From unhealthy school lunches to heavy backpacks, kids and parents face a variety of challenges to maintaining health and wellness during the school year. As summer draws to a close and classes begin, this back-to-school wellness guide can help you and your children navigate these challenges.
Lighten the Load
On the first day of school each year, kids comes home with new classmates, new teachers — and a heavier backpack. A heavy load can cause chronic back pain in children, so to avoid side-effects from weighty textbooks, encourage your children to leave their books in lockers or at home whenever possible to prevent back strain.
Talk to your child about using both straps to carry the backpack, since putting all the weight on one side can contribute to pain in the back, neck or shoulder. Remind your child to maintain proper posture while wearing their backpack: Slouching or dropping the head will increase pressure on the cervical spine.
It also is important to choose the right backpack. Pick one that is no larger than the child’s torso. It should have a padded back, and straps that are wide, padded, and adjustable. Multiple compartments can help balance the load.
Basic Precautions Can Help Prevent Illnesses
When they return to school, kids are exposed to a wide range of health hazards, such as colds, the flu, and lice. Make sure your child follows some basic principles to reduce the chance of getting sick at school:
- Avoid touching eyes, nose, and mouth (this is the primary way diseases are spread)
- Drink plenty of water
- Cover the mouth and nose while coughing and sneezing
- Wash hands with soap and water frequently throughout the day, and tuck hand sanitizer in the backpack
- Be careful not to share brushes, combs or hats, which can spread lice, an unpleasant reality in schools
Schedule a visit to the doctor to evaluate your child for any illnesses. Make sure they are up to date on shots.
While it may be tempting to send a sick child to school, it is better to wait until they have been symptom-free for 24 hours before letting them return. Teachers and other parents will appreciate your precautions to limit the spread of the sickness.
The classroom is the first place your child may notice vision problems. Be aware of any increase in difficulty completing assignments — it may be vision-related.
Prepare Lunches And Snacks Ahead
School lunches, which often are high in salt, fat, and sugar, are considered a contributing factor to increasing childhood obesity rates. While buying lunch at school is always available for busy weeks and kids in need, with a bit of preparation and planning, you can provide your children with nourishing lunches to bring to school every day of the week.
Packing healthful lunches doesn’t have to be an insurmountable task. Preparing fruits, veggies, healthy snacks, and meals ahead of time saves time and effort later, making your morning routine a breeze. Create a master list of tried-and-true favorites and the groceries needed to prepare them. Set aside an afternoon or evening once or twice a week to plan and prepare meals for the week. Try creating a meal plan and breaking down the tasks needed to fix each meal.
The same principles can be applied to keeping a stock of after-school snacks. Children often come home from school ravenous, with dinner several hours away. For busy kids, junk food provides inadequate fuel for studying or physical activity.
Resist the urge to buy junk food and prepare quick, easy snacks instead. Some easy foods to grab and go include fresh fruits and vegetables, high-fiber granola bars that are low in sugar, and protein-rich foods like hard-boiled eggs, peanut butter, and hummus.
For more ideas about healthy options that can help keep up energy and reduce stress, check out this recent blog post.
Start on the Right Foot
Properly fitting shoes can affect your child’s posture: Foot problems which typically first appear in childhood, can contribute to back pain. Check for calluses, excessively flat feet, and other concerns to ensure proper support and fit. Small children can’t always communicate if shoes fit improperly, so look for shoes with room for growth, plenty of flexibility, and breathable fabrics.
Find a Balance Between School And Physical Activity
Homework and studying are an unavoidable part of going back to school, but helping your children achieve a balance between work and physical activity gives them the freedom to be happier and healthier.
The World Health Organization recommends kids spend at least 60 minutes a day doing physical activities. In addition to the physical benefits of exercise, research suggests that regular exercise can ward off anxiety and depression in children, increase self-esteem, and improve academic performance and quality of sleep.
Your children exercise their brains all day in school and while doing homework, so exercising their bodies provides a needed balance. Make a plan to keep track of goals for completing homework and spending time on the move.
