Anti-inflammatory Drugs (NSAIDs) Effect on Spine Pain "Clinically Unimportant"

Trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes: "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."  "All NSAIDs have been associated with cardiovascular and gastrointestinal risks," state the authors, who found "NSAIDs were associated with higher number of patients reporting gastrointestinal adverse effects in the short-term follow-up (i.e., <14 days)."

The authors referenced additional studies showing acetaminophen/Tylenol is ineffective, and opioids appear only to offer small benefits for this condition.  When this result is taken together with those from recent reviews on acetaminophen and opioids, it is now clear that the three most widely used, and guideline-recommended medicines for spinal pain do not provide clinically important effects over placebo.

Treating Lower Back Pain

        An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as the first options for acute, subacute, and chronic low back pain, rather than medications, as previously recommended in the original 2007 guideline.

        Based on two background evidence reviews and a systematic review sponsored by the Agency for Healthcare Research and Quality (AHRQ), the guideline partially updates the 2007 joint ACP / American Pain Society guideline and features three recommendations for all clinicians treating adult patients presenting with low back pain.

        Patients should select nonpharmacologic treatment such as massage or acupuncture with spinal manipulation.  For patients with chronic low back pain, clinicians and patients should initially select nonpharmacologic treatment with exercise and multidisciplinary rehabilitation.

        In patients with chronic low back pain who have had an inadequate response to nonpharmacologic therapy, clinicians and patients should consider pharmacologic treatment with nonsteroidal anti-inflammatory drugs as first-line therapy, or tramadol or duloxetine as second-line therapy.

        Thatcher Chiropractic is located at 3535 American Drive in Colorado Springs, Colorado near the intersection at Austin Bluffs Parkway and Academy Boulevard.  Dr. Thatcher treats many patients with low back pain and the office accepts most major health insurance.  For more information you can visit our website at thatcherchiropractic.com.  If you have additional questions or if you wish to schedule an appointment, please contact us by phone.  You can reach us at (719) 574-3700.

Abstaining from Headache Medicine May Cure Drug Rebound Headache

        An article published in the Western Journal of Medicine in 1998, discussed the etiology of some chronic daily headaches.  This article recommends discontinuation of the daily headache medicine for some people who suffer from chronic daily headaches.  The daily use of medication to treat headache symptoms often causes drug rebound headaches.  Furthermore, failure to stop taking daily pain medication in some cases, the article warns, can lead to drug resistant headaches.

        A review of the medical literature found that up to 78 percent of patients studied who suffered from chronic daily headaches experienced a marked lessening of symptoms just by cutting out daily use of headache symptom medicine.  The study reports that many common prescription and non-prescription medicines, including narcotics, pain pills containing caffeine, or as little as three aspirin per day can cause a rebound headache.

        Symptoms from drug-induced, rebound headaches are usually relieved after patients go through a wash-out period of 8 weeks without taking daily medication, although symptoms often improve much sooner.  Once a person stops taking daily pain medication they may feel worse for about 2 weeks before the improvement trend begins.

        Thatcher Chiropractic is located at 3535 American Drive in Colorado Springs, Colorado near the intersection at Austin Bluffs Parkway and Academy Boulevard.  For more information, you can visit our website, thatcherchiropractic.com.  If you have questions or to schedule an appointment, please feel free to contact us by phone at (719) 574-3700.

Low Back Pain: Adjustments Superior to Muscle Relaxants

        A study published in the Journal of Manipulative and Physiologic Therapeutics revealed the superiority of adjustments when compared to prescription muscle relaxants in the treatment of low back pain.

        One hundred ninety two patients with low back pain were assigned to one of two intervention groups (adjustments with placebo medicine or muscle relaxants with sham adjustments) or to a control group (sham adjustments with placebo medicine).

        After just two weeks, chiropractic adjustments with placebo medicine proved to be more effective than sham adjustments and placebo medicine and muscle relaxants and placebo adjustments in reducing low back pain.  Overall, further improvement was seen in patients' low back pain severity after four weeks as judged by each outcome measure.  Therefore, if your lower back pain is not responding to muscle relaxants prescribed by your doctor, contact our office.

