Both Back Surgery and Spinal Manipulation Present Risks

Patients who are suffering with neck pain and considering both surgery and chiropractic treatment should be aware of the risks and discuss them openly with their healthcare providers.

In the case of any surgery, there may be serious complications from anesthesia, excessive bleeding, blood clots that lead to pulmonary embolism and infection. These general risks are added to the more specific risks of surgery on the spine. These may include a dural tear (the dura surrounds the spinal cord and a tear can cause leaking of cerebrospinal fluid), spinal cord injury and persistent or increased pain from an unsuccessful procedure.

Spinal manipulation may also cause dangerous complications. Spinal manipulation has been associated with disc herniation, cauda equina syndrome (pain, weakness or loss of bladder and bowel function) and vertebrobasilar accident (a tear in a major artery of the neck). These complications can be just as serious as the complications associated with surgery.

If similarly severe complications may result from either course of treatment, how can a patient weigh the risk of each option? Managing risk isn’t just about understanding “worst-case”-type scenarios, it’s also about understanding how likely these and other complications are to occur. This is where some additional research findings can help.

How Frequently Do Serious Complications Actually Occur?

In April 2010, the journal Spine (published by Lippincott Williams & Wilkins) included an article that summarized the incidence of adverse events in spinal surgery based on the authors’ review and analysis of the existing literature. They found complication rates for spinal surgery ranging from 5% to 19%. Similarly, the American Journal of Medicine in 2002 published the results of a study that examined the incidence of serious adverse events for spinal manipulation. By comparison, researchers involved in that work reported complication rates ranging from one out of every 400,000 manipulations to one out of every two million.

So now we can see that the risk of a serious adverse event from spinal manipulation is extremely low relative to the risk posed by surgery. That’s one reason that the Mayo Clinic and many other reliable healthcare organizations around the world consider spinal manipulation very safe when performed by someone trained and licensed to provide this type of chiropractic care.

Whenever we talk about risk, it’s always important to remember that almost everything we do can be ‘associated’ with some type of adverse event. Driving a car, handling scissors, and even eating dinner can all lead to serious complications. The best way to handle these risks, including the risks of spinal manipulation, is to understand them and keep them in perspective. Healthcare providers are uniquely qualified to help you do that. If you or someone you care about is interested in chiropractic care—including its potential benefits and risks—please call our Concord chiropractic office at (925) 681-0801;  Pleasant Hill chiropractic office at (925) 676-8200; and Brentwood chiropractic office at (925) 308-7575 to make an appointment.

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References:

Dekutoski, MD, M. B., Norvell, PhD, D. C., Dettori, PhD, J. R., Fehlings, MD, PhD, FRCSC, FACS, M.G., & Chapman, MD, J. R. (2010).

Surgeon Perceptions and Reported Complications in Spine Surgery. Spine, 35(9S). Retrieved August 31, 2011.

Staff, M. C. (n.d.). Chiropractic adjustment: Risks – MayoClinic.com. Mayo Clinic. Retrieved August 31, 2011.

Stevinson, MS, C., & Ernst, MD, PhD, E. (2002). Risks Associated With Spinal Manipulation. The American Journal of Medicine, 112(7), 566-571. Retrieved August 31, 2011. 

The B group of vitamins is probably the most commonly misunderstood of the vitamins, simply because the B vitamins are several distinct vitamins lumped together. Additionally, the fact that the vitamins in this group are known by both letter, number and name is confusing to many people. Here is a quick list of the B vitamins found in the Vitamin B complex group.

• B1 is also thiamin
• B2 is also riboflavin
• B3 is also niacin
• B5 is also pantothenic acid
• B6 is also pyridoxine
• B7 is also biotin
• B9 is also folic acid
• B12 is also cobalamin

You should note that there are four additional substances in the B complex group, though they are not known as vitamins. They are choline, lipoic acid, PABA and inositol. When you purchase B complex vitamins, these four will not be included. Furthermore, one or two of the recognized B vitamins may also be omitted. B5 and B7 are so widely available in food that most people get plenty of these vitamins even if they aren’t eating a healthy diet.

There are gaps in the numbers of the B vitamins because our understanding of them has evolved over time. Initially there was only a single B vitamin. Later it was recognized that what had been referred to as a single vitamin, actually had many components. These component parts where numbered 1,2,3,4, etc… Even later it was determine that some of these components (such as B4) did not meet the criteria of being a vitamin and they were dropped. That’s how we ended up with 8 B-vitamins with non-sequential numbers.

