Last month the American Chiropractic Association (ACA) called for doctors and patients to consider conservative care in the treatment of lower back pain. The press release cited two recent studies on the effectiveness of the widely recommended drug acetaminophen in treating spinal pain.
One study by researchers in Australia, published in British Medical Journal in March 2015, reviewed all available research on the use of the over-the-counter medication acetaminophen (also known as Tylenol or paracetamol) as a treatment for neck pain, lower back pain, and hip or knee osteoarthritis. Studies that qualified for analysis involved the use of acetaminophen or a placebo and examined its effect on quality of life, pain, and disability.
The analysis revealed that as a treatment for lower back pain, acetaminophen’s effectiveness compared to that of a placebo in reducing intensity of pain, improving disability rates, and improving quality of life. There was a slight improvement in patients with osteoarthritis of the hip or knee, but it was not clinically significant. The study was conducted by researchers associated with the University of Sydney, the University of New South Wales, and the Centre for Education and Research on Ageing at Concord Hospital.
Another study cited by the ACA, published in July 2014 in The Lancet, focused specifically on the effectiveness of acetaminophen for lower back pain. This study was conducted on patients at 235 primary care clinics in Sydney, Australia, between 2009 and 2013. Patients with lower back pain were assigned to one of three groups and received instructions to take a placebo, to take acetaminophen three times a day for four weeks, or to take acetaminophen as needed for pain over four weeks.
Patients treated for lower back pain with acetaminophen, whether using as needed or taking daily doses, experienced no significant improvement in recovery time compared with placebo patients. The study was funded by the National Health and Medical Research Council of Australia and GlaxoSmithKline Australia.
A recent report released by the NIH also documented the ineffectiveness of prescription painkillers as long-term treatment for chronic pain. The report called for an increase in individualized treatment and conservative care.
ACA Emphasizes Conservative Treatment
The ACA is asking physicians to consider recommending conservative treatment – including chiropractic — first.
ACA President Anthony Hamm, D.C., said conservative care is not only less risky than the use of painkillers, but it can also be more cost-effective. Prescription painkillers may be associated with high rates of addiction, while acetaminophen is increasingly linked to other health problems.
A growing body of evidence supports the effectiveness of conservative treatments like chiropractic for long-term relief and resolution of spine and joint condition. Recent research shows that when treating spinal stenosis, conservative treatment and surgery have similar long-term outcomes and that chiropractic is effective for reducing knee osteoarthritis-related pain and pain in the cervical spine.
Dr. Hamm recommends chiropractic treatment when back pain sets in to prevent further costs down the line and to help patients return to functional living more quickly. Chiropractic may be a better option for long-term relief when compared with OTC or prescription medication. Patient-centered chiropractic treatment focuses on a variety of factors that cause or worsen muscle pain and can help patients avoid costly, risky medical procedures and medications.
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NFL Chiropractors Are an Integral Part of Team Health Care
Over the past few decades, chiropractic care has become increasingly important in the National Football League. All 32 NFL teams currently employ a chiropractor, and many current and former NFL players have spoken out about the value of chiropractic during and after their careers.
Hall of Famer Jerry Rice — considered the greatest wide receiver of all time — has been a spokesperson for the Foundation for Chiropractic Progress. Hear what he has to say about chiropractic in the video below.
The New York Giants’ team chiropractor, Dr. Robert DeStefano, D.C., describes health care in the NFL as a coordinated team, comprised of many types of medical professionals: orthopedists, athletic trainers, physical therapists, and more. A survey of NFL chiropractors found that before chiropractic treatment was common in the NFL, players generally sought chiropractors on their own or were referred to one by an athletic trainer. After treating one player, many others were quickly referred to see them.
Dr. Michael Miller, D.C., of the New England Patriots claims he became the first official team chiropractor in the NFL when he began treating Patriots players 30 years ago. When chiropractic treatment started becoming popular, chiropractors often met players in hotel rooms or parking lots to provide adjustments. Now they typically share the training room with other medical professionals who treat the team, or provide adjustments in the locker room.
