Here are the top 10 chiropractic research studies of 2013.

1. Immediate Benefits of Chiropractic Visible on MRI: For the first time, researchers used MRI to document changes in spinal gapping immediately after a chiropractic adjustment.

 2. AMA Recommends Chiropractic Before Resorting to Surgery: The Journal of the American Medical Association released new guidelines for back pain treatment that encouraged patients to seek chiropractic and physical therapy before resorting to surgery.

3.Chiropractic as Effective as Epidural Injections for Lumbar Disc Herniation: Patients with lumbar disc herniation were randomly assigned to receive either nerve root  injections or chiropractic care. Overall, 76% of chiropractic patients reported feeling "better" or "much better" after treatment compared to just 62.5% of injection patients.

4. Chiropractic Lowers Blood Pressure: Hypertensive patients had reduced diastolic blood pressure readings after receiving chiropractic adjustments in a new study.

5. Chiropractic Best Option for SI Joint Pain: Chiropractic care was better than physical therapy or injections of corticosteroids for sacroiliac joint dysfunction.

6. Neck Adjustments Immediately Improve Joint Position Sense: Cervical manipulation was shown to improve joint position sense, which could assist in improving mobility in patients with neck pain.

7. Chiropractic Better than Medical Care Alone for Back Pain: Military personnel with back pain had a significantly better chance of recovery when they received a combined treatment of chiropractic and medical care, compared to those who only received medical care.

8. Spinal Adjustments Relieve Muscle Pain Instantly: Patients with myofascial pain experienced immediate improvements in pressure pain thresholds after receiving chiropractic adjustments.

9. Cervical Disc Herniation Eased by Chiropractic: A study of patients with cervical radiculopathy showed that 85% experienced significant reductions in pain and disability after receiving chiropractic care for three months.

10. Chiropractic Thaws Frozen Shoulder Syndrome: Patients had a 78% improvement in pain after receiving chiropractic care for frozen shoulder syndrome. In another study of patients treated with manipulation under anesthesia, patients had significant reductions in nighttime pain and shoulder stiffness.

With the New Year just around the corner, now's the time to start thinking about how you can make meaningful changes to your life for better health. Here are seven steps you can take to improve the health of your spine and your overall wellness.

1. Get at least 30 minutes of daily exercise. Many of the benefits of regular exercise can be experienced with as little as 30 minutes of physical activity a day. Not only will you decrease your risk of obesity and diabetes, you'll also experience a reduction in back pain,migraine, and other neuro-musculoskeletal symptoms.
2. Deep breathing. Meditation, going on walks, and taking breaks throughout the day can all aide in stress reduction. Lowering your stress can make your immune system more resilient and decrease chronic pain flare-ups.
3. Laugh more often. Laughter doesn't just relieve mental stress; it also fires off a cascade of physical reactions that benefit your health. Studies show that laughing can stimulate the heart, muscles, and lungs-- not to mention the flurry of endorphins that are released after a good giggling session.
4. Eat your greens. Cruciferous vegetables like broccoli and kale, which are rich in calcium, can help to decrease your risk of osteoarthritis. Spinach, lentils, and beans are high in magnesium, a vitamin shown to benefit patients with back pain.
5. Quit smoking. Cigarette smoking increases your risk of spinal conditions and arthritis. Smoking cessation has been tied to an improvement in spinal pain. As a bonus, new research shows that smokers who attempt to quit in January are more successful because of the extra motivation the New Year provides.
6. Lose weight. Carrying extra weight increase the load on your spine and joints, making you more susceptible to sciatica, disc herniation, and osteoarthritis.
7.  See a chiropractor. The spine plays an important role in your overall health by ensuring that your nervous system is functioning smoothly. As spinal specialists, chiropractors do not only relieve pain from spinal conditions, they can also assist in improving your overall health. Research has shown that chiropractic adjustments reduce the stress hormone cortisol and boost the presence of infection-fighting antibodies in the body.

See your Dr. Hozjan for ways to have a healthier, happier new year.

