Medical doctors are increasingly ignoring the recommended guidelines for treating back pain, a new study from the Journal of American Medical Association finds.
Researchers from the Beth Israel Deaconess Medical Center in Boston examined records for 23,918 doctor visits related to back pain between 1999 and 2000. They discovered that medical doctors are actually getting worse at employing evidence-based treatments.
Current guidelines from the American Medical Association recommend that acute back pain be treated first with conservative, active treatments like chiropractic care and exercise rehabilitation. Over-the-counter non-steroidal anti-inflammatory drugs can be used to ease short-term pain, rather than narcotics like Oxycontin which can actually make matters worse, according to recent research.
However researchers found that physicians are overprescribing narcotics and overusing expensive testing.
During the study period, prescriptions for narcotics grew from 19.3% to 29.1%, reflecting a national trend of growing opioid use. Lead researcher, Dr. John Mafi, explained that during the 1990s medical doctors were widely accused of ignoring patients' pain. While some of the criticism was valid, many physicians overreacted by doling out more serious painkillers. Now around 43% of patients with back pain show signs of substance abuse disorders, Mafi and his colleagues found.
Doctors are also relying too heavily on imaging techniques no longer deemed necessary for every type of spinal pain. Use of MRI and CT scans grew from 7.2% to 11.3% during the study period, despite research demonstrating such scans are not always useful for many cases of back and neck pain. Although these scans do not harm the patient, they typically don't find anything wrong, and can cost around $1,000 per a scan.
That may be why patients under standard medical care tend have more medical costs associated with their back pain treatment compared to chiropractic patients, according to a recent study. Chiropractic patients can also expect to receive evidence-based treatments like exercise therapy and spinal adjustments. A study of military personnel with back pain earlier this year found that those treated by a chiropractor had better results compared to patients treated with standard medical care alone.
Mafi JN, et al. Worsening trends in the management and treatment of back pain. JAMA 2013; doi:10.1001/jamainternmed.2013.8992.
New research helps to explain why chiropractic is so effective for low-back pain. Using MRI scans, researchers were able to document the immediate benefits of chiropractic adjustments.
Patients with low-back pain have restricted mobility in the lumbar spine that results in degenerative changes and fibrous adhesions within the joints of the vertebrae.Researchers hypothesized that chiropractic adjustments increase gapping between the joints of the vertebrae, which breaks up adhesions and allows the joints to move freely.
In a new study, 112 patients with low-back pain were randomly assigned to receive either chiropractic adjustments, side-posture positioning, or two control treatments.
Immediately after the treatment, they received an MRI scan that allowed researchers to analyze spinal gapping.
The chiropractic patients had the most substantial spinal gapping, and patients treated with a combination of chiropractic adjustments and side-posture positioning had the greatest reduction in pain.
This study shows how chiropractic can restore spinal health to decrease disability and pain.
Cramer GD, et al. Magnetic resonance imaging zygaphosphyseal joint space changes (gapping) in low back pain patients following spinal manipulation and side-posture positioning: a randomized controlled mechanisms trial with blinding. Journal of Manipulative and Physiological Therapeutics 2013; pii: S0161-4754(13)00055-9. doi: 10.1016/j.jmpt.2013.04.003.
Many parents of children with chronic-health conditions struggle to help their child manage ongoing pain and symptoms. They also worry about the potential effects certain medical treatments and drugs can have on their child's health. That could be why more parents are now seeking natural treatment options like chiropractic.
In a recent study, chiropractic was one of the most commonly-used alternative therapies for children with chronic-health problems.
The study included more than 900 parents of children being treated at cardiology, gastroenterology, neurology, oncology, and respiratory clinics in Canada. Parents were asked about their child's use of alternative therapies and products.
Nearly half of parents said their child used an alternative therapy in addition to receiving conventional treatments. Almost 10% of parents said they'd pursue complementary and alternative medicine (CAM) prior to conventional treatments, and 5% said they used alternative medicine in place of traditional care.
Of the two hospitals included in the survey, at one hospital, 71% of children had received CAM therapies, while 42% had used CAM therapies at the other. The most common CAM therapies were massage, chiropractic, relaxation, and aromatherapy.
Several parents also said their child took multivitamins and minerals and had used herbal supplements and homeopathic remedies in the past. However, parents did not always communicate with primary-care physicians about their child's use of herbal supplements and minerals, which had some observers worried.