Organized sports can provide lessons in teamwork, social skills and build character traits like perseverance. But for younger children, unstructured playtime is a fast-disappearing, yet important aspect of learning and development.
Whatever form of exercise your children choose, aim for at least an hour a day of physical activity.
Refocus Your Family Routine
Returning to school is all about new beginnings and it’s a great opportunity to reintroduce structure to your family life. Summer is often a time of relaxation and recuperation from the stress of a long school year, but if the first day of school catches you unprepared you’ll be struggling to keep up with everyone’s different schedules.
Try making a master schedule and calendar, particularly if you’re juggling students in different levels of school, with different events. You’ll know at a glance if you can supervise a school field trip or make it to the soccer game.
Avoid morning chaos by handling chores like laundry and meal planning the night before. Handle homework reminders at least an hour before bedtime to avoid excuses. For children anxious about going back to school or attending for the first time, try a practice run going to school in the morning. Another trick is to adopt a school mealtime schedule. Easing unsure children into a new school routine can calm fears and make school an enjoyable experience.
We hope this guide will help you and your family stay healthy and happy as the new school year fast approaches. If you have any questions or would like more information about back-to-school health and wellness, please don’t hesitate to contact us.
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Comfort Foods Aren’t So Comforting in the Long Run
Stress can cause us to turn to comfort foods — and drinks. But consoling ourselves with these carbohydrates, fats, salt, and caffeine can do more than tip the scales: Eating foods that boost cholesterol and sodium levels can increase the risk of heart attack or developing diabetes.
Fatty, salty foods are not the best choice. There are healthy alternatives that actually reduce blood levels of cortisol, the stress hormone, while providing the comfort we crave during stressful periods.
Which Foods Should You Avoid?
When you consume comfort foods like chocolate or potato chips, your body reacts in ways that increase your stress. Here are a few of the most common things we reach for while stressed and how they can affect our bodies:
- Sugar and Caffeine: Sugar and caffeine can both cause a temporary boost in energy and mood, but that latte or soda will eventually cause you to crash, making your stress and anxiety worse.
- Simple Carbohydrates: Simple carbs like baked goods made with white flour provide few vitamins and can cause an eventual crash because of their sugar content. Additionally, stress already raises your blood glucose levels, so piling on more sugar increases your risk of developing diabetes.
- Trans Fat: Trans fats are found in many junk foods like popcorn with margarine, frozen pizza, coffee creamer and more. A study conducted in 2014 found that trans fat intake increased stress levels and brain inflammation, causing memory impairment.
- Lactose: Ice cream might seem comforting during a stressful time at work or school, but lactose can cause dietary distress in some people.
What Should You Eat When You’re Stressed?
If you want to stabilize your blood glucose and levels of cortisol while stressed or sleep-deprived, what should you eat for optimal performance?
Rather than consuming stress-inducing foods like the ones mentioned above, try these stress-relieving options instead:
- Leafy Green Vegetables: Vitamins and minerals in dark green vegetables — including folate, which has been linked to increased dopamine levels — can help boost your mood. Magnesium, found in veggies like Swiss chard, regulates cortisol.
- Fish: Containing omega fatty acids, fish are good for your heart and manage your adrenaline levels. They also contain choline, which boosts your memory.
- Fresh Fruits and Vegetables: Your immune system can be weakened by chronic stress. Beta-carotene, an antioxidant found in carrots, boosts your immune system. Eat oranges and other citrus fruits to get a dose of antioxidant vitamin C. Potassium-rich fruits and veggies like bananas and avocados keep your blood pressure low.
- Complex Carbohydrate Foods: High-fiber foods fill you up and may prevent overeating that often comes with sleep deprivation caused by stress. Complex carbohydrates can stimulate serotonin production in the brain, helping you to relax.
- Yogurt: While ice cream may aggravate your digestive system, yogurt contains cultures that help to regulate digestion and maintain a variety of gut flora.