One thing that all the B vitamins share is that they are water soluble. Any excess vitamin B is not stored, but rather is excreted in the urine. That means that all the B vitamins need to be constantly replenished from our diets.
B vitamins are found in whole unprocessed foods including grains, meats and vegetables. In general, the more processed that food is, the lower the content of all the B vitamins. A daily multi-vitamin is a great way to ensure that you are getting all the B complex Vitamins your body needs on a daily basis.

One of the most commonly recognized uses of the B vitamins is an energy booster. Many popular energy drinks that claim a natural boost of energy without sugar or caffeine are high in B vitamin complex.

There are too many components in the Vitamin B complex to discuss the health benefits, deficiencies and Recommended Daily Allowance for the whole group in a single article. Look for future articles about each of these important nutrients.

If you have questions about your current nutrition and supplement plan, just ask. Our chiropractors from Concord, Brentwood and Pleasant Hill are here to help!

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Bibliography:

B Vitamins MedlinePlus. (n.d.). Retrieved 8 10, 2011, from National Institutes of Health.

Micronutrient Information Center. (n.d.). Retrieved 8 11, 2011, from Linus Pauling Institute at Oregon State University.

While a wide variety of over-the-counter and prescription medications have been developed to relieve this pain, they generally do little to address the underlying cause of the problem. In addition, many of these compounds can have unwanted side effects, particularly if they’re used often, over a prolonged period of time or in combination with other medicines. A growing awareness of both the limitations and risks of pharmaceuticals has led many headache sufferers to explore alternative approaches to managing them, including chiropractic.

Understanding Headaches

Headaches occur for many reasons and can vary greatly in their intensity and duration. They may arise on their own (these are termed “primary headaches” and account for about 90% of all headaches) or be triggered as a result of some other health condition (described as “secondary headaches”). Chiropractic physicians most commonly encounter three types of headaches in their work:

Tension headaches are primary headaches that are brought on by unrelieved muscular contractions in the head, neck and shoulders, usually as a result of stress that cannot find an outlet. These muscular contractions can themselves become the source of broader tension and stress throughout the body, setting in motion a feedback loop that eventually produces a headache.

Migraine headaches are also primary headaches. They are sometimes referred to as vascular headaches because they happen when blood vessels in the head suddenly expand, or “dilate”. However, we know that the nervous system and genetic factors are also leading contributors. Sufferers report a wide range of triggers and related symptoms. Research into the exact cause of migraines is ongoing, and the condition has stubbornly resisted efforts to find a pharmaceutical “silver bullet”.

Cervicogenic headaches are secondary headaches produced when pain begins in the neck or back of the head and is referred to the forehead or the area behind, in and around the eyes. Trauma, chronic tension and disease are some of the more common initial sources of neck pain that is referred to the head. Trigger points in the neck, shoulder blade and spine may also be sources of these headaches, though they can be much more difficult to identify.

How Martin Family Chiropractic Can Help

There is a large and growing body of medical research that suggests chiropractic care can be effective in preventing or reducing the frequency and severity of primary headaches. There is also some evidence that it may have benefits for cervicogenic headache sufferers.

Chiropractic manipulation of the spine and neck is used to improve the alignment of the spine and relieve muscle tension. It also reduces nerve irritation and improves vascular flow. Your chiropractic physician may also include massage and other therapies as part of a well-rounded treatment plan. He or she will likely suggest exercise, stretching and relaxation techniques as well as nutritional strategies designed to help prevent future headaches.

If you or someone you know is looking for lasting relief from chronic headaches, we encourage you to call our doctors of chiropractic today. The sooner you make the call, the sooner we can help you put an end to the suffering.

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References

Headaches and Chiropractic. American Chiropractic Association. Accessed August 2011.

Encyclopedia of Alternative Medicine. AltMD. Accessed August 2011.

Information for Patients. American Headache Society. Accessed August 2011

Research Spotlight: Study of Spinal Manipulative Therapy for Neck-Related Headaches Reports Findings on Dose and Efficacy. National Institutes of Health, National Center for Complementary and Alternative Medicine. Accessed August 2011.

National Institutes of Health MedlinePlus. Accessed August 2011.

The Reasons Behind the “Back to Basics” Movement
For a majority of runners either considering or actively experimenting with barefoot running, it’s not about trying to rediscover their inner caveman. Rather, these individuals are looking for ways to improve comfort, reduce wear and tear on their bodies and add years to their running lives. A 2009 bestselling book called “Born to Run”, written by Christopher McDougall, evangelizes barefoot running and ties many of our species’ running-related maladies to the use of shoes. But does running barefoot actually solve the problem? And do the obvious risks outweigh the potential benefits?