Herbal and dietary supplements can change how the body reacts to certain drugs, warned Dr. Josephine Briggs, director of the National Center for Complementary and Alternative Medicine, who commented on the issue in recent article from The Huffington Post. She encouraged patients to talk with physicians about their herbal and dietary supplement use, and reminded physicians to take the time to ask.
The study suggests that the use of CAM therapies like chiropractic among children is on the rise. Studies show that chiropractic care is a safe, effective treatment for children with musculoskeletal complaints, headache, and more.
Adams D, et al. Complementary and alternative medicine use by pediatric specialty outpatients. Pediatrics 2013; doi: 10.1542/peds.2012-1220.
If you spend your days in an office, you're probably familiar with the aches and pain that come with long hours of computer work. A new study showed that up to 89% of office workers suffer from some sort of musculoskeletal pain; whether that be in the neck, back, shoulders, wrists, or knees.
Although this pain can start as a dull ache at work, if left unaddressed, it may develop into a repetitive motion injury or other serious disorder. Seeking early treatment can reduce your risk for developing these conditions. Studies suggest that chiropractic care can relieve and prevent carpal tunnel syndrome, back pain, and neck disorders associated with working.
Work-related Pain Study
To estimate the prevalence of musculoskeletal (MSK) conditions in office workers, researchers surveyed 91 employees who worked at a university office setting. The employees rated their pain and responded to questionnaires on job satisfaction and health.
Neck pain was the most common complaint, affecting 69.2% of workers. Lower back pain was the second most common (58.2%), followed by knee problems (41.8%), shoulder concerns (35.2%) and pain in the upper back (34%). People with MSK complaints were also more likely to be dissatisfied with their jobs. Wrist, shoulder, and low-back pain were most the significant predictors of poor job satisfaction.
Other recent research has shown that stressed, over-worked employees have an increased likelihood of suffering from back pain, headache, and shoulder problems.Stress of course isn't the only thing causing musculoskeletal pain. Poor posture, unhealthy work stations, and previous musculoskeletal injuries can exacerbate the risks associated with repetitive motions or long hours hunching over a computer.
Doctors of chiropractic can create treatment plans that address the multifaceted nature of work-related pain. Not only do chiropractors work to correct dysfunctions in the joints and spine, they'll also help you identify appropriate preventive measures through posture correction, ergonomic training, and exercise therapy. Some studies suggests that chiropractic adjustments may also improve your body's response to inflammation and stress, providing you with protective benefits against further MSK injuries.
Loghmani A, et al. Musculoskeletal symptoms and job satisfaction among office-workers: A Cross- sectional study from Iran. Acta Medica Academica 2013;42(1):46-54. doi: 10.5644/ama2006-124.70.
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Fortunately, a recent study offers hope to sciatica patients: chiropractic care can speed the recovery from sciatica flare ups and allow patients to return to work sooner (2).
The study evaluated 44 Norwegian workers after they came to the hospital with severe sciatica pain. Most of those patients had been experiencing pain for three or more weeks prior to their hospital visit.
The hospital chiropractor examined each patient to evaluate his/her posture and gait, range of motion, and palpation of the lumbar spine.
The chiropractic then performed various joint adjustments to the spine and other limbs that had been injured through patients compensating for pain. Ice treatment was also used to relieve soft tissue soreness.Patients were treated daily in the hospital and later three times a week for the first two weeks. Some patients needed additional follow-up treatment but typically did not exceed 14 treatments.
In matter of 21 days, 91% of patients returned to work full-time. Two patients returned to work part time. Researchers concluded this study demonstrates the potent benefits of collaboration between chiropractors and orthopedic surgeons. Chiropractic care can put an end to your sciatica pain so you can begin living your life fully again.
Posted in chiropractic, Chiropractic News, Sciatica, sciatica treatment, Understanding Sciatica
- Arana E, Marti-Bonmati L, Vega M, et al. Relationship between low back pain, disability, MR imaging findings and health care provider. Skeletal Radiology 2006;35(9):641-7.
- Orlin JR, Didriksen A. Results of chiropractic treatment of lumbopelvic fixation in 44 patients admitted to an orthopedic department. Journal of Manipulative and Physiological Therapeutics 2007;30:135-139.