August 30, 2000 [Volume 1, Issue 21]

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In this issue of To Your Health:

• For Low Back Pain, Look to Chiropractic
• Investigate Before You Operate
• Muscle Now = Muscle Later?
• Smoking, Pregnancy Just Don't Mix

It's estimated that eight out of 10 people suffer from back pain at some point in their lives. A recent study on the prevalence of musculoskeletal disorders in the U.S. estimated that 40 million Americans aged 20-64 will experience "frequent" low back pain (LBP), with 15% suffering from LBP lasting up to two weeks at a time!

There's no clear-cut way to resolve back pain, but chiropractic offers the most promise. Witness the results of a recent study comparing one-month outcomes for 93 chiropractic patients and 45 medical patients with chronic, recurrent LBP. Chiropractic care included spinal manipulation and various forms of physiotherapy, averaging four patient visits. Medical care averaged one visit and frequently included the prescription of anti-inflammatory drugs.

Patients treated by chiropractors showed better overall improvement and satisfaction after one month than patients treated by family physicians. Chiropractic patients showed substantial decreases in pain severity, functional disability, and pain quality, while medical patients showed only minimal improvements with regard to the first two measures, and deterioration in the third.

If you're suffering from low back pain, the road to recovery may not be an easy one, but it begins with chiropractic! Schedule a consultation with a chiropractor today, and for more information on back pain, visit https://www.chiroweb.com/tyh/backpain.html.

Reference: Nyiendo J, Haas M, Goodwin P. Patient characteristics, practice activities, and one-month outcomes for chronic, recurrent low-back pain treated by chiropractors and family medical physicians: a practice-based feasibility study. Journal of Manipulative and Physiological Therapeutics, May 2000: Vol. 23, No. 4, pp239-45.

Investigate Before They Operate

Because all surgeries involve some form of risk, the decision to operate should never be made lightly. Controversy over physician recommendations for surgical procedures abounds, with several studies suggesting that some patients may not receive vital care, while others are exposed to unnecessary risks.

The Agency for Health Care Policy and Research (AHCPR) sponsored a series of studies intended to improve the quality of patient care, specifically practice guidelines and criteria for surgical procedures. One of these studies, the Women's Health and Hysterectomy Project, focused on hysterectomy because "it is the second most common operation women have, and there are significant concerns among researchers and the public that it might be overused."

Researchers examined 497 women from nine Southern California managed care organizations who had the procedure between August 1993 and July 1995. A staggering 70% of the hysterectomies were judged "inappropriate" based on published criteria.

Hysterectomy involves removal of the cervix, uterus, fallopian tubes, and sometimes the ovaries. Although uterine or cervical cancer, fibroid tumors, and other serious conditions may make this type of surgery unavoidable, the authors of this study note that they found "substantial evidence of underuse of established diagnostic and therapeutic regimens before proceeding to hysterectomy."

Before you go under the knife, get a second opinion from a health care professional, and make sure you're fully informed of possible nonsurgical options.

Reference: Broder MS, Kanouse DE, Mittman BS, et al. The appropriateness of recommendations for hysterectomy. Obstetrics & Gynecology 2000: Vol. 95, pp199-205.

Additional information on women's health can be found at https://www.chiroweb.com/tyh/women.html

Muscle Now = Muscle Later?

You're working hard at the gym every week, lifting weights and building muscle strength and endurance. In fact, you're absolutely thrilled with your appearance and the various health benefits your commitment to fitness is providing. But what will all this muscle do for you when you get older? It may help you grow old gracefully, according to a study in Medicine & Science in Sports & Exercise that investigated the