When Work Hurts

Whether you're lifting boxes, operating heavy machinery, or sitting at a desk all day, back pain can strike at any time. Occupational low back pain (LBP) is a major cause of disability and missed work days, and evidence implicates psychosocial factors, perhaps more significantly than biomechanical workload, in the progression and persistence of acute and chronic LBP.

As a result, many treatment programs and management strategies are adopting a multidisciplinary approach toward LBP in the workplace. Early intervention involving light mobilization and information/recommendations on their condition may be the most cost-effective method of returning patients to normal levels of activity - a premise investigated in a recent study involving 457 LBP patients. All patients were suffering from 8-12 weeks of low back pain and were randomized into two groups: an intervention group given information and advice to stay active, and a control group treated with conventional primary health care, tending toward recommendations of bedrest and reduced activity.

Patients in the intervention group had higher rates of return to full work status than patients receiving conventional care. Specifically, 51.9% of patients in the intervention group returned to full-duty work within three months vs. 35.9% of controls, and this disparity was maintained at six and 12-months follow-ups (61.2% vs. 45% within six months, 68.4% vs. 56.4% within 12 months).

Your doctor of chiropractic can provide you with more information on the potential causes and most effective methods of managing low back pain.

Reference: Hagen EM, Eriksen JR, Ursin H. Does early intervention with a light mobilization program reduce long-term sick leave for low back pain? Spine 2000: Vol. 25, No. 15, pp1973-76.

For more information on low back pain, go to http://www.chiroweb.com/tyh/backpain.html

Pacifiers May Increase Ear Infection Risk

It's estimated that 75-85% of children in Western countries habitually use a pacifier during infancy and early childhood. Although pacifier use has long been considered a relatively harmless habit, recent evidence points to increased risks of oral/dental problems and recurrent ear infections (acute otitis media, or AOM).

A study in Pediatrics examined pacifier use as a potential contributor to AOM by pairing 14 well-baby clinics in Finland, with one clinic in each pair designated for intervention and the other clinic serving as the control. At intervention clinics, parents were instructed to limit their children's pacifier use during visits to the clinic; at control clinics, no such recommendation was offered.

Results showed that in 272 children at the intervention clinics, pacifier use decreased by 21% and the incidence of AOM decreased by 29% compared with children (212) at control clinics. Overall, children who did not use a pacifier continuously suffered 33% fewer episodes of AOM than children who did use a pacifier, leading the authors to suggest limiting pacifier use to "moments when the child is falling asleep."

Reference: Niemela M, Pihkari O, Pokka T, et al. Pacifier as a risk factor for acute otitis media: a randomized, controlled trial of parental counseling. Pediatrics, Sept. 2000: Vol. 106, No. 3, pp483-88.

The Do's and Don'ts of Stretching

If you're one of those natural athletes who finds it unnecessary to stretch or warm up before competition, you're probably setting yourself up for a serious muscle strain or tear. The proposed benefits of stretching include a direct or indirect decrease in muscle stiffness, and as any athlete will admit, muscle stiffness is a primary concern before, during and after strenuous physical activity.

Instead of ignoring the value of stretching and risking a painful, frustrating injury, why not take note of these recommendations on stretching that appeared in the August 2000 issue of The Physician and Sportsmedicine:

Heat, ice and warmup all increase the effectiveness of stretching, although only warmup is likely to prevent injury.

One 30-second stretch per muscle group is sufficient to increase range of motion in most healthy people.

Contract-relax and hold-relax stretching techniques appear to be the most effective for increasing range of motion; however, the muscular contraction necessary for these techniques may increase the risk of injury compared with more static stretches.

Individuals may be able to determine appropriate stretching duration and style by holding a stretch until no additional benefit is obtained. Your doctor of chiropractic can tell you more about appropriate stretching techniques and outline a comprehensive exercise and wellness program suitable to your needs.