It’s hard to resist ordering take-out or reaching for a pint of ice cream when stress takes over. Keeping your kitchen stocked with healthier alternatives will help you avoid comfort food that may end up worsening your stress. Stick with whole grains and fresh foods like a salad or a yogurt parfait with fruit. Remember that food is fuel and you must make a choice: weigh your body and brain down with fatty, sugary junk foods — or empower your body with healthful choices to help you through a stressful time.
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One of the highlights of working in healthcare is the opportunity to develop relationships with patients from all walks of life. Every patient that walks into one of our 11 Tuck Chiropractic locations has a unique story to tell. At our Bedford location Jen is one of our regulars, seeing Dr. A.J LaBarbera to maintain a happy, healthy spine and joints. What initially began as a single chiropractic visit 8 years ago, to treat sinus problems and lower back pain, has transformed into a long-lasting relationship. Not only are we able to consistently help her maintain overall joint and back health but we have also relished the chance to support her in other aspects of her life.
Jen has a job in retail that requires heavy lifting, which is quite strenuous on her back and joints. Even though Jen makes the effort to lift in a safe and proper way, odd movements are inevitable as she gets the job done—and these movements can leave her back and joints feeling aggravated. Jen explained how she has managed to overcome these work challenges with chiropractic care, saying, “Regular adjustments, along with various exercises that I have been taught, keep me able to do my job.”
The benefits Jen has experienced due to chiropractic treatments don’t end at work though. Jen likes to work hard and play even harder—she is a martial artist. She explained how she feels consistent adjustments have helped her to participate in this sport and improve her performance, “As a martial artist, proper alignment allows better quality of movement. I’ve noticed that when I am doing well and not in a lot of pain, that I can get my kicks up much higher and can achieve greater degrees in flexibility.” She has found that one key to her overall happiness, health, and success is staying on top of her joint and back health through her regular chiropractic treatments.
According to Jen, seeing Dr. A.J. for adjustments is a major contributor to how great she feels and her ability to stay active both at and after work. But more than that, Jen knows that Dr. A.J genuinely cares about her overall health. Dr. A.J. explained, “Being a true advocate for our patients is how we can ensure that they get the care they need; whether it is within our group, with another provider, or even another health care discipline altogether. This collaborative effort really helps to resolve patients’ issues and also assists them in meeting their health goals.” Jen also talked about Dr. A.J.’s advocacy on her behalf; she explained, “I had an issue with foot pain a few years ago. He referred me to a podiatrist to treat me, because the pain had lingered on. If he determines that a referral is best for a patient, he isn’t afraid to go that route to help them heal.”
Another thing the Bedford team loves about Jen is how she shares her passions with us. We all enjoy catching up with her when she comes by the office. “At one point, Dr. Matthis answered questions on chiropractic, while I was working on a Biology paper,” Jen told us. She continued, “Dr. Keene also took time to tell me about Athletic Training, as I have been looking at possible college majors. Earlier this year, Dr. A.J. came to Super Kicks Martial Arts to discuss goals with our students.” We value the way that our relationship with Jen transcends the clinical environment into every day living, interests, and aspirations.
Working with Jen is a joy and the Tuck Chiropractic team is thankful that she trusts us with her health care. We also appreciate that she welcomes us into other areas of her life, allowing us to understand how our chiropractic treatments fit into the bigger picture of who she is. Jen’s story is a great encouragement to continue striving to leave a positive impact on every life we touch. Thanks Jen and we hope Tuck Chiropractic can continue to help you achieve your health goals!
A study published in April 2014 in Chiropractic and Manual Therapies found that after six months of chiropractic treatment, 90 percent of pregnant patients with lower back pain reported clinically significant improvement. The study was led by researcher Cynthia Peterson, a professor of chiropractic medicine at the University of Zurich in Switzerland.
Researchers recruited 115 patients who were pregnant and experiencing lower back or pelvic pain who were eligible to receive manipulation therapy. Patients had been referred to a chiropractor by a gynecologist, who then recruited them for the study. Information was collected on how long each patient had been experiencing back pain, whether they had experienced lower back pain in a previous pregnancy, and where their pain was located.