Almost half of team chiropractors travel with their teams to away games, according to the Professional Football Chiropractic Society.
Common NFL Injuries
NFL players can suffer numerous injuries throughout their careers in practice, games, and even during off-season training. The NFL reported more than 4,000 injuries in 2011. Injuries can vary widely and are often related to a player’s position. Injuries commonly occur in the upper body, such as the neck and shoulder, as well as in the extremities, such as the lower leg, knee, ankle, and foot.
Another common and serious type of injury affecting NFL players are concussions. For many years the NFL denied the possibility of long-term health problems associated with repeated blows to the head. But in 2014 the NFL acknowledged the dangers of multiple concussions and estimated that brain injuries will affect as many as one in three retired players.
Brain injuries can cause players to develop neurological disorders such as dementia at higher rates. Due to these findings, the NFL has taken significant steps to cut down on traumatic brain injuries, including penalizing, fining, and even suspending players for certain types of hits to the head. The NFL has also developed elaborate sideline protocols to diagnose concussions during games. As a result, the number of NFL player concussions fell by 13 percent between 2012 and 2013. But due to the physical nature of the sport, concussions are an unavoidable injury for many NFL players.
What Do Chiropractors Treat NFL Players For?
NFL chiropractors spend a lot of time keeping their players in shape, giving an average of 30 to 50 treatments per week.
According to the 2002 survey of NFL chiropractors, the most common injury NFL chiropractors treat is lower back pain. They also frequently treat players for “burners” and “stingers,” nerve pain commonly associated with contact sports. They typically occur as a result of injury to the nerve supply of the upper arm, usually blows to the neck or shoulder. Untreated, these injuries can cause pain that radiates from the shoulder to the hand.
Other acute injuries treated by NFL chiropractors include muscle strains, whiplash, and neck pain.
Players can also develop chronic conditions such as carpal tunnel misalignment and temperomandibular joint (TMJ) dysfunction. These conditions, like acute injuries, can seriously inhibit a player’s ability to take the field. Chiropractic realignment can relieve pain from these chronic injuries, while preventing them from getting worse.
Treatment for Concussions
NFL players may also seek chiropractic care for headaches, which are often a secondary complaint after a concussion.
Several case studies show that chiropractic treatment can assist with improvement in a wide range of post-concussion disorders. Some of those disorders include attention deficit, dizziness, visual dysfunction, delayed reaction, depression and trouble sleeping.
Chiropractors are often among several health professionals treating players after a game, and therefore have the opportunity to observe players for post-concussion signs and symptoms, such as dull headaches, fatigue, irritability, tinnitus, and anxiety, among other complaints. Catching these signs early is vital, since an untreated concussion can cause brain injury that leads to seizures and even death.
Chiropractic Care and Injury Prevention
Early in an NFL player’s career, injuries can mean the difference between years of playing professional football or just one short season. According to statistics website Statista.com, the average NFL career lasts just over three years, which means many players are racing the clock.
Throughout NFL history, players have been given numbing agents to “play through the pain.” This temporary relief for injury can cause further damage and hinder healing. Understanding of pain has developed past this short-term strategy to deal with injuries, and chiropractors provide a valuable part of the solution.
In a news conference preceding the 2013 Super Bowl, NFL Commissioner Roger Goodell said preventing head injuries is his first priority moving forward with the league. “I’ll do anything that’s going to make the game safer and better,” he said.
As the NFL seeks to ensure the health of players, chiropractic care will continue to play an important role in injury rehabilitation and performance.
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The American Chiropractic Association celebrates Correct Posture Month in May each year. Good posture is essential to maintaining the musculoskeletal balance of our bodies, which prevents harm to joints, ligaments, bones, and muscles. Proper posture can also help prevent muscle fatigue by allowing the muscles to use energy in the most efficient way possible.
