Thursday, August 27, 2015

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The Great Challenge: Chiropractic Adjustments vs. Acupuncture vs. NSAIDs!





Wouldn’t it be nice if we could assess three common types of treatment for neck and back pain to determine which is the most effective? Here is a look at three studies that compared three popular forms of care for chronic spinal pain to determine the short-term and more importantly, the LONG-TERM benefits of chiropractic manipulation, acupuncture, and non-steroid anti-inflammatory drugs (NSAIDs, like Advil).
The FIRST published study included a pilot group of 77 patients complaining of chronic spinal pain (neck, mid-back, or low-back pain). These patients were separated into one of the three treatment groups and received either NSAIDs, acupuncture, or chiropractic manipulation. Patients received care for four weeks with outcome measures (questionnaires) used to assess changes in pain and disability. After a 30-day time frame, only patients who received chiropractic manipulation (CM) reached a level of statistically significant improvement, supporting CM to offer the best SHORT-TERM BENEFITS for those with chronic back/neck pain.
The SECOND study included 115 patients, again randomized, to receive either one of the same three treatments, but this time the outcome data was gathered two, five, and nine weeks after the start of treatment. Again, those who received chiropractic manipulation (CM) experienced the best overall improvement at nine weeks.
The THIRD study involved follow-up from the same patient group from the SECOND study two years later. Once again, participants completed outcome assessments that measure pain and disability. This time, the results showed that only patients in the chiropractic manipulation group maintained long-term improvements in pain and disability.
There have been other studies looking at the efficacy and benefits of SMT (spinal manipulative therapy) both in comparison with other forms of care (as presented here) as well as with different conditions or diagnoses. Perhaps the most exciting results were published in 2008 by the International Bone and Joint Decade 2000-2010 Task Force on Neck Pain. They divided patients into four groups (Group 1: Neck pain with little to no interference with activities of daily living – ADLs; Group 2: Neck pain that limits ADLs; Group 3: Neck pain with radiculopathy or radiating arm pain from a pinched nerve; Group 4: Neck pain with serious pathology such as cancer, fracture, infection, and/or systemic disease.) The researchers concluded that chiropractic care was highly recommended especially in Grades 1 and 2 (which includes the majority of neck pain sufferers). Interestingly, many multidisciplinary physician groups now incorporate chiropractic care as part of their “team” approach, which also offer pain management in the form of medications, injections, PT, and when necessary, surgery. They have seen the value of spinal manipulation for neck pain and often seek out chiropractic because it’s safe, beneficial, and cost effective!
We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for neck pain or headaches, we would be honored to render our services.  Visit http://www.olsonchiropracticcenter.com for more information.

Tuesday, January 20, 2015

Neck Pain - When Should I Come In?


Neck Pain – When Should I Come In?


Neck pain is one of the most common complaints patients have when they come to a
chiropractic office for the first time, second only to low back pain. Neck pain
affects all of us at some point in life, and for some, it can become a chronic,
permanent problem that can interfere with many desired activities and lower
their quality of life. There are many different causes, and prompt evaluation
and treatment is important is some cases.

Neck pain and stiffness are the two most common symptoms that present for
evaluation and treatment. This can be located in the middle of the neck and/or
on either side and can extend down to the shoulders and / or chest. It can
contribute to or cause tension headaches that can travel up the back of the head
and sometimes behind the eyes. Pain often increases with neck movement, such as
when turning the head to check traffic while driving and/or it can hurt at rest
while held in static positions, such as when reading a book. Neck pain can come
on gradually or quickly and often cannot be traced to a specific injury or cause
making it a challenge to figure out. While neck pain is often not serious or
life-threatening, there are causes that should be evaluated promptly. If you
wake up with acute neck pain associated with very limited range of motion, this
may be due to torticollis, or wry neck, and prompt treatment helps it resolve
more quickly than “waiting it out.” Torticollis can be caused by exposure to a
draft, changes in weather, trauma, or after a cold or flu. When in doubt, come
in for an evaluation and treatment, as anxiety associated with the “fear of the
unknown” only adds to the stress associated with neck pain and it’s ALWAYS best
to be “…safe than sorry!”

Numbness or tingling may accompany neck pain and can be located in the face,
arms, hands, and/or fingers. This is one of those times to come in promptly, as
these symptoms may indicate the pinching of a nerve root in the neck. There are
MANY chiropractic treatment approaches that effectively treat nerve root
pinching, and treatment should NOT be delayed. Other common symptoms may include
clicking, crunching, or grinding noises, technically called crepitus, which may
or may not be benign. If the noise is accompanied by pain, especially if it
radiates down to the shoulder blades or arms (either side or both), it’s time to
promptly come in. Any time symptoms occur acutely or come on fast, it’s best to
get evaluated as soon as possible.