Patients received chiropractic manipulation therapy (also known as a chiropractic adjustment) from their chiropractors — the frequency and specific type of treatment was left to the discretion of each chiropractor. The patients’ improvement in rate of pain was measured at one week, one month, three months, six months and one year after the first treatment. More than 50 percent of patients reported improvement in pain levels at every interval of measurement, with 90 percent of patients reporting improvement at one year.
Lower Back Pain in Pregnancy
Lower back pain affects as many as 80 percent of pregnant women and medicating back pain is highly discouraged during pregnancy for the safety of the mother and child. However, back pain can persist after pregnancy has ended in 94 percent of women, making it a serious issue for health care providers to address. Additionally, lower back pain and pelvic pain combined can increase disability rates during pregnancy.
While research has not definitively pinpointed the root cause of back pain during pregnancy, it is largely assumed to be a result of biomechanical changes in the body from increased weight, changing balance, and softening of ligaments due to hormonal changes. This study on chiropractic care during pregnancy aimed to build on the limited but promising results of previous research.
Chiropractic Care During Pregnancy
Chiropractic manipulation therapy provides a conservative, non-invasive alternative treatment that is demonstrated to be successful. No severe adverse effects were reported by study participants, which reflects the safety of chiropractic care.
The study does contain some limitations, such as variations in the type of treatment conducted by individual chiropractors. However, a slight variation in treatment reflects personalized care for each patient’s unique situation. Chiropractors aim to treat their patients based on the individual’s needs and comfort rather than just the symptoms. Beyond manipulation, chiropractors can also work with patients to lower back pain outside the chiropractor’s office by creating a personalized routine of stretches, ergonomic sleeping, sitting and standing positions, and other daily habits.
For pregnant women who struggle with disabling back and pelvic symptoms, this study affirms chiropractic care as a successful alternative to invasive treatment.
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Inflammation is a part of your body’s natural defenses against disease. But sometimes it can cause more problems than it solves. Excess inflammation can cause heart disease, diabetes, stroke, vascular dementia, and other health problems.
Your immune system responds to bacteria and other stimuli by creating inflammation, which can include symptoms like redness, heat, swelling, pain, and loss of function. When someone suffers from pain in their neck or low back, it is often a result of inflammation caused by injuries to the ligaments and muscles around the joints of the spine. In fact, the level of inflammation is usually consistent with the amount of pain a person can experience.
Your body can also produce inflammation as a response to what you eat. This immune response creates chronic inflammation that is less noticeable than the redness or swelling that comes with a wound, and it is still somewhat difficult to identify.
Your diet plays a large part in your body’s inflammation level. Eating foods that are high in salt or fat — combined with smoking or a lack of exercise — can cause chronic, low-grade inflammation.
5 Ways You Can Fight Inflammation
Numerous studies have established the benefits of an anti-inflammatory diet. While it won’t cure diseases caused by chronic inflammation, what you eat can help you reduce inflammation. Here are a few simple changes you can make to your diet — changes that can also contribute to improved mobility and overall health.
- Eat Your Fruits and Vegetables. Doctors have long extolled the virtues of fruits and vegetables, and not just because they’re full of vitamins and fiber. They also contain a powerful mix of anti-inflammatory substances. Eat tomatoes, cherries, leafy greens, blueberries, and strawberries to get a healthy dose of these substances.
- Fats Matter. Saturated and trans fats can boost inflammation, so switch to olive oil, nuts, and fish for sources of healthy fats.
- Don’t Be Too Refined. Highly refined carbohydrates like white rice and white bread cause a spike in blood pressure, which in turn causes your body to produce more cytokines. Cytokines are proteins, some of which cause inflammation in the body.
- Easy on the Alcohol. Having an alcoholic drink lowers levels of C-reactive protein, another protein linked to inflammation, but take it easy: levels go back up after drinking too much.
