This study appeared in a recent issue of the Spine Journal which is the official journal of the North American Spine Society. In addition, it was authored by researchers affiliated with UBC and the International Collaboration on Repair Discoveries (ICORD). The study wanted to compare the effectiveness of clinically supported 'guidelines' for treatment of acute, mechanical low back pain versus the 'usual care' patients would receive from their family doctors.
Clinical practice guidelines (CPG's) are meant to serve as a 'map' of sorts for doctors in regards to treatment of their patients with specific conditions. CPG's help a doctor determine what's the best treatment option available based on clinical trials and evidence collected over time. Interestingly enough, CPG's for the treatment of low back pain patients have been around for some time now but evidence shows that most patients who see their family doctors for this condition do not get treatment based on these guidelines.
So now the question is, "...does it make a difference whether a patient is treated according to Clinical Practice Guidelines (CPG's) versus regular care from their family doctors?" In short, this study has found that yes, it does make a significant difference.
For clarification, patients were divided up into two different groups. One group was treated according to CPG's which included; acetominophen, a light exercise program, 4 weeks of Chiropractic treatments and return to work in 8 weeks time. The second group was treated by their family doctors, whichever way they 'seemed fit'. The type of treatment measures the family doctor group received included; prescription pain relievers, massage therapists, kinesiologists and/or physiotherapists. All participants were surveyed at the beginning, then again at 8, 16 and 24 weeks into the trial.
Some important findings include; at 16 weeks, 78% of the patients treated by a family doctor were still taking prescription pain killers on either a daily or 'as needed' basis. At 16 weeks, condition specific improvements, clearly favored the group whose care included Chiropractic.
Another interesting finding was that manipulations/mobilizations that were performed by Physiotherapists were shown to have no clinically worthwhile benefit when compared with advice and acetominophen alone. The difference here can probably be attributed to the difference in education and experience that Chiropractors have when treating patients who are suffering from acute low back pain.
At the last survey performed on participants (at 24 weeks into the study), the difference in improvements in the two groups was found to be "clearly significant" in favor of the CPG's groups care that included Chiropractic compared to the group treated by a family doctor.
It is also important to note that current guideline based care endorses the use of spinal manipulations performed by Chiropractors. Although, several other disciplines including; massage, physiotherapy, physical therapy and kinesiologists may claim that 'spinal manipulations' are included in their care, Chiropractors are still the preferred specialists when it comes to this treatment just based on their education and experience alone.
So if you're suffering from severe back, low-back, hip, neck, shoulder pain, visit my office just off Commercial Drive in East Vancouver. Remember to leave a comment or visit my website here; COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC!!!
Notes: The Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain.
Spine J. 2010 Dec;10(12):1055-64.
This is a topic that I think is necessary for all doctors to be considering with their patients. Regardless if you're a family doctor, dentist, specialist or chiropractor. Obesity is a growing problem in our society today. With overall obesity rates in the US alone hovering around 30%, it's clear that our diets could be way better.
Now from a clinical aspect, I see patients who are in varying degrees of discomfort and distress. In the majority of cases I have the opportunity to not only help a patient deal with pain but I also have the chance to educate people on their overall health. This is a fundamental role of a doctor. He or she must be invested in the well being of their patients and if they can impart good advice on healthy diet or lifestyle habits, they should be doing it.
So the topic today is, "... can eating the right foods actually help to reduce pain?". I believe that, yes! it can definitely make a difference. Now everybody has heard the age old adage, "...you are what you eat." Now if that's true, than it stands to reason that eating the wrong things can have a detrimental effect on your overall health. As more and more research is done on chronic health issues that plague humans, a lot of scientists are realizing that inflammation is a major concern.
“Fats in foods can have the greatest effects on the inflammatory process,” says Charles Friedman, DO, pain management specialist of Pain Relief Centers in Pinellas Park.
So what's the solution? Well a good place to start is with the big "O". No not Oprah, but with Omega fats. By now lots of people have at least heard of Omega fatty acids, but you may not realize where to get them and that there are different kinds.
Omega-3 fatty acids are great to help reduce inflammation and calm stress. Fish, flax seeds and walnuts are common sources of Omega-3's. Omega-6 fatty acids are also essential however too much of it is actually harmful to your health. Omega-6 can be found in packaged convenience foods, meats such as pork, beef and chicken as well as in egg yolk. In western diets it is very easy to overload on Omega-6 and not get enough Omega-3's. In fact is you have brittle nails or suffer from fatigue, it may be an indication you need more Omega-3 fatty acids in your diet!
Another nutrient to consider is Omega-9 fats. This can be found in foods such as; olive oil, pecans, almonds, sesame oil and macadamia nuts. Omega-9 fats are known to help reduce inflammation ,which in turn can help patients suffering from pain.
Finally, remember when your mom told you to, "....eat your vegetables!". Well, she may have been on to something. Vegetables are known to carry anti-oxidants and these factors can actually help to stop the inflammation process from even starting! Now there's something to chew on. So the next time you're in pain, consider all the natural ways that you could be helping to reduce your discomfort. If you're going to eat anyways, isn't it better to eat smart?
If you like this article, leave a comment and if you're in the Commercial Drive neighborhood of East Vancouver, come visit the clinic. You can also visit my website at; COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC!!!
Did you know that 'back pain' is one of the leading reasons why people visit an Emergency Room? Also among the leading reasons for ER visits include; fever, chest pain, abdominal pain, childhood earaches and injuries involving trauma.
This is concerning because some sources indicate that the average time a patient with a, 'routine' case will wait in the ER is between 3-5 hours. Remember this is an AVERAGE wait time because I know from personal experience that it can be much longer than that. Understandably, people with back pain who visit the ER are in dire straits. In the majority of cases, the pain they are suffering from is severe. On another level, the pain is also extremely worrisome because most of these patients have no idea of what's wrong. They have sought care at the emergency looking for answers and most importantly, relief.
Well according to Benjamin W. Friedman, M.D., of the Albert Einstein College of Medicine in Bronx, N.Y., colleagues conducted a retrospective analysis of data from the National Hospital Ambulatory Medical Care Survey, an annual survey of nationally representative emergency department visits in the United States, from 2002 to 2006. And their findings may or may not surprise you.
For patients that present to the ER with significant back pain, the chances are good the treatment they will receive is a prescription for drugs. Opioids were given to 61.0% of patients, with nonsteroidal anti-inflammatory drugs given to 49.9% and muscle relaxants to 43.1%.For those who are not aware, Opioids are pain killers.
In my clinic I consider it essential that patients seeking care for back or spine related issues gain an understanding of the cause of their pain, not just masking the pain. Many spine related issues can be traced back to strains, sprains and mis-alignments of some sort. But which is which? Patients who present to my clinic all receive a thorough physical and orthopedic exam. The purpose for this is so we can identify the most probable cause of the problem. Starting here, we can devise a sensible, organic and conservative plan to address the issues, not just simply masking the pain.
If you're in the Commercial Drive area of East Vancouver, come visit the clinic or check the website here;COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC !!!!