But that’s not all. Research shows that posture can impact your overall health and happiness in several other important ways.
1) Good posture can improve your self-esteem.
A study conducted by a team of researchers in New Zealand and published in the journal Health Psychology found that when participants sat up straight, they reported feeling strong, enthusiastic, and excited, whereas a slouching posture corresponded with feelings of fear, hostility, and passivity. Researchers also reported that subjects in the upright position maintained a better rate of speech and stronger pulse.
2) Good posture can ease symptoms of depression and increase positive thoughts.
Professor Eric Peper, a researcher at San Francisco State University has studied the connection between posture and mood. In one of Peper’s experiments, participants reported that upright posture naturally led to more positive thoughts. His research as well as previous studies conducted by other researchers point to a mind-body relationship that runs both ways: bad posture can lead to increased feelings of depression, while good posture has the potential to increase positive thoughts and lift mood.
3) Good posture can increase feelings of power, self-control, and confidence.
Researchers from Columbia and Harvard universities conducted a study on posture and found that closed body postures, such as slouching inward, led to higher levels of the stress hormone cortisol compared to expanded body postures. Participants with expanded body postures reported feeling more powerful and confident. An assessment of desire to take risks also found that open body postures made participants feel more inclined to take risks.
4) Good posture can reduce back and neck pain.
It’s clear that good posture has some powerful mental and emotional effects, but good posture can also help reduce back and neck pain. Bad posture can lead to strain on the joints and ligaments, as well as muscle soreness. Over time, chronic bad posture can cause premature wearing of the spinal structures, as well as secondary problems like headaches. Good posture helps to maintain balance and support for all areas of the body.
5) Good posture can improve oxygen intake by as much as 30 percent.
Besides causing damage to the structures of the body, bad posture can also reduce your ability to intake oxygen. Author and physician Jacob Teitelbaum recommends sitting up straight with an expanded chest, which can increase oxygen intake by as much as 30 percent. The increase in the amount of airflow provided by good posture provides more oxygen to the brain and muscles, giving your body an overall energy boost.
How Can You Improve Your Posture?
With all the evidence pointing to the benefits of good posture, you may be wondering about the best way to improve yours. This May, start making posture a priority with these guidelines for better sitting and standing habits — habits that may help you feel better physically and emotionally.
- Be sure your ears, hips, and shoulders are all lined up, and align your feet with your hips and shoulders.
- Keep your knees from locking by bending them slightly and bear your weight on the balls of your feet instead of your heels.
- Engage your core muscles, and roll your shoulders back to avoid slouching.
- Your weight should be evenly distributed between your “sit bones.”
- Don’t cross your legs, and keep your knees level with or slightly higher than your hips.
- In an optimal sitting position, your feet should be flat on the floor.
- While sitting at a desk your shoulders should be relaxed and your arms should be at a right angle, with your forearms parallel to the floor.
With so much of our lives spent either sitting or standing, keeping these tips in mind can go a long way toward improving your posture.
If you have any questions or would like more information about the benefits of good posture or how to improve yours, please don’t hesitate to contact us.
Wishing you a happy and healthy Correct Posture Month, from the team at Tuck Chiropractic Clinic!
Sitting can also have negative effects on the structures of your body, including the upper and lower back, neck, hip muscles and joints, and spinal discs. Many people may assume that exercising could counterbalance these effects. However, even regular exercise does not significantly reduce the danger caused by hours of sitting every day, according to a study conducted by the University of Queensland in 2009. Daily hours spent sleeping, watching TV, using a computer at home and eating, compounded by hours spent sitting at work, could cause major health problems.
Sitting at a desk for extended periods is a common plight: 86 percent of Americans sit all day at work, according to a survey conducted by Research Now and Ergotron. Since regular exercise outside of work is not enough to counteract the negative effects of sitting, desk workers face an increased risk of health problems. However, there are some great alternatives to break up the amount of time spent sitting at work while maintaining high levels of productivity.