Thatcher Chiropractic is located at 3535 American Drive near the intersection at Austin Bluffs Parkway and Academy Boulevard in Colorado Springs, Colorado 80917.  For more information, you can visit our website: thatcherchiropractic.com.  If you have additional questions or wish to schedule an appointment, please feel free to contact us by phone at (719) 574-3700.

Old whiplash injury? It's still not too late for treatment!

        Whiplash injuries result from indirect injury to the cervical spine and produce a syndrome comprising headache, neck and upper back pain, arm nerve pain, or a combination of these.  Often times people with whiplash receive no treatment or the wrong kind of treatment following injury.  A study published in The Journal of Orthopedic Medicine entitled A Symptomatic Classification of Whiplash Injury and the Implications for Treatment further explored earlier evidence showing people with chronic (condition had gone on for more than 3 months) whiplash would benefit from chiropractic treatment.

Research!

        In this study, the objective was to determine which patients with chronic whiplash would benefit from chiropractic treatment.  The study design recognized three groups of patients.  Group 1 consisted of patients with isolated neck pain associated with restricted neck movement.  Group 2 consisted of patients with neurological symptoms or signs associated with a restricted neck movement.  Group 3 comprised patients who described an unusual group of symptoms with a bizarre distribution.

Outcome...

        The outcome of this study revealed that 72% of group 1 benefited from spinal manipulation and 94% of group 2 benefited from the same treatment.  However, only 27% of the group 3 patients improved following treatment.  The results of this study seem to confirm the efficacy of chiropractic, along with other previous research, in the treatment of chronic whiplash injury.  The authors of this study have documented through their literature review that chiropractic has been proven effective in the treatment of chronic whiplash.

       Thatcher Chiropractic is located at 3535 American Drive in Colorado Springs, Colorado 80917 near the intersection at Austin Bluffs Parkway and Academy Boulevard.  You can visit our website, thatcherchiropractic.com, for more information.  If you have additional questions or wish to schedule an appointment, please feel free to contact us by phone at (719) 574-3700.

Low Back Pain? ... It's commonly a Sacroiliac Syndrome

What is it?

        The sacroiliac joints are located on either side of the tailbone (sacrum) where it meets the pelvic bones.  Most people refer to the sacroiliac joint as their "hip."  A problem with the sacroiliac joint is referred to as a "sacroiliac syndrome."  This syndrome often comes as a result of pelvic joint and ligament sprain as a result of sudden injury or movement.  Sacroiliac Syndrome can also develop without a particular event.  In other words, the pain starts out of nowhere.  Results can be severe ligament and muscle injury and the inability to stand up straight without sharp pain in the lower back.  At times the pain can radiate into the leg(s).

Sacroiliac Syndrome accounts for approximately 25% of all low back problems.

How can I fix the problem? 

        Actually, following a detailed examination to confirm the diagnosis, the treatment is very quick and very effective.  The standard of care for this condition is exercise, stretching, and manipulation to the sacroiliac joints.  On occasion, physical therapy modalities are necessary in the early stages of a new problem.

       Thatcher Chiropractic is located at 3535 American Drive in Colorado Springs, Colorado 80917 near the intersection at Austin Bluffs Parkway and Academy Boulevard. You can visit our website, thatcherchiropractic.com, for more information and if you have additional questions or wish to schedule an appointment, please feel free to contact us by phone at (719) 574-3700.

Automobile Passengers Injured in Minor Collisions?

        Health care providers of many fields have long known injuries are common in what seems to be minor collisions.  The Archives of Physical Medicine and Rehabilitation published the article Clinical Response of Human Subjects to Rear-End Automobile Collisions confirming this observation with scientific methods.

What the Research Says...

        In this study, unsuspecting human beings were lap/shoulder belted into a Honda Accord, a curtain was hung directly behind the Accord and the subjects were given ear plugs so that the collision would be a surprise, and then a Volvo station wagon smashed into the Accord from behind at 2 1/2 and 5 miles per hour.  The study showed that many of the crash subjects hurt following the impact and, even for those who did not have pain or symptoms, they had measurable clinical deficits, comparing pre-accident with post-accident examinations.

What Should Accident Victims Do?