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At least five of the most common medical treatments for migraines are unnecessary and potentially risky, argued the American Headache Society (AHS) in the November/December issue of the journal Headache.

After performing a meta-analysis of the research and consensus of its members, the AHS recommended that patients and doctors think twice before using the following five treatments:

1. Brain scans in people with stable headaches that meet the criteria for migraine.
2. CT-scans should not be used when MRI is available. MRI can pick up on more conditions causing headache than CT-scans and does not expose patients to radiation.
3. Surgery. Surgical deactivation of migraine trigger points is still considered experimental, and should be avoided outside of a clinical trial.
4. Narcotics. Opioid and butalbital-containing pain medications should not be the first line of treatment. These pain killers are effective but can be habit forming, especially in patients with chronic pain conditions.
5.  Prolonged use of over-the-counter pain medications. Reaching for ibuprofen or other over-the-counter pain medications day in and day out can wreck havoc on your kidneys, liver, and stomach. There is also a real risk of medication overuse headache. The AHS recommended that patients not take over-the-counter pain medications more than twice a week.

"There are a lot of strategies that can work that are better than just grabbing handfuls of Motrin," explained AHS president Dr. Elizabeth Loder. Biofeedback therapy teaches patients to change how their body responds to pain and physical symptoms.

Preventive strategies like having a regular exercise routine, keeping a headache journal, stress reduction techniques, and monitoring your diet for certain "headache trigger" foods can also help.Research has even suggested that regular exercise was as effective as a drug called topirmate for preventing migraine headache. Many patients also find that chiropractic adjustments can reduce the frequency and severity of their migraines.

Primary reference:
Loder, E. et al. Choosing wisely in headache and migraine: The American Headache Society's list of give things physicians and patients should question. Headache 2013: doi:10.1177/0333102411419681. http://onlinelibrary.wiley.com/doi/10.1111/head.12233/pdf.
Secondary references:
Varkey E, et al. Exercise as migraine prophylaxis: A randomized study using relaxation and topiramate as controls. Cephalalgia 2011; doi:10.1177/0333102411419681. 

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Patients new to chiropractic often wonder, "How long will it take to recover from an episode of back or neck pain?" While the answer is highly individual, a team of researchers sought to see whether there were any general trends in how quickly patients recover from back pain when under chiropractic care.

A new study published in the Spine Journal examined patients' dose responses to chiropractic adjustments for chronic lower back pain. Dose response helps doctors understand how much of a specific treatment is needed for relief. Currently there have been no large-scale studies analyzing the dose response of chiropractic treatment.

In the study, 400 patients with chronic lower back pain were randomly assigned to receive varying levels of treatment: 0, 6, 12, or 18 sessions of spinal manipulation administered by a chiropractor.

Every patient met with a chiropractor three times per week for six weeks, however only patients in the 18 dose group received spinal adjustments at each appointment. The other patients received the number of spinal adjustments they were assigned, and the remaining appointments consisted of light massage as a control.

After 12 sessions, the mean average patient had a 20% improvement in pain and disability. Patients receiving 18 sessions of spinal adjustments did not appear to have additional benefits over the 12 session group. Reductions in pain and disability were sustained at the one-year follow-up. The researchers concluded that 12 sessions of spinal adjustments provided the most favorable outcomes.

Twelve of course may not be the magic number for everyone, since there are a number factors influencing recovery from back pain (such as genetics, obesity, activity level, past injuries, and mental health.) However this study does demonstrate that even patients with persistent back pain can experience meaningful reductions in pain and disability.

Once you've recovered from your initial episode of back pain, getting regular chiropractic care can prevent you from experiencing future episodes of pain. Chiropractors can provide maintenance care with advice on using exercise, nutrition, physical therapy, and spinal adjustments to prevent chronic symptoms. Recent research suggests that chiropractic patients fare better than traditional care patients when it comes to this maintenance care period after the initial relief. The study showed that chiropractic patients experienced fewer episodes of recurring back pain than medical care patients.