- The Spice of Life. The way you season your food can also quell inflammation. Try adding turmeric and ginger, which both fight inflammation.
The Mediterranean Way of Eating
The Mediterranean diet is a well-known example of an anti-inflammatory diet plan. During the 1960s, residents of that area had among the highest adult life expectancies in the world, as well as low incidence of heart disease, cancer, and other illnesses.
Based on the traditional eating habits of residents of Crete, Greece and Southern Italy, the diet generally includes lots of fruits and vegetables and fewer servings of meat and dairy products.
Cuisine in the Mediterranean starts with olive oil, since olives are cultivated there. Olive oil is rich in monounsaturated fatty acids, which are considered a healthful dietary fat. The diet also emphasizes foods rich in polyphenols, antioxidants, and fiber. Selectively eating complex carbohydrates such as whole grain pasta and avoiding refined carbohydrates like white bread is healthier than cutting out carbs altogether, according to dietary research.
The health benefits of the Mediterranean diet are backed by research. In one study, men with prostate cancer had a significantly higher chance of surviving the disease if they followed the Mediterranean diet.
Staying Close to Nature
Eating foods that are closer to their natural state, like fresh vegetables and fruit, and avoiding highly refined or highly processed foods are likely to make you feel better and help you fight inflammation, according to research. An anti-inflammatory diet may protect you against diseases that decrease your quality of life and your life expectancy. Whether you follow the Mediterranean diet or make a few simple dietary swaps, reducing inflammation is an important step to overall wellness.
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Later this summer Dr. Logan Brooke, of Tuck Chiropractic Clinic in Blacksburg, will be traveling to Colorado for two weeks to work with some of the most gifted athletes in the world at the Olympic Training Center in Colorado Springs.
This opportunity came about after Dr. Brooke completed the Certified Chiropractic Sports Physician course and worked with the local Virginia Tech Rugby Club Team for two years. Brooke was then given an invitation for the two-week rotation by the U.S. Olympic Committee after an initial application process. From August 17th– September 1st, Brooke will be working at the USOC facility in Colorado Springs, CO. The currently scheduled programs and camps include: Weightlifting, Men’s Gymnastics, Modern Pentathlon, Triathlon, and many more.
Dr. Logan Brooke joined the Tuck Chiropractic family in June 2009. He is a 2005 cum laude graduate of Palmer College of Chiropractic. After graduating, he practiced chiropractic in Ohio and has served on chiropractic humanitarian trips to India, Brazil, Fiji, and Africa. In 2013, Dr. Brooke completed his specialization as a Certified Chiropractic Sports Physician through the American Chiropractic Board of Sports Physicians. Dr. Brooke has worked with and learned from doctors at the highest level of the profession, including Doctors to the USA Olympics Team, whom he will join in August.
Dr. Brooke stated, “I am grateful to the USOC for inviting me to their Colorado Springs facility to take part in fulfilling the dreams of our Olympic athletes. Chiropractic care is an integral part in their sports medicine program and I have the opportunity to utilize my skills and talents while collaborating with some of the greatest minds in all of sports medicine.”
Dr. Brooke sees patients full time at Tuck Chiropractic’s Office at 620 North Main St. in Blacksburg.
An overview of current research, published in the Journal of the Canadian Chiropractic Association, shows that chiropractic care may have a role in helping prevent falls in elderly patients who suffer from mechanical neck pain or dizziness.
Elderly patients often experience nonspecific dizziness and chronic neck pain at the same time. Both of these symptoms are risk factors for falls, the leading cause of fatal and nonfatal injuries in adults 65 and older. Falls can result in increased morbidity and complications. In the United States, one in three older adults experiences a fall each year.
Dizziness tends to increase with age. The central nervous system receives signals from the body to provide a sense of balance, and several of those signals are from muscles associated with the cervical spine. While the cause of nonspecific dizziness is not known, many researchers suggest it is caused by age-related deterioration of sensory inputs that assist with balance.