        Everyone involved in an automobile accident is not injured.  However, the research indicates that individuals involved in a motor vehicle accident, whether or not they are having pain or symptoms, should be examined by someone familiar with these types of injuries.


        Thatcher Chiropractic is located at 3535 American Drive near the intersection at Austin Bluffs Parkway and Academy Boulevard in Colorado Springs, Colorado 80917.  You can visit our website, thatcherchiropractic.com, for more information.  If you have additional questions or wish to schedule an appointment with us, please feel free to contact us by phone at (719) 574-3700.

Lower Back Problems: Why is Chiropractic Manipulation so Effective?

        If you have been bothered by your lower back, you are not alone.  Eight out of ten adults will experience a low back problem at some time in their lives.  And most will have more than one episode of acute low back problems.

        Most times, the symptoms are blamed on poor muscle tone in the back, muscle tension or spasm, back sprains, ligament or muscle tears or joint problems.  Sometimes nerves can be irritated by "slipped" discs causing buttock or leg pain.

        In the past, individuals with acute low back problems often subjected themselves to physical therapy, prolonged bed rest, uncomfortable traction, heavy sedation to cover the pain, injections, hospitalization, and even surgery.  These approaches were expensive and sometimes failed to produce favorable results.

        To learn more, the Agency for Health Care Policy and Research (AHCPR), a division of the U.S. Department of Health and Human Services, conducted a study.  After a multidisciplinary panel studied the problem for two years, they learned that spinal manipulation was indeed one of the preferred treatments for acute low back pain.  The Panel also endorsed the short term use of anti-inflammatory drugs and exercise.  Other studies since AHCPR have shown the effectiveness of manipulation for chronic low back problems.

      
        Thatcher Chiropractic is located at 3535 American Drive in Colorado Springs, Colorado 80917 near the intersection at Austin Bluffs Parkway and Academy Boulevard.  For more information, you can visit our website, thatcherchiropractic.com.  If you have additional questions or wish to schedule an appointment with our office, please feel free to contact us by phone at (719) 574-3700.

Foot Pain? Maybe it is Plantar Fasciitis

        Plantar fasciitis is a very common kind of tendonitis, but instead of a tendon it is the plantar fascia of the foot that is inflamed.  The plantar fascia is a sheet of connective tissue that stretches from the heel to the toes, spanning the arch (or bottom) of the foot.

        Muscle knots, technically known as myofascial trigger points, are a factor in almost all cases.  A trigger point is a section of super-contracted and irritated muscle tissue that can cause mild stiffness to extreme pain.  Trigger points not only cause pain and problems directly, but they also develop in response to other biomechanical problems.  Often times, the other biomechanical problems involve the joints and muscles of the legs, thighs, and lower back / pelvic region.

        The typical approaches used in the treatment of plantar fasciitis include shoe inserts, night splints, footwear assessment, stretching / massaging of the plantar fascia, injections, and surgery.  In this office, I add another dimension which is an assessment for muscle involvement and joint fixation of the lower back, legs, and feet.  If present, treatment of the joint fixation or muscle involvement coupled with the aforementioned approaches usually results in better, lasting relief.

       Thatcher Chiropractic is located at 3535 American Drive in Colorado Springs, Colorado 80917 near the intersection at Austin Bluffs Parkway and Academy Boulevard.  For more information, you can visit our website, thatcherchiropractic.com.  If you have additional questions or wish to schedule an appointment with Dr. Thatcher, please feel free to contact us by phone: (719) 574-3700.

Study Finds Manipulation Effective and Preventive in Chronic Low Back Pain

        A study published in the Journal of Manipulative and Physiological Therapeutics examined the efficacy of periodic manipulative treatment in patients with chronic low back pain, following an initial phase of intensive chiropractic manipulative treatments.

        The study assessed the pain and disability levels of 2 groups of participants.  The first group received 12 treatments in an intensive 1-month period, but no treatment in a subsequent 9-month period.  The second group received 12 treatments in an intensive 1-month period and also received spinal manipulation every 3 weeks for a 9-month period.