References
Haas M, et al. Dose-response and efficacy of spinal manipulation for care of chronic low back pain: a randomized controlled trial. Spine Journal 2013; pii: S1529-9430(13)01390-9. doi: 10.1016/j.spinee.2013.07.468.

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Nearly a third of Americans have high blood pressure, putting them at risk for heart disease, stroke, and number of health conditions. While medication is the primary treatment for hypertension, there are several non-pharmaceutical ways to manage high blood pressure including, stress reduction, weight loss, and diet changes. Now, a growing body of research suggests that chiropractic care could help.

Researchers from Sherman College of Chiropractic have found preliminary evidence that regular chiropractic care reduced blood pressure in middle-aged African Americans. Earlier research has suggested that chiropractic adjustments can decrease blood pressure in patients with cervical spine dysfunction or anxiety. However there have been no age and racial-specific studies on the effects of chiropractic on blood pressure.

Researches conducted a non-randomized, non-controlled pragmatic study to evaluate the feasibility of a future clinical trial. The results are still considered preliminary, but since they support earlier findings, they are highly suggestive as to the potential effects chiropractic can have on blood pressure.

The study included 58 hypertensive patients of African American descent who were over the age of 40. Patients received one year of chiropractic care for various spinal conditions, and their blood pressure was taken three times throughout the course of the study.

The researchers discovered that in patients with a BMI lower than  50, diastolic blood pressure significantly decreased over the course of treatment. Patients with a BMI higher than 50 (considered severely obese), did not experience the same drops in blood pressure. This lead researchers to suggest that obese patients may be "more resistant" to blood pressure reductions when it came to chiropractic care.
Chiropractic care isn't the only hands-on therapy that may help with hypertension. A studypublished earlier this year showed that massage decreased blood pressure in pre-hypertensive women.

Primary reference:
McMasters KL, et al. Blood pressure changes in African American patients receiving chiropractic care in a teaching clinic: a preliminary study. Journal of Chiropractic Medicine 2013; 12(2): 55-59.
Additional references:
Yates R.G., Lamping D.L., Abram N.L., Wright C. Effects of chiropractic treatment on blood pressure and anxiety: a randomized, controlled trial. Journal of  Manipulative and Physiological Therapy 1988;11(6):484488. [PubMed]
McKnightM.E., DeBoer K.F. Preliminary study of blood pressure changes in normotensive subjects undergoing chiropractic care. Journal of  Manipulative and Physiological Therapy 1988;11(4):261266. [PubMed]
Knutson G.A. Significant changes in systolic blood pressure post vectored upper cervical adjustment vs resting control groups: a possible effect of the cervicosympathetic and/or pressor reflex. Journal of  Manipulative and Physiological Therapy 2001;24(2):101109. [PubMed]
Bakris G., Dickholtz M., Meyer P.M. Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study. Journal of Human Hypertension 2007:16. [PubMed]

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Is the change in seasons giving you the sniffles? Seasonal allergies could make you suffer from more severe migraine headaches, according to new research from the University of Cincinnati University of Cincinnati (UC), Montefiore Medical Center and the Albert Einstein College of Medicine of Yeshiva University and Vedanta Research.

The study, published in the journalCephalalgia, is one of the first to establish a direct link between nasal allergies (rhinitis) and the frequency of migraines.
"The fact that rhinitis occurred in more than half of these individuals emphasizes that these disorders are intimately linked," said Jonathan Bernstein, MD, medicine professor and clinical research director in the division of immunology, allergy, and rheumatology at UC.

Around 12% of Americans suffer from migraines headaches, while anywhere between 25-50% of the population is affected by seasonal allergies. Researchers were curious to see whether rhinitisirritation or inflammation of the nasal membranes was anyway related to migraine headaches. They analyzed data from the 2008 American Migraine Prevalence and Prevention (AMPP) Study, which included nearly 6,000 respondents.

