA, Greenland P, Cochrane B, Robbins J, Aragaki A, Dunbar-Jacob J. Depression and cardiovascular sequelae in postmenopausal women. Arch Intern Med 2004:164, pp289-298.

What Alcohol Can Do to Your Brain

Atherosclerosis comes from the Greek word "athero" (gruel or paste) and "sclerosis," or hardness. Fatty deposits and other substances, or plaque, accumulate in the artery's inner lining, and are more prone to occur when a person ages. This can cause blockage of blood flow or clot different blood vessels, which can eventually lead to a heart attack or stroke.

A group of 1,909 middle-aged adults underwent cerebral MRI exams. The study found that White matter lesions and ventricular and sulcal size increased as alcohol consumption increased. Lead researcher Jingzhong Ding explained: "There is no brain tissue in the ventricular and sulcal areas, as these areas are filled with cerebrospinal fluid. Therefore, an increase in ventricular and sulcal size indicates a reduction in the brain tissue, or brain atrophy, around the ventricular and sulcal areas."

Previously, the Cardiovascular Health Study, sponsored by the National Heart, Lung and Blood Institute, found that moderate alcohol intake was associated with fewer brain infarcts (dead tissue). This study adds to this existing evidence, and the researchers note that "the process might begin earlier in life than [previously] suggested."

For more information on general health click here.

Reference: Ding J, Eigenbrodt ML, Mosley TH, Hutchinson RG, Folsom AR, Harris TB, Nieto FJ. Alcohol intake and cerebral abnormalities of magnetic resonance imaging in a community-based population of middle-aged adults. Stroke 2004:35, pp16-21.

Grapefruit: More Than Just a Tangy Treat?

Grapefruit is a good source of vitamin C, potassium, and dietary fiber, and it's a good way to get your recommended five daily servings of fruit and vegetables. Recently, researchers added diabetes protection to the potential list of benefits associated with regular grapefruit consumption.

Researchers surveyed 100 overweight volunteers who were on varying diets: One group ate half a grapefruit three times a day; another group drank a glass of grapefruit juice prior to every meal; while group did not consume any grapefruit. After 12 weeks, grapefruit eaters had shed an average of 3.6 pounds - with some losing as much as 10 pounds. Juice drinkers lost an average of 3.3 pounds, and those without grapefruit in the diet lost only 0.5 pounds apiece.

Researchers attributed the grapefruit-mediated weight loss to the burning of sugar, facilitated by insulin and indicated by lowered glucose levels, which could be good news to the estimated 18.2 million people in the U.S. that have diabetes. Moreover, this study paves the way for further research on a larger scale, researchers said.

Get a jump-start on the next round of results by consuming grapefruit (and a regular supply of fruits and vegetables) to maintain health, and if for nothing else - the taste.

For more on nutrition click here