When neck muscles experience pain or dysfunction, a connection is disrupted and the brain receives mixed signals from different parts of the body, which can cause dizziness, according to current research. Dysfunction in the muscles of the cervical spine is more likely to be associated with disrupted balance, vertigo, and nonspecific dizziness, more so than dysfunction of the muscles of the lumbar spine.
Whether neck pain is the result of physical trauma or muscular dysfunction, it is associated with dizziness at high rates, along with back pain.
How Chiropractic Can Help
Spinal manipulation is a common technique used by chiropractors to treat neck pain. A study published in 2014 in Spine found that spinal manipulation combined with home exercise was an effective treatment for neck pain in elderly patients.
For elderly patients with dizziness with no known cause, traditional medical treatments are limited. While more research is needed, several studies on the efficacy of spinal manipulation in the treatment of neck pain show consistent improvement in balance and symptoms of dizziness as well.
Chiropractic is a safe, conservative treatment for dizziness and neck pain in elderly patients. To alleviate symptoms, doctors of chiropractic can provide a treatment plan that combines several therapies, such as home exercise, therapeutic massage, physiotherapy modalities, and spinal manipulation. Even though conservative measures often yield great results, Chiropractors often will collaborate with other health care providers to help facilitate a resolution of symptoms for patients as well.
The literature review suggests that more rigorous, large-scale studies should be conducted on the effectiveness of spinal manipulation as a treatment for dizziness. This is especially necessary because of the cost, rate of disability, and morbidity associated with falls in adults 65 and older.
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People spend roughly one third of their lives sleeping. A good night’s sleep is a substantial factor in the quality of your overall health, and inadequate sleep can wreak havoc on you mentally and physically. The position you sleep in can have a huge impact on the quality of your sleep.
So, what’s the best position for sleeping? The answer varies depending on individual health concerns such as back pain, neck pain, and acid reflux, to name a few. It also depends on which position is the most comfortable for you. Above all, you should avoid sleeping in any position that causes stiffness or pain.
Pros and Cons of Common Sleeping Positions
1) Sleeping on Your Back
Sleeping on your back is one of the most highly recommended sleeping positions.
- Acid reflux sufferers can avoid nighttime heartburn in this position
- Keeps the spine in a neutral, comfortable position
- Some back pain patients find relief sleeping on their backs
- Those who snore may snore louder in this position
Tip: Sleeping on your back may be more comfortable with a pillow under your knees.
2) Sleeping on Your Side
If sleeping on your back is uncomfortable or painful, sleeping on your side is also a highly recommended position.
- Reduces snoring
- Eases neck pain and back pain
- Reduces acid reflux if you sleep on your left side
- During pregnancy, sleeping on your side can improve blood flow and provide more comfort than sleeping on the back or stomach
- Side sleeping may increase the chance of developing wrinkles and sagging skin on the side you favor
Tip: Try a pillow between your knees, under your waist or under your neck in this position.
3) Sleeping in Fetal Position
About 40 percent of people sleep in some variety of the fetal position, on their sides with legs curled up toward the chest. While fetal position may feel comfortable for some sleepers, it is not a recommended sleeping posture.
- Often a comforting position
- Restricts expansion of the diaphragm, which leads to shallow breathing
- Can increase pain from arthritis
- Can causes tension, aches, and pains
Tip: If fetal position is your normal sleeping posture, try stretching your legs out a bit into side sleeping instead.
4) Sleeping on Your Stomach
- For snorers, sleeping on your stomach provides relief by opening the airways
- Causes pressure on the joints, muscles, and spine and can lead to neck and back pain
- Difficult to avoid putting pressure on the spine
- Spending hours with your head turned to the side is bad for the cervical spine and can cause nerve pain
Tip: If you must sleep on your stomach, aim for a very thin pillow or sleep without a pillow to avoid straining your neck.
Choosing the Right Mattress and Pillow
The position you sleep in can influence your quality of sleep, and so can your sleeping equipment.