• Two out of three people with migraine reported suffering from rhinitis, also known as nasal allergies, seasonal allergies, or hay fever.
• Migraine sufferers with rhinitis had a 33% greater risk of suffering from frequent headaches.
• People with "mixed rhinitis" whose nasal symptoms were triggered by both allergic and non-allergic triggers were 45% more likely to suffer from frequent headaches and 60% more likely to have more disabling headaches than those without rhinitis. (Allergic triggers included cats, dogs, mold, or tree pollen while non-allergic included cigarette smoke, weather changes, perfumes, and gasoline.)

"The nose has largely been ignored as an important site involved in the initiation and exacerbation of migraine headache," said coauthor Richard Lipton, MD, in a press release. "Rhinitis exacerbates migraine, as these results suggest, treating rhinitis may provide an important approach to relieving headache in people with both disorders."

Many chiropractors can assist patients in the natural management of both migraine headache and allergies. Getting adequate treatment for both conditions may be crucial for reducing the frequency of migraine headache.
 
References
Martin, VT. Chronic rhinitis and its association with headache frequency and disability in persons with migraine: Results of the American Migraine Prevalence and Prevention (AMPP) Study.Cephalalgia 2013; 10.1177/0333102413512031.

chiropractor charlotte southpark 28209

Is the change in seasons giving you the sniffles? Seasonal allergies could make you suffer from more severe migraine headaches, according to new research from the University of Cincinnati University of Cincinnati (UC), Montefiore Medical Center and the Albert Einstein College of Medicine of Yeshiva University and Vedanta Research.

The study, published in the journalCephalalgia, is one of the first to establish a direct link between nasal allergies (rhinitis) and the frequency of migraines.
"The fact that rhinitis occurred in more than half of these individuals emphasizes that these disorders are intimately linked," said Jonathan Bernstein, MD, medicine professor and clinical research director in the division of immunology, allergy, and rheumatology at UC.

Around 12% of Americans suffer from migraines headaches, while anywhere between 25-50% of the population is affected by seasonal allergies. Researchers were curious to see whether rhinitisirritation or inflammation of the nasal membranes was anyway related to migraine headaches. They analyzed data from the 2008 American Migraine Prevalence and Prevention (AMPP) Study, which included nearly 6,000 respondents.

• Two out of three people with migraine reported suffering from rhinitis, also known as nasal allergies, seasonal allergies, or hay fever.
• Migraine sufferers with rhinitis had a 33% greater risk of suffering from frequent headaches.
• People with "mixed rhinitis" whose nasal symptoms were triggered by both allergic and non-allergic triggers were 45% more likely to suffer from frequent headaches and 60% more likely to have more disabling headaches than those without rhinitis. (Allergic triggers included cats, dogs, mold, or tree pollen while non-allergic included cigarette smoke, weather changes, perfumes, and gasoline.)

"The nose has largely been ignored as an important site involved in the initiation and exacerbation of migraine headache," said coauthor Richard Lipton, MD, in a press release. "Rhinitis exacerbates migraine, as these results suggest, treating rhinitis may provide an important approach to relieving headache in people with both disorders."

Many chiropractors can assist patients in the natural management of both migraine headache and allergies. Getting adequate treatment for both conditions may be crucial for reducing the frequency of migraine headache.
 
References
Martin, VT. Chronic rhinitis and its association with headache frequency and disability in persons with migraine: Results of the American Migraine Prevalence and Prevention (AMPP) Study.Cephalalgia 2013; 10.1177/0333102413512031.


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New research shows that spinal adjustments can result in immediate improvements in cervical joint function. A new study from Korea Nazarene University shows that cervical manipulation, also called neck adjustments, can significantly improve joint position sense, which may improve neck mobility in patients with neck pain or whiplash.

Joint position sense is a major component of proprioception, or the body's awareness and ability to control your limbs without looking at them. Patients with neck pain and whiplash injuries have been found to have impaired joint position sense in their neck and upper limbs. This may limit the ability of the joint to move fluidly with speed and accuracy. Poor joint position sense in neck pain patients has also been tied to symptoms of dizziness. Earlier research has shown that neck adjustments, commonly used by chiropractors, can improve elbow joint position sense. However, there have been no studies on the effects of neck adjustments on healthy individuals without neck pain.