Dizziness is another common symptom that can result from neck problems and is
often associated with movement such as rising from laying or sitting. Certain
positions of the neck can also bring on dizziness. This is sometimes caused by
the “stones” in the inner ear shifting out of position and is technically called
BPPV or “benign paroxysmal positional vertigo.” When this occurs, we can usually
manage it very well with treatment and specific BPPV exercises. Other times,
dizziness may be due to a restriction in blood flow reaching the brain. In which
case, a prompt evaluation is VERY appropriate, especially if blackouts occur.

Sleep interruption or difficulty falling asleep are other good reasons to seek
prompt evaluation and treatment. Sleep loss can lead to many problems such as
excessive fatigue, tiredness, irritability, and just generally feeling poor!
Remember, prompt care usually results in prompt resolution!

We realize you have a choice in whom you consider for your health care provision
and we sincerely appreciate your trust in choosing our service for those needs.
If you, a friend, or family member requires care for neck pain, we would be
honored to render our services.  Visit http://www.olsonchiropracticcenter.com for
more information.

Saturday, April 5, 2014

The Many Faces of Carpal Tunnel Syndrome


Carpal Tunnel Syndrome (CTS) was first reported in the late 1800’s and the first
surgery was noted in 1933. In the beginning, CTS surgery was rarely performed,
reportedly because the nerve pinch was present somewhere before the median nerve
reached the wrist or carpal tunnel. In brief, possible compression sites include
the cervical nerve roots (C5-7), the brachial plexus, thoracic outlet, above the
elbow, in the proximal and/or mid forearm, and finally at the wrist / carpal
tunnel.
Estimating the frequency of CTS is challenging due to the fact that the pinch or
entrapment may include more than one area before the wrist resulting in double
and multiple crush syndromes. One European study reported the incidence of CTS
at 5.8% in women and 0.6% in men while another reported 3.4% in the United
States. Even the causation of CTS is all over the board. For example, the annual
incidence of CTS in automobile workers ranges between 1-10%, while in a fish
processing plant, it was reported to be as high as 73%! To make this even more
challenging, the cause of CTS is commonly associated with other conditions such
as diabetes and pregnancy. In diabetics, CTS ranges between 14% and 30% and
those who are pregnant have a 2% incidence. Even harder to report is the
incidence of median nerve pinching proximal to the wrist as this ranges between
as little as 1% to as high as 75% for pronator tunnel syndrome in already
symptomatic women. Gender is also a factor as women are reported to be four
times more likely to develop CTS than men. If there is NO other condition
associated with CTS, the term “idiopathic” is applied, and this reportedly
occurs 43% of the time.
Another issue making CTS a challenge to diagnose is the many risk factors
associated with it, and sometimes studies are published that contradict one
another about the possible risk factors. There are studies that report CTS is
more likely to occur with conditions including: 1) Jobs or activities associated
with wrist flexion or extension; 2) Hysterectomy without ovary removal; 3)
Obesity; and 4) Varicosities in men. Some studies indicate risk criteria such
as: 1) Use of birth control pills; 2) Age at menopause; 3) Diabetes; 4) Thyroid
dysfunction; 5) Rheumatism; 6) Typing; and, 7) Pinch grasping. One study
reported the highest incidence to occur in those with previous wrist fracture
(Colles’ fracture), and common conditions included rheumatoid arthritis,
hormonal agents or ovary removal, diabetes, and pregnancy. Another study
reported obesity and hypothyroid as being risk factors, but not all studies
support that theory. Certain medications have been reported to be associated
with higher CTS risk including: 1) Insulin, 2) Sulfonylureas (diabetes meds); 3)
Metformin; and 4) Thyroxin.
As doctors of chiropractic, we perform a thorough history, examination, and
offer MANY non-surgical, non-pharmaceutical ways of treating CTS. Some of these
approaches include: 1) Joint and soft tissue manipulation of the neck, shoulder,
elbow, forearm, wrist, and hand; 2) Wrist splinting, especially at night; 3)
Vitamin B6 and anti-inflammatory nutrients; 4) Home exercises for the neck, arm
and hand; 5) Work station / ergonomic evaluations; 6) Dietary counseling for
various conditions listed previously; 7) Co-management with primary care,
rheumatology, neurology, orthopedics, and others.
We realize you have a choice in whom you consider for your health care provision
and we sincerely appreciate your trust in choosing our service for those needs. 
If you, a friend, or family member requires care for Carpal Tunnel Syndrome, we
would be honored to render our services.  Visit http://www.olsonchiropracticcenter.com for more information.