Choose a mattress that is firm enough to support your body in your ideal sleeping position. A sagging, limp mattress can certainly lead to a lackluster night’s sleep. Since the life of a mattress is typically five to seven years, periodically replace your mattress if possible. Additionally, flipping your mattress every few months can help it stay firm longer.
Pillows also play an important role in your rest. Depending on your sleeping position, you may need a fluffier pillow or a thinner one. Regardless of which you choose, remember to consider how much support you will need for the head and neck in each sleeping posture.
For instance, when you sleep on your side, your head needs plenty of support from a thicker, firm pillow so your neck doesn’t end up at an awkward angle. When sleeping on your back, a fluffy pillow keeps your head and neck supported without strain. Ergonomic pillows tend to be firm and shaped specifically to relieve pain from lack of support while sleeping.
If you’re not getting adequate sleep on a consistent basis, or you’re not sure which sleeping position is ideal for you, a doctor of chiropractic can guide you to the best ergonomic sleeping position for your health concerns.
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A study published in the Journal of Manipulative and Physiological Therapeutics in October 2014 used functional magnetic resonance imaging (fMRI) to evaluate how the brain reacts to spinal manipulation used by chiropractors. Brain scans revealed that spinal manipulation and other types of manual therapy have an immediate effect on functional connectivity between regions of the brain that are responsible for processing pain.
Previous research has established a connection between neurophysical changes in regional brain communication and manual therapy. Many patients seek chiropractic care for pain relief, and multiple studies testify that chiropractic treatment relieves pain in neck pain patients, lower back pain patients, and others.
This study, conducted by researchers at the University of Florida, suggests that increases in functional connectivity or brain communication after manual therapy underlie pain relief.
Functional Connectivity and Pain Processing
Functional connectivity (FC) is defined as communication between regions of the brain, and in the case of this study, refers to communication between the pain-processing regions of the brain.
There are several areas of the brain associated with processing and modulating pain, including the thalamus, primary and secondary somatosensory, cingulate, and insular cortices. These regions are referred to together as the pain processing network. Activity in the PPN is part of pain recognition, but it also includes the interaction between the PPN and other areas of the brain.
The researchers recruited participants, 24 of whom (17 men and 7 women) completed exercises designed to induce lower back pain. They were separated into three groups, each of which was treated with one form of manual therapy — either spinal manipulation, therapeutic touch, or spinal mobilization.
Participants were measured for pain intensity and sensitivity, and underwent an fMRI 48 hours after the pain-inducing protocol. They were randomized to one of the three treatment groups and then received the same measurements after treatment. All manual and manipulative therapies were administered by a physical therapist or chiropractor, using a standardized set of techniques.
Before and after undergoing their assigned treatment, participants were measured for changes in functional connectivity (FC) between regions of the brain that process and respond to pain. Functional MRIs revealed changes in FC between several regions of the brain after treatment. Several of these changes in connectivity between brain regions were shared between patients from all three of the treatment groups.
Manual Therapy, Functional Connectivity and Pain Relief
Manual therapy consists of a variety of physical rehabilitation techniques, including spinal manipulation, spinal mobilization, therapeutic touch, tissue massage, and other techniques. According to the American Chiropractic Association, manual therapies are the most common treatment administered by chiropractors.
Researchers examined activity in the pain processing network and also how it reacted with other areas of the brain after treatment. Results found clinically significant changes in functional connectivity between several areas of the brain that appeared to be directly related to manual therapy.
Changes were also recorded in pain intensity and pain sensitivity. All three groups reported similar changes in pain intensity, but no changes were found in pain sensitivity.
These results may indicate that after manual therapy, functional changes are an underlying mechanism of pain relief.
More Research Needed
This study is unique because it includes more precise measurement than previous studies, including fMRIs of patients in a resting state before treatment.
Due to a lack of a control group that received no treatment — as well as the relatively small sample size — more research is needed to confirm the association between manual therapy and increased functional connectivity. It also suggests future study on the effects and changes of MT on patients with chronic pain, since these results are only applicable to patients with acute pain.
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