Korean researchers examined the effects of neck adjustments on the joint position sense in a group of 30 healthy volunteers. Half the volunteers were treated with neck adjustments and light massage while the other half were treated with massage only for a control. Joint position sense was determined by measuring joint position error before and after the interventions using a digital dual clinometer. The participants were shown twice how to position their necks at six different angles (such as 35 degrees flexion and a 35 degree extension) and then were asked to recreate that angle on their own. The difference in the position measured and the correct angle was calculated as the joint position error.

All participants showed improvements in joint position sense after treatment. However, participants who received a neck adjustment had significantly better improvements in two of the angles measured (left lateral flexion and left rotation) compared to the massage-only group. The researchers suggested that massage had the capacity to improve joint position sense, but that the combined treatment of neck adjustments and massage was the most effective for increasing range of motion. They concluded by recommending that cervical joint manipulation and massage by used in combination when treating patients with reduced joint position sense due to decrease range of motion, neck pain, or whiplash.

The findings suggest that chiropractic neck adjustments could immediately improve cervical range of motion, which may help to explain why patients may experience reduced neck pain after a single session of chiropractic care.
 
Reference
Gong, Wontae. Effects of cervical joint manipulation on joint position sense of normal adults. Journal of Physical Therapy Science 2013;  25:721723.
Haavik H, and Murphy B. Subclinical neck pain and the effects of cervical manipulation on elbow joint position sense. Journal of Manipulative and Physiological Therapeutics 2011; 34(2):88-97. doi: 10.1016/j.jmpt.2010.12.009. 

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Going on a daily 20 minute walk can decrease your risk of back pain by up to 32% if you're overweight, according to new research.

Earlier studies have shown that being overweight, obese, or inactive increases your risk of back pain, but this is one of the first major studies to use objective measures to track activity levels with accelerometers. The study, published in the Spine Journal, included 6, 796 adults who participated in the National Health and Nutrition Examination Survey.

The results confirmed that the more overweight a person is, the more likely they are to suffer from back pain. The risk of low back pain was 2.9% in normal weight people (BMI 20-25), 5.2% in overweight people (BMI 26-30), 7.7% in obese people (BMI of 31-35), and 11.6% in ultra obese people (BMI of 36 or more). (A 5? 6? person weighting 165 is considered overweight by these measures, while another 5? 6? person weighing 190 is considered obese.).

At the same time, "incredibly modest" changes in physical activity was found to significantly cut the risk of back pain. The average overweight individual experienced a 32% reduced risk of back pain if they increased their amount of moderate physical activity by fewer than 20 minutes per day. (Moderate activity could be brisk walking, gardening, or riding a bicycle.) In ultra obese individuals, increasing activity levels by just 1 minute per day reduced the risk of back pain by 38%.

These findings provide hard data for what chiropractors and other spinal specialists have noticed for years. That's why many chiropractors support patients in weight loss to prevent and reduce back pain. In fact, earlier research has shown that not losing weight may interfere with the benefits of physical therapy and other noninvasive treatments for back pain.

Currently there are two main theories to explain why obesity increases the risk of back pain. It's possible that the extra weight creates mechanical changes affecting the spine, or that metabolic changes lead to hormonal changes and inflammation. While scientists have yet to determine the exact causes, it's clear that your weight and risk of back pain are closely connected.
 
References
Fauber, J. Milwaukee Journal Sentinel/MedPage Today. October 10, 2013. Accessed Novemeber 25, 2013. http://www.medpagetoday.com/MeetingCoverage/AdditionalMeetings/42209
Smuck M, et al. Does physical activity influence the relationship between low back pain and obesity? Spine Journal 2013; pii: S1529-9430(13)01649-5. doi: 10.1016/j.spinee.2013.11.010.

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