Reference: Shrier I, Gossal K. Myths and truths of stretching: individualized recommendations for healthy muscles. The Physician and Sportsmedicine, Aug. 2000: Vol. 28, No. 8, pp1-10.

For more information on sports and fitness, visit http://www.chiroweb.com/tyh/sports.html

Keeping Bones Strong with Soy

Why include soy in your diet? According to the Food and Drug Administration, consumption of 25 grams of soy protein daily may reduce the risk of cardiovascular disease, and recent research suggests other benefits. (See "Reducing Cholesterol with Soy Protein" in the October 2000 To Your Health.)

Recent animal experiments provide evidence that soy can also influence bone density, although the authors of this study from the American Journal of Clinical nutrition believe they are the first to examine this potential association in women nearing menopause. Sixty-nine women were randomly assigned to receive soy protein isolate or whey protein for 24 weeks, and bone mineral density (BMD) and bone mineral content (BMC) were measured before and after treatment.

Results: Bone loss was observed in the control group but not in the soy group. The authors note that these results could translate into a decreased lifetime risk of osteoporosis, and suggest that soy supplementation could prove an effective alternative for hormone replacement therapy in postmenopausal women.

Soy milk, soy cheese, soy burgers and tofu are popular soy products, but the most convenient source may be soy protein isolate, a powder that can be mixed into drinks or combined with different foods. Your doctor of chiropractic can provide you with more information on soy and other foods key to a healthy diet and lifestyle.

Reference: Alekel DL, St. Germain A, Peterson CT, et al. Isoflavone-rich soy protein isolate attenuates bone loss in the lumbar spine of perimenopausal women. American Journal of Clinical nutrition 2000: Vol. 72, pp844-52.

Taking the Sting out of Whiplash

For many people, the term "whiplash"conjures up a fairly uncomfortable image: being rear-ended by another car and having your head suddenly snapped back and forth by the impact. Despite innovations in automotive design, whiplash injuries have become increasingly frequent in the past 30 years. Symptoms of whiplash can include serious and lingering neck pain, back pain, headaches and dizziness; no single effective treatment has been identified to deal with this chronic, frustrating condition.

But help may be on the way. A recent study in Spine suggests that early, active treatment is most effective for managing whiplash symptoms. In the study, "active" treatment consisted of repetitive motion exercises performed at home (10 times every hour, beginning within 96 hours of injury); "standard" treatment involved home exercises performed only a few times each day, starting two weeks after injury.

Results showed that 38% of patients receiving immediate, active treatment reported "no pain" at six-month followup, compared to only 5% of patients receiving delayed standard treatment. The authors note that this type of active home treatment is an "ideal form of rehabilitation" because it expends only small resources within the health care system.

It's time to whip whiplash! If you or someone you know is suffering from whiplash, schedule an appointment today with a doctor of chiropractic.

Reference: Rosenfeld M, Gunnarsson R, Borenstein P. Early intervention in whiplash-associated disorders. A comparison of two treatment protocols. Spine 2000: Vol. 25, No. 14, pp1782-87.

For more information on low back pain, go to http://www.chiroweb.com/tyh/backpain.html

Poor Diet Linked to Increase in Childhood Asthma

If you're an asthma sufferer, you're well aware that attacks can come suddenly or gradually, last for minutes or days, and cause considerable distress and frustration. You're also probably familiar with the classic symptoms of asthma: shortness of breath, coughing, tightness and itchiness in the chest and throat, and wheezing.

Asthma is more common in children than adults, although in both the list of potential causes is long and varied. The influence of diet on asthma has not been adequately considered in research - at least until now. In a study performed in Saudi Arabia, 114 children with a reported history of asthma and/or wheeze were compared with 202 children with no such history.

Among the variables found to be associated with asthma was diet, specifically eating at fast food outlets, consuming low levels of vegetables, milk, fiber, vitamin E, magnesium, calcium, sodium and potassium. The authors suggest that dietary factors during childhood are an important predictor of this condition, concluding: "change in diet has been a determinant of the worldwide increases in asthma and allergies."