        The results of the study showed both groups maintained their pain scores at levels similar to the post-intensive treatments throughout the follow-up period.  For the disability scores, however, only the group that was given spinal manipulations during the follow-up period maintained their post-intensive treatment scores.  The disability scores of the other group went back to their pre-treatment levels.

        This study concluded that spinal manipulation is effective for the treatment of chronic low back pain.  Additionally, the study suggested the follow-up manipulations, in chronic low back pain, may be beneficial to patients to maintain subjective, post-intensive treatment disability levels.


        Thatcher Chiropractic is located at 3535 American Drive in Colorado Springs, Colorado 80917 near the intersection at Austin Bluffs Parkway and Academy Boulevard.  For more information you can visit our website, thatcherchiropractic.com and if you have additional questions or wish to schedule an appointment, please feel free to contact us by phone at (719) 574-3700.

Whiplash Injuriues: What to Expect When the Unexpected Happens

        Whiplash as a result of an automobile accident becomes increasingly prevalent as we enter the winter season in Colorado Springs.  Contrary to the name "whiplash," injuries are not caused by the neck being "whipped."  Injury occurs when the neck is forced through a rapid series of movements at a rate faster than the bones, muscles, and ligaments can react.

        Types of injuries that may occur include torn muscles and ligaments, fracture, nerve inflammation, or vertebral joint misalignment.  What this means to the victim is a combination of a few or many of the following symptoms: swelling or tenderness of the neck, headaches, dizziness, vision changes, pain in the upper extremities, or a reduced ability to turn and bend at the neck.  It is not uncommon that a victim experiences fatigue and irritability in conjunction with the symptoms previously mentioned.  The trauma of the event itself, added to pain and disability, however slight, often creates stress that may linger into the stages of treatment and recovery.

        As the body attempts to adapt to injury, especially in the case of lesser injuries, symptoms may not appear for a number of days or even weeks.  Following an accident, it is recommended in the scientific literature that people receive an examination with or without symptoms.  If you or someone you know is experiencing symptoms, the need for evaluation by a doctor of chiropractic is immediate.  If there is an injury, the sooner the proper treatment is received, the person is generally better off in the long term and needs less rehabilitative treatment.

        Thatcher Chiropractic is located at 3535 American Drive in Colorado Springs, Colorado 80917 near the intersection at Austin Bluffs Parkway and Academy Boulevard.  For more information you can visit our website, thatcherchiropractic.com and if you have additional questions or wish to schedule an appointment, please feel free to contact us at (719) 574-3700.

Slipped Disc? (What is it, the research, and how can I fix it?)

What is it?

        Slipped disc?  Herniated disc?  Ruptured disc?  These are just a few of the confusing terms associated with the injured spinal discs.  The disc is a small gelatinous mass situated between the spinal bones.  The disc serves as a connector, spacer, and shock absorber for the spine.  When healthy, discs allow normal turning and bending.  With an injured disc, patients can find themselves unable to move freely and suffering moderate to severe low back and/or leg pain.

What the current research says...

        Chiropractors have enjoyed a long history of successfully treating disc injuries.  A study was published in the prestigious Journal of Manipulative and Physiological Therapeutics regarding the manipulative treatment of disc herniations.  This study examined 27 patients who had a documented disc herniation on Magnetic Resonance Image (MRI) that corresponded with clinical findings.  The patients were treated using manipulation, physical therapy modalities, and exercise.  Treatment time ranged from 8 weeks to 6 months.  Following symptomatic and clinical resolution, a repeat MRI was performed.

        The study found that 22 of 27 (81.5%) had good clinical outcomes; 17 of 22 (77%) had not only good clinical outcome but also evidence of reduced or resolved disc herniation upon repeat MRI scanning.  Five patients (18.5%) had a marginal or poor outcome, but none had worse clinical signs or pain ratings at the end of the study.  At the beginning of the study, all 27 patients had left work because of the severity of pain; at follow-up 21 were back to work at their former occupations.


Thatcher Chiropractic is located at 3535 American Drive in Colorado Springs, Colorado 80917 near the intersection at Austin Bluffs Parkway and Academy Boulevard.  For more information you can visit our website at thatcherchiropractic.com and if you have additional questions or wish to schedule an appointment with us, please feel free to contact us by phone at (719) 574-3700.