What Does Science Say About Running Barefoot?

The idea is controversial among medical researchers and healthcare providers as well as among runners themselves. At the center of the debate is our understanding of the musculoskeletal system and the biomechanics of running, and it’s fair to say that the evidence today doesn’t point clearly in one direction or the other. In fact, the leading researchers on the topic at Harvard University’s Skeletal Biology Lab are careful to point out that none of the information they present is meant to answer questions about how people should run and whether running barefoot or with shoes is any more likely to cause(or prevent) any particular type of injury. So if you’re thinking about adopting the barefoot running lifestyle yourself, it’s worth considering a handful of points about which there seems to be some general agreement:

1. We run much differently when we wear shoes. For example, long-time shoe wearers (that’s most Americans) tend to take longer strides and land further back on the foot, producing a harder heel strike that would be uncomfortable or painful without shoes. Shoe wearers also generally lean forward more. By contrast, experienced barefoot runners are far more likely to have a forefoot or midfoot strike and will tend to run in a more upright position.

2. The differences in running style mean that impacts and stresses are distributed and absorbed differently by the body. Research suggests that the hard heel strike creates a higher-frequency impact that tends to move upward through a runner’s bones, while the lower-frequency impact of landing on the forefoot travels through the muscles and soft tissue.

3. The fact that most Americans wear shoes from an early age means that our bodies adapt to it. And we probably adapt in a couple of different ways. Not only do we learn to move differently when we have shoes to absorb the impact and protect us from cuts and scrapes, we also strengthen (or weaken) different parts of our bodies in the process. If you’ve “grown up” running in modern athletic shoes (which enable long strides and hard heel strikes), it’s unlikely that your feet and calves have the same muscle strength as a those of an experienced barefoot runner. It’s also unlikely that you have the same sorts of calluses.

4. Just because we’ve walked and run in shoes for most of our lives doesn’t mean we can’t do something different, but it does mean that we should be smart about making a change. The last thing you want to do is to inadvertently increase the risk of some types of injury in the course of trying to prevent others (upping the odds of sprains, strains and tendonitis to reduce the likelihood of stress fractures, for instance). It takes time for a runner to adjust his or her form and for the body to make its own adjustments. For this reason, it’s important to make a gradual change and pay close attention to your running technique. Your own body will provide some feedback on your progress, but education and common sense should play a central role in helping you set appropriate goals and expectations.

5. Whether you choose to run in shoes or to run barefoot, good form matters. And it matters a lot. Countless coaches and trainers have gone on the record saying that bad form contributes to more running-related injuries than any other single factor. Dr. Daniel Lieberman recently provided a wonderful quote to Gretchen Reynolds of the New York Times:

“Humans may have been built to run barefoot, but we did not evolve to run barefoot with bad form.”

If you’re a runner looking for a healthier approach–especially if you are experiencing pain or have a history of injury, your Martin Family chiropractic physician can help! As experts in diagnosing, treating (and, even better, preventing) muscular and skeletal problems, our chiropractors use a variety of proven techniques to relieve pain, promote healing and improve performance. Best of all, they can help keep you running at your best! Call our office today to make an appointment.

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References & Resources:

• Lieberman, D., et. al., Biomechanics of Foot Strikes & Applications to Running Barefoot or in Minimal Footwear. Harvard University Skeletal Biology Lab. Accessed August 2011.
• McDougall, Christopher, “Born to Run: A Hidden Tribe, Superathletes, and the Greatest Race the World Has Never Seen” 2009.
• Reynolds, Gretchen, “Are We Built to Run Barefoot?”. The New York Times. June 8, 2011. Accessed August 2011.

Back pain relief is just one component of chiropractic care, but it is often a patient’s first introduction. Back pain is horribly debilitating affecting all aspects of work and personal life. If you are suffering from back pain, you are not alone. Here are a few facts about back pain that may (or may not) surprise you.

• Back pain is the number one disability for those under age 45.

• In the United States of America alone, there is an expected 31 million people with lower back pain at any given time.

• Back pain runs second, after only the common cold, as the top reason for visiting a healthcare provider in the United States.

• Experts place the likelihood of any person to experience some type of back problem in their lifetime at about 80%. That’s four out of every five people!

• Over 50 billion dollars are spent per year in the pursuit of clearing up cases of back pain.

• Around 30 to 40 percent of all workplace absences are due to back pain.

• Approximately one quarter of U.S. adults reported having low back pain lasting at least one whole day in the past three months, and 7.6 percent reported at least one episode of severe acute low back pain within a one-year period.

