June 8, 2000 [Volume 1, Issue 15]

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In this issue of To Your Health:

• Bed Rest Ineffective for Back Pain
• NSAIDs May Contribute to Congestive Heart Failure
• Vitamin C Lowers Women's Risk of Gallbladder Disease
• Never Too Late to Start Exercising

Rest has been standard recommendation for low back pain (LBP) for years, especially within the medical community. This recommendation persists despite research evidence suggesting that prolonged rest serves no purpose and may delay return to work and resumption of normal activities.

This report from the International Paris Task Force on Back Pain outlines the role of activity in the treatment of back pain. In addition to presenting numerous recommendations and summaries, the authors offer the following key points as summary to their findings:

• Bed rest is contraindicated in subacute and chronic cases of LBP.

• In acute cases, bed rest should neither be enforced nor prescribed.

• If authorized (based on pain indication), bed rest should be for the shortest duration possible.

• Patients whose pain is intense enough to justify bed rest should be referred for a specialized back pain evaluation if daily activities have not been resumed after 10 days of strict bed rest (defined as getting up only to go to the bathroom) and adequate pain therapy.

Are you suffering from low back pain? If you think bed rest is the solution to your pain, think again. As the authors note (see above), if your pain is intense enough to justify bed rest, schedule a “specialized back pain evaluation” with an expert in managing and resolving back pain -- your doctor of chiropractic!

Reference: Abenhaim L, Rossignol M, Valat JP, et al. The role of activity in the therapeutic management of back pain: Report of the International Paris Task Force on Back Pain. Spine, Feb. 15, 2000 (supplement): Vol. 25, No. 4S, pp1-25.

If you’d like to find out more about back pain and how chiropractic can help, visit https://www.chiroweb.com/tyh/backpain.html

NSAIDs May Contribute to Congestive Heart Failure

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for migraines, sprains, strains, and countless other conditions in which pain and/or inflammation result. NSAIDs have come under fire in recent years, with mounting evidence suggesting possible dangerous side effects associated with their use.

One of the most severe potential side effects may be congestive heart failure (CHF) in susceptible patients, according to a study in the March 27, 2000 issue of the Archives of Internal Medicine. Patients admitted to hospitals with a primary diagnosis of CHF (365 cases) were compared with patients without CHF (658 cases) admitted to the same hospitals for other conditions. Patients were interviewed to gather data on recent use of aspirin and other NSAIDs.

Results: Use of NSAIDs in previous week doubled the risk of hospital admission for CHF. Additionally, patients who reported taking higher levels of NSAIDs in the previous week were more likely to be admitted for CHF than patients taking lower levels.

Why this relationship exists is unknown, although the authors speculate that possible drug interactions (NSAIDs and other drugs used by heart patients) may contribute to the problem. They emphasize that “NSAIDs should be used with caution in patients with a history of cardiovascular disease.” Talk to your doctor about the potential dangers of NSAIDs and other commonly prescribed drugs.

Reference: Page J, Henry D. Consumption of NSAIDs and the development of congestive heart failure in elderly patients. Archives of Internal Medicine, March 27, 2000:160, pp777-84.

Vitamin C Lowers Women's Risk of Gallbladder Disease

The gallbladder’s most important function is to store bile, a substance manufactured in the liver which helps the body digest fatty foods. Cholesterol is a normal component of bile; if too much cholesterol accumulates in the gallbladder, gallstones eventually result. Because estrogen is an important risk factor for gallstone formation (it increases the concentration of cholesterol in bile), women are at particular risk for the disease.

Experimental animal studies suggest that ascorbic acid (vitamin C) may play a role in preventing gallstones, an observation that led to a recent study published in the Archives of Internal Medicine. As part of the Third National Health and Nutrition Examination Survey, 7,042 women and 6,088 men provided data on vitamin C intake and the incidence of gallbladder disease. Results showed that increasing serum levels of ascorbic acid were related to a reduced risk for clinical and asymptomatic gallbladder disease in women, but not in men. Specifically, each standard increment increase in ascorbic acid level reduced the risk of a woman getting the disease by 13%.

Your chiropractor can provide you with more information on these results and suggest nutritional guidelines appropriate to your needs.

Reference: Simon JA, Hudes ES. Serum ascorbic acid and gallbladder disease prevalence among U.S. adults. The Third National Health and Nutrition Examination Survey (NHANES III). Archives of Internal Medicine 2000: Vol. 160, pp931-36.

For additional information on women’s health, go to https://www.chiroweb.com/tyh/women.html

For more information on nutrition, visit https://www.chiroweb.com/tyh/nutrients.html

Never Too Late to Start Exercising

No doubt you’ve heard about the many documented benefits of physical activity: decreased incidence of disease and increased vitality and wellness. Are you participating in a consistent exercise routine? If you’re not, it’s never too late to start.

Consider a study that appeared in the British Journal of Sports Medicine which examined the potential relationship between balance and postural control deficits and the incidence of falls. Specifically, the authors sought to determine whether it is of value for the elderly to start physical and sporting activities (PSA). Sixty five men and women (aged 60-85) were divided into four groups based on reported levels of PSA (always practiced; never practiced; lately begun; or stopped at an early age), and a series of posture tests provided information on overall balance control and other variables.

Consistent participation in physical and sporting activities optimized balance control. Subjects who never practiced PSA had the worst balance control; subjects who always practiced PSA had the best control. Most interesting perhaps was the observation that subjects who had begun PSA late in life had nearly the same postural control as those who had always practiced PSA.

As the authors suggest in their conclusion, “…PSA are extremely useful for elderly people even if it has not been a lifelong habit.” These findings are particularly important, as accidental falls are the primary cause of death among the elderly population. Whatever your age, take advantage of the many benefits of consistent physical activity. For more information, contact your chiropractor.

Reference: Perrin PP, Gauchard GC, Perrot C. Effects of physical and sporting activities on balance control in elderly people. British Journal of Sports Medicine 1999: Vol. 33, No. 2, pp121-26.

For more information on senior health issues, visit https://www.chiroweb.com/tyh/senior.html

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