Get Moving on the Clock
Here are six ways to get out of that desk chair and get moving on the clock:
1) Use a Standing Workstation. A study published by the Centers for Disease Control and Prevention found that standing workstations reduced time spent sitting, upper back and neck pain, and even improved mood state of employees. The American Medical Association now recommends that employers provide alternatives to sitting desks “to create a healthier workforce.”
Adjustable standing desks can cost upwards of $300, so if you’re looking for a cheaper alternative, try building your own DIY standing desk like this one made out of Ikea furniture. Just be sure to build your workstation at the proper height. This diagram is a helpful guide to determining how tall your standing desk should be.
2) Take Frequent Microbreaks. Sitting can cause muscle stiffness, so if you can’t use a standing desk, try taking microbreaks. A study published in the journal Applied Ergonomics found that workers who took microbreaks (averaging around 30 seconds every 20-40 minutes) experienced less muscle pain and discomfort with no negative impact on productivity. Professor of Health Services Toni Yancey of the University of California recommends using these breaks to stand up and march in place, dance, or walk a quick lap around your office.
3) Hold Walking Meetings. Research suggests managers spend as much as 25-80 percent of their time in meetings. While it may not always be possible to leave the office, holding walking meetings is a great way to get moving at work. Fresh air and a change of scenery can make your meetings more productive. Most importantly, regular walks can contribute to a healthier lifestyle, lowering your risk for cancer and type 2 diabetes.
4) Walk During Your Lunch Break. Taking a brisk walk or even a casual stroll during lunch is a quick and easy way to get out of your chair. A study published in the Scandinavian Journal of Medicine and Science in Sports tracked 56 office workers who took 30-minute walks during their lunch breaks. Not only did the participants improve physical fitness, but walks during the lunch hour also improved mood, increased relaxation, and decreased tension, regardless of how fast participants walked. For people who struggle to find time to exercise regularly, lunchtime exercise is a great way to increase physical fitness and counteract hours in a desk chair. If possible, take your walk outside, since experiencing natural environments can increase the benefits of your exercise, according to studies.
5) Stand While Making Calls. Standing up while making phone calls is an easy way to get out of your chair and break up your time spent sitting.
6) Technology Can Help. While technology often is the cause of even more time spent sitting, there are several devices on the market than can help you track fitness and decrease sitting, including the FitBit, Jawbone, and Apple Watch, among others. These devices can help you set fitness goals, remind you to get up and move during desired periods of time, measure your daily activity and calories burned, track sleeping patterns and diet, and much more.
Moving at Work May Increase Productivity, Too
Reducing the amount of time you spend sitting is good for your long-term health, but it could also increase your work ethic and job performance. A study conducted by professor Avner Ben-Ner of the University of Minnesota found that, over a yearlong period, employees of a company who used treadmill desks increased productivity at work.
The employees walking on treadmills experienced an increase in quality of work, quantity of work, and quality of exchanges with colleagues. The study also found that the 40 out of 400 employees at the company who used treadmill desks increased overall physical fitness, exercising more outside of work as well as at their desks. While treadmill desks are not a realistic option for every workplace, this study demonstrates that movement throughout the day can be extremely beneficial to overall health and productivity.
Lowering your risk for Sitting Disease can have a big impact on your health. Use these tips to get moving at work and share them with your coworkers to create a more productive, healthy workplace.
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The National Institutes of Health released a report in January 2015 documenting chronic pain treatment and its effectiveness in the United States today. A panel of researchers reviewed available research on chronic pain treatment in America to produce the report. The NIH also hosted a workshop to review current pain treatment methods, inviting many experts and speakers to address the current state of chronic pain treatment.
Of the 100 million Americans who suffer from chronic pain, approximately 5 to 8 million manage their pain with opioid painkillers. The report, published January 15 in The Annals of Internal Medicine, found that pain management treatment in America has not been particularly successful.