Your doctor of chiropractic can provide you with information on asthma and allergies, while outlining a nutritional program appropriate for you and your children.

Reference: Hijazi N, Abalkhail B, Seaton A. Diet and childhood asthma in a society in transition: a study in urban and rural Saudi Arabia. Thorax 2000:55, pp775-59.

For more information on childhood conditions that may be helped by chiropractic care, go to http://www.chiroweb.com/tyh/childhood.html.

Height, weight Influence Postmenopausal Breast Cancer

Breast cancer is the second most common cancer to strike women. (Skin cancer is the most common.) In the United States alone in the year 2000, an estimated 180,000 new cases of breast cancer will be diagnosed, and nearly 40,000 women will die from the disease.

Age, personal history, family history, early menstruation (before age 12), and late pregnancy (after age 30-35) are established risk factors for breast cancer. Increasing evidence suggests that physical characteristics such as height and weight may also play a role. A study published in the American Journal of Epidemiology examined the relationship between height, weight and breast cancer risk as part of the Pooling Project of Diet and Cancer, with particular focus on the potential influence of menopausal status. Seven previous studies were analyzed from data on more than 337,000 women with 4,385 incident cases of invasive breast cancer.

Increasing height was associated with increased risk of breast cancer in postmenopausal women. High weight and body-mass index (BMI, a measure of weight in relation to height) were associated with a reduced risk of breast cancer in premenopausal women but with an increased risk in postmenopausal women. The authors emphasize that weight is a modifiable risk factor that represents an "important opportunity for prevention of postmenopausal breast cancer."

Schedule regular screenings for breast cancer, and talk to your doctor about what you can do to minimize your risk. As these study results suggest, adopting a sensible diet and exercising regularly to maintain a healthy weight may be an important step in the prevention of this horrific disease.

Reference: Van den Brandt Pa, Speigelman D, Yaun S-S, et al. Pooled analysis of prospective cohort studies on height, weight, and breast cancer risk. American Journal of Epidemiology 2000: Vol. 152, pp514-27.

For additional information on women's health, visit http://www.chiroweb.com/tyh/women.html.

Height, Willow Bark Extract for Low Back Pain

The bark of the willow tree has been used for centuries for pain relief and fever reduction. The principal active ingredient in willow bark is salicin, a compound from which aspirin is derived. However, unlike aspirin (and many other pain-relieving medications), natural salicin is not associated with any adverse effects such as gastrointestinal discomfort or bleeding.

Many low back pain (LBP) sufferers take aspirin and other pain-relieving medications to combat their pain. Herbal remedies have been suggested as effective alternatives because of their relatively low incidence of side effects. In a study designed to evaluate the effectiveness of willow bark extract in managing LBP, 210 patients received low-dose (120 milligrams of salicin) or high-dose (240 mg) extract or placebo for four weeks. A pain medication ("tramadol") also was provided for all patients if necessary during the study period.

Of 191 patients completing the study, 39% of the high-dose group and 21% of the low-dose group reported being "pain-free" after four weeks, defined as having no pain for at least five days without the use of tramadol. Only 6% of the control group achieved such success, leading the authors to conclude that willow bark extract "may be a safe way for patients to diminish LBP compared to other drugs, especially when considering the low incidence of reactions."

Talk to your doctor about the dangers of over-the-counter and prescription medications, and find out about the many nonpharmaceutical alternatives currently available for treating back pain and a variety of other conditions. If you're suffering from back pain or would like to prevent back pain before it strikes, schedule and appointment with a doctor of chiropractic. You can also access information on line at http://www.chiroweb.com/tyh/backpain.html.

Reference: Chrubasik S, Eisenberg E, Balan E, et al. Treatment of low back pain exacerbations with willow bark extract: a randomized double-blind study. American Journal of Medicine 2000: Vol. 109, pp9-14.