• One-half of all working Americans admit to having back pain symptoms each year.

• Approximately 2 percent of the U.S. work force is compensated for back injuries each year

• Lower back pain accounts for two thirds of all back pain-related cases.

• More than two-thirds of back strains are caused by lifting and other exertions like pulling and pushing.

• Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.

The key to proper treatment of back pain is to understand the cause. Remember, pain is always a sign that something else is wrong and if continually ignored may lead to more serious harm. Chiropractors are experts in assessing the root cause of your back pain and putting you on the right course to recovery.

Get adjusted. Visit Concord chiropractors and see how can they help you with your back pain. Chiropractic adjustment is a term used by chiropractors to describe their techniques to spinal manipulation. The benefits of chiropractic adjustment ranges from short-term, pain relieving effects to long-term health and wellness and preventive care.

You may want to consider massage therapy for your back pain. Massage therapists can put pressure on your the muscles in your back that are bothering you which could help alleviate some of your pain. If being used for the purpose of helping back pain, some insurances may even cover massage services.

Consider adding massage into your lifestyle. Studies have found that massage not only benefits you physically (by alleviating back pain), but also mentally. Massage therapy has been linked to lowering anxiety and depression, as well as, increasing the quality of the patient’s sleep! All of which are stressors that can be triggers to back pain.

Make sure to consult your doctor about alternative methods to treatment as well, including acupuncture and possibly even massage. Other methods as well are available, and these solutions might be of aid to help alleviate your chronic back pain. Acupuncture is a rather old and proven treatment, so be open to different suggested treatments that your doctor might recommend.

Back pain is one of the most common complaints of pregnant women. The extra load the baby places in front of the mother causes the body to compensate by leaning backward, putting strain on the lower back. The best treatment for this type of pain is massage therapy to loosen up those tight muscles.

Try a massage for back pain. A gentle massage can help to ease back pain, relaxing tight muscles and gets the blood flowing. Even if you can’t see a professional masseuse, you can give yourself a mini-massage. Put your hands on your waist, and place your thumbs at either side of the spine. Press gently, moving up, down, and around in a small circle. If you find a tender area, pay special attention to it. Work gradually up either side of your spine, an inch at a time.

For a lighter amount of back pain one good option that you have is to get a massage. This can be a great way to relax and remove the symptoms of the back pain, but remember that it will do nothing to help with the causes of why you have this pain.

By following the tips that you have read in this article you should be able to get some badly needed relief. Give the straegies time to work. You are also advised to continue to work with your doctor, and check with him if you have any doubts about the suitability of any of these tips in your case.

Related articles

• Some Surprising Statistics About Back Pain (martinfamilychiropractic.com)

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Chiropractors have suggested the use of water for lots of reasons. One of the problems that we Americans appear to have is that we don’t consume ample water each day. The common thread of thinking is that you must have around eight glasses of water every day. It makes your body hydrated which also then keeps the oxygen level high in your body. The problem is that many people are taking in more caffeine as well as an excessive amount of carbonated drinks with lots of sugar.

The trouble with these carbonated drinks and a lot of caffeinated drinks is that there are toxic compounds in those refreshments. The sugar may also greatly increase the chance of a person getting high blood pressure particularly if you consume way too much of it. People need lots of water in order to keep the body cleansed and hydrated. Think about the very fact that our brain is about 80% filled with water. Moreover, water is what makes our digestive system operate and keeps our respiratory system in order too. The other thing is that the disc between our spines is also fluent in mostly made of water. It is therefore imperative that you drink water and keep those discs in good shape.

Surely chiropractic doctors also insist that drinking water should be free of other sugar induced compounds. There are several companies around that are adding high glucose levels of ingredients which can be just as bad as putting in a number of tablespoons of sugar. Of course, some water supply is not very appetizing and as such the explanation why people have gotten used to drinking vitamin enhanced water. But again a lot of them also have added glucose which isn’t essentially a good thing to have.

There are lots of reasons why a lot of people don’t wish to drink water. They include things of course that may sustain your clothes with residue that’s difficult to see until it has poured on you. You will even find some kind of water which includes iron whether oxidized or soluble. They are not easy to detect until it actually oxidizes in the air and results in “rest” stains.

Whatever you decide to do, be sure that you consume sufficient water so you can keep your body going strong. It also helps to ensure that you don’t wear out yourself through dehydration. Eight glasses of water is not difficult amount to drink. This runs specifically true if you’re taking it the whole day instead of aiming to cram it in all one time. Take into account, that if you’re an athlete or playing sports you want to drink much more water because your body will lose it in the efforts that you broaden in your sport.