The "Aging" Lower Back - Part 1



Low back pain (LBP) can arise from many causes. Nearly everyone has or will
suffer from LBP at some point in time, though it is most common in the
30-year-old to 50-year-old group and it affects men and women equally. However,
what about the elderly population and low back pain? Let’s discuss back pain
unique to the geriatric population…
We’ve all heard of the “wear and tear” factor as it applies to clothing,
automobiles, shoes, and tires, but it affects our bones and joints too! A
condition that none of us can fully avoid is called osteoarthritis (OA). OA is
the “wear and tear” factor on our joints, particularly the smooth covering
called hyaline cartilage located on the surfaces of all moving joints. It’s the
shiny, silky smooth surface that we’ve all seen at the end of a chicken leg when
we separate it from the thigh. Osteoarthritis is the wearing away of that shiny,
smooth surface and it can eventually progress to “bone-on-bone” contact where
little to no movement is left in the affected joint. Bone spurs can also occur
and be another potential generator of back pain. OA is NOT diagnosed by a blood
or lab test but rather by an accurate history, physical examination, and
ultimately, an x-ray. However, when the low back is affected by OA, it may not
even hurt! Yes, in some cases, there may be a significant amount of OA on an
x-ray and that patient may not have significant problems. Or the opposite can
occur and some patients with very little arthritis can have a lot of back
trouble. It’s FREQUENTLY very confusing. The “take-home” message with OA is
that, in and of itself, it does not always generate pain. This is why the
history, physical examination, and the response to treatment (chiropractic
adjustments, exercise, and possibly some lifestyle changes in diet and activity)
are MORE important than the amount of arthritis found on the x-rays. Ultimately,
we will ALL get OA sooner or later. It’s usually a slow, gradual process that
may slowly change our activity level. Ironically, KEEP MOVING is the best advice
we can give to the patient with OA.
There are a number of conditions associated with OA that affect the spine and
respond well to chiropractic treatment. Degenerative disk disease (DDD) is one
of those conditions found in association with OA. In fact, another name for OA
is “degenerative joint disease” (DJD)! The normal anatomy of the intervertebral
disk (IVD) consists of a thick, tough outer layer of fibroelastic cartilage and
a central “nucleus” that is more liquid-like and allows the IVD to function like
a shock absorber. As we age, the water content gradually “dries up” and the
shock absorbing quality is lost.
As chiropractors, we address OA (DJD) and DDD with a number of HIGHLY EFFECTIVE
treatments but most important (in many cases) is the use of spinal manipulation
or adjustments. “Exercising the joint” with manipulation and mobilization
reduces the tightness and stiffness associated with OA and DDD. Exercises are
also important and can give the OA/DDD patient a way of controlling this
condition on their own. Diet, activity modification/encouragement, and periodic
adjustments help a lot! Next month, we will continue this discussion!
We realize you have a choice in whom you consider for your health care provision
and we sincerely appreciate your trust in choosing our service for those needs. 
If you, a friend, or family member requires care for back pain, we would be
honored to render our services. Visit http://www.olsonchiropracticcenter.com for more information.

Saturday, March 1, 2014

Chiropractic and Neck Pain in Children | Yankton Chiropractor | Brian Olson SD



Children have been treated by chiropractors for spinal problems ever since
chiropractic was founded in 1895, and neck pain is no exception. Neck pain is
surprisingly common in kids, though not quite as common as it is in adults,
reaching a similar occurrence rate by age 18. Studies conducted in the United
States and in other countries report similar findings, leaving one to conclude
there is a high prevalence of neck pain in kids all over the world. There are
many causes of neck pain with a few being unique to children and some that could
be a warning sign of something dangerous, such as meningitis. But far more
commonly, neck pain in kids is NOT dangerous. Let’s take a look!
Looking at neck and shoulder pain in high-school-aged students, 931 males
between 16 and 19 years of age were surveyed. More than two out of five students
(44.3%) had recurrent neck and shoulder pain more than once a week with an
overall prevalence of 79.1%. THAT’S A LOT! The study reported the student’s
average sitting time was 10.2 hours a day, 59% did NOT sit up straight, and
11.9% reported that they stretched their neck and shoulders regularly throughout
the day. Students with recurrent neck and shoulder pain also reported frequent
fatigue and depressed moods. Looking specifically at 1,122 backpack-using
adolescents, 74.4% were classified as having back or neck pain. When compared to
non- or low use backpackers, there was nearly a two times greater likelihood of
having back/neck pain! Also, females and those with a large body mass index
(overweight) were also significantly associated with back/neck pain. Lastly,
they found when compared to adolescents with no back/neck pain, those with pain
carried significantly heavier backpacks.
Another common cause of neck pain in adolescents is a condition called
torticollis or, “wry neck.” This is basically a muscle spasm of certain neck
muscles that rotate and extend the head from the neutral / normal position,
often described as being “stuck” in this position. Though there are several
types of torticollis, it can be triggered by almost anything including a change
in weather, sleeping in a draft, following an infection like a cold or flu,
maintaining a faulty prolonged posture, certain types of medications, and many
others. Some studies describe torticollis as usually improving within one to
four weeks, but in the hands of a chiropractor, it usually takes two to three
days for the acute pain to subside and one week to completely finish the job! Of
course, this varies depending on the case. Infants can be born with “congenital
torticollis,” which occurs in 0.3 to 2.0% of newborns. Here too, chiropractic is
VERY effective.
We realize you have a choice in whom you consider for your health care provision
and we sincerely appreciate your trust in choosing our service for those needs. 
If you, a friend, or family member requires care for neck pain, we would be
honored to render our services.  Visit http://www.olsonchiropracticenter.com for more
information.