Chronic pain is typically defined as pain lasting longer than three weeks. It is one of the leading causes of disability in America, and opioid painkillers are the most common form of pain management prescribed by health-care professionals.
While information exists to support short-term opioid therapy for acute pain, the report found that no conclusive research has been conducted on long-term opioid use.
Dangers of Opioid Treatment
The increase in opioid abuse and addiction has been a concern for many doctors. The report notes that many physicians feel unprepared to treat patients with chronic pain due to insurance limitations, lack of tools to assess patients individually, and lack of access to experts like pain management specialists. It also describes a lack of research into effective, alternative methods of pain management.
The number of opioid prescriptions nearly tripled between 1991 and 2011, and the number of overdoses on painkillers increased along with it. More than 16,000 deaths caused by opioid overdose were reported in 2012. The number of hospitalizations related to painkillers also has increased: In 2010 there were four times as many as in 2007.
There are some unfortunate risk factors such as increased likelihood of eventual dependence at a young age, depression, and prescribed psychotropic medications. One study also linked painkiller use to a significantly higher incidence of hip, upper-arm, or wrist fracture.
Other risks associated with opioid use included increased risk of motor vehicle accidents, heart attack, and sexual dysfunction.
Individualized Treatment Meets Patients’ Needs
Chronic pain treatment requires a multidisciplinary approach in part because it is often accompanied by psychosocial factors that can increase feelings of isolation and depression. One-third to three-quarters of chronic pain patients will experience depression. Inability to work or perform tasks such as child care can strain family and work relationships, causing anxiety and depression.
A multidisciplinary approach to treatment should be tailored to the individual patient’s needs. Alternatives to pharmacological treatment include physical therapy, chiropractic, acupuncture, and relaxation therapy. Regular physical activity and adequate sleep are very important for chronic pain patients.
The panel of researchers who reviewed the available data made several recommendations to empower physicians to better treat chronic pain patients. They recommended the NIH and other federal agencies host more conferences to further discuss and synthesize better methods of treatment. They also recommended giving physicians more tools to make better decisions about treatment.
Chiropractic as Part of a Team Approach
There is already evidence to support the success of alternative treatment for chronic pain. A 2000 study by Nyiendo et al. published in the Journal of Manipulative and Physiological Therapeutics found that patients treated with chiropractic care for chronic lower back pain were more satisfied with their treatment. Fifty-six percent reported their pain was better or much better, compared to only 13 percent of patients treated by a family physician.
Patients also received better results from cervical spinal manipulation for chronic neck pain. A literature review of studies on chronic neck pain published in the March/April 2007 issue of the Journal of Manipulative and Physiological Therapeutics found that chiropractic treatment reduced chronic neck pain significantly. The treatment was effective up to 12 weeks afterward.
Chiropractic has also been established as a successful addition to traditional care, according to the Nyiendo study. Because chronic pain sufferers often experience a multitude of symptoms, a multidisciplinary approach to treatment is the best way to adequately address all of them.
If you experience chronic pain, chiropractic treatment may be a valuable key to successfully managing it. Please contact us at Tuck Chiropractic Clinic to learn how.
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Manual and Manipulative Therapy (MMT) Shows Clinically Significant Improvement
A pilot study published in January 2015 in the Journal of Manipulative and Physiological Therapeutics found that a common chiropractic treatment, manual and manipulative therapy (MMT), had promising results when administered in addition to rehabilitation for osteoarthritis of the knee.
The study examined 83 patients in two outpatient clinics associated with chiropractic universities: Durban University of Technology in Durban, South Africa and Cleveland Chiropractic College in Los Angeles, California. Three groups of patients with knee osteoarthritis received varying treatment: One group had six MMT treatment sessions administered by a chiropractor, one group had rehabilitation training and home rehabilitation, and the third group received both treatments.
After the four-week treatment period, the results indicated that patients who were treated with both chiropractic care and rehabilitative treatment, or chiropractic care alone saw the most clinically significant improvement in their arthritis pain.
This pilot study indicates the need for a confirmatory trial to further assess the effectiveness of all three treatment methods, due to the significant improvement observed in patients from all three groups.
What Is Osteoarthritis?
Osteoarthritis is a degenerative joint disease that causes cartilage to wear down significantly. Cartilage provides the cushion between bones that helps joints function. Without it, bones rub against each other and the end result is pain, inflammation, and loss of mobility. Osteoarthritis is graded on a scale from mild to severe, depending on how much degeneration of cartilage is present. It is typically diagnosed with evaluation of symptoms, X-rays, and range of motion and mobility tests.
Because osteoarthritis makes moving joints painful, it can also severely limit range of motion. One of the top five causes of disability among the elderly, osteoarthritis is as likely to cause disability as cardiovascular disease.
Osteoarthritis tends to affect patients over 40, but it can also occur in younger patients. It is sometimes caused by genetic predisposition and can also occur as a result of joint-intensive exercises like running and basketball. Athletes who are active in sports requiring running, jumping, or other constant uses of joints should be conscious of their heightened risk for developing osteoarthritis. Occupations requiring repetitive lifting of heavy objects, pulling motions, walking long distances, and similar vigorous activities also increase the risk of knee osteoarthritis.
While some may immediately notice mild osteoarthritis pain and swelling, many patients tolerate gradually increasing pain from osteoarthritis for some time before recognizing it as a problem.
Chiropractic Treatment for Osteoarthritis
Chiropractic care is currently recommended for patients who have mild to moderate cases of osteoarthritis of the knee. In addition to MMT therapy described above, your chiropractor can also recommend gentle exercise to decrease inflammation of the joints based on the severity of your osteoarthritis and pain.
A review of current literature conducted in 2012 found sufficient evidence to suggest that, while initial exercise is painful, that eventually an exercise regimen will decrease pain due to osteoarthritis.
Low-impact activities like aquatic exercise and strengthening exercises can ease joint pain without increasing joint damage.
For more information about osteoarthritis and how chiropractic can help, please don’t hesitate to contact us.
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New research from the New Zealand College of Chiropractic’s Centre for Chiropractic Research, published in the journal Experimental Brain Research, indicates that spinal manipulation may prevent fatigue and boost muscular function.
All 18 study subjects were men between the ages of 18 and 40 with spinal dysfunction not related to trauma, bone deformation, infection, or inflammation. They all had a self-reported history of chronic, low-level spinal pain, but had not previously pursued treatment for it.
Researchers measured participants’ muscle electricity activity, absolute force, and H-reflex curves, which indicate spinal cord excitability, as well as the strength of participants’ ability to send a command from the brain to a muscle, or cortical drive.
The results demonstrated an increase in muscle electrical activity of almost 60 percent. There also was an increase in absolute force of 16 percent. The brain’s ability to contract a muscle increased by 45 percent and there was a small but measurable shift in the H-reflex curve.
What Is Spinal Manipulation?
Spinal manipulation, also referred to as a “chiropractic adjustment,” is a chiropractic procedure that re-establishes spinal joint function by applying controlled pressure to joints that have decreased function or have been immobilized. Spinal joint dysfunction commonly occurs as the result of an injury to tissue that causes pain and inflammation. Chiropractic adjustment of the compromised joint loosens tight muscles and eases pain, helping injured tissues to heal. Spinal manipulation is typically administered manually by a chiropractor and is the most common chiropractic technique.
This study follows previous research conducted by Dr. Heidi Haavik, director of research at the New Zealand College of Chiropractic, on spinal manipulation’s contribution to altered motor control and sensorimotor integration. It is the first to establish a connection between an improvement in brain control of muscle function and spinal manipulation. Past research demonstrated a link between spinal manipulation and a change in various aspects of nervous system function, such as reflexes, cognitive processing, and processing speed.
Dr. Haavik said that this research indicates applications for spinal manipulation. The increase in net excitability and muscle control could make spinal manipulation a potentially beneficial treatment for patients who have lost muscle function, such as stroke patients or those who have lost muscle function after orthopedic surgery.
Dr. Haavik also pointed out that the potential relevance of the study’s findings to the athletic community warrants further study. The increased cortical drive, increased muscle strength, and prevention of fatigue following spinal manipulation could have valuable effects on sports performance.
Chiropractic’s Neurophysiological Effects Studied
The New Zealand College of Chiropractic’s Centre for Chiropractic Research has set out to research sensorimotor integration in relation to chiropractic treatment. This study was the result of collaboration between the center and neurophysiologist Kemal Türker, professor at the Koc University School of Medicine in Istanbul, Turkey. Funding for this study was provided by a grant from Spinal Research, The New Zealand Hamblin Trust, and the New Zealand College of Chiropractic.
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A new study conducted by Dartmouth-Hitchcock Medical Center in New Hampshire found that surgery and conservative treatment for spinal stenosis had similar long-term outcomes in function, disability, and pain management.
According to the American Chiropractic Association, spinal stenosis is broadly defined as a narrowing of the spinal canal. It does not always cause symptoms, and often occurs as a result of normal spinal degeneration due to age. Typical symptoms include pain or numbness in the legs, trouble walking, and lower back pain.
The study, published in the January 15 edition of Spine, focused on about 650 spinal stenosis patients. Some underwent surgery, while others pursued conservative care like physical therapy or pain medication.
The participants were recruited from 13 spinal treatment centers in 11 states. They had experienced symptoms for longer than 12 weeks, a typical benchmark for a chronic condition. The study was funded by the National Institutes of Health, the Centers for Disease Control and Prevention, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the Office of Research on Women’s Health, and the National Institute of Occupational Safety and Health.
Similar Outcomes for Spinal Stenosis Patients
Study participants were split into two groups. Just under half chose to be randomly assigned to either surgery or nonsurgical treatment, while the rest made their own choice between. After eight years, 70 percent of those randomized to surgery eventually underwent a procedure, while 52 percent of those originally randomized to conservative treatment also underwent surgery.
The subjects were asked to evaluate numerous symptoms and physical function at three months, six months, and eight years after undergoing some form of treatment. During the first four years or so, surgery patients reported better function, less disability, and less pain.
But by the time the surgery patients reached six to eight years of treatment, most did not report feeling better or experiencing more function than patients who chose conservative care. Patients who underwent conservative care chose physical therapy, chiropractic, epidural injections, anti-inflammatory drugs, or opioid analgesics. While either treatment was considered safe, 18 percent of surgery patients had to undergo a second surgery.
A number of the original participants were not included in follow-up data and they tended to be sicker, older and experienced worse outcomes with conservative care or surgery. According to researchers, this exclusion of older, sicker participants means the final results may be a bit “optimistic,” but should be unbiased between surgery and conservative care nonetheless.
Deciding on Spinal Stenosis Treatment
Because spinal stenosis is chronic and cannot be cured, spinal stenosis patients must choose treatment carefully. Researchers noted that neither treatment successfully eliminated all pain or reduced function. Study leader Dr. John Lurie said that the study’s results will help doctors and patients make more informed decisions about treatment options for spinal stenosis.
It is the largest and highest-quality study conducted on the outcomes of spinal stenosis treatments so far. Researchers note that it is also the first study to show that, even eight years after making the choice, patients who opt to skip surgery can still manage pain and disability successfully with alternative treatment.
While chiropractic care was only one of the alternatives to surgery discussed in this study, the results might encourage patients to think about trying conservative treatment before a surgical consult. According to the National Institutes of Health, some patients who receive chiropractic treatment for spinal stenosis reported increased function and mobility, and reduced pain. For patients who are unwilling or unable to undergo surgery, chiropractic may provide a viable option for relieving suffering from stenosis.
You can learn more information about the symptoms, causes, and treatment options for spinal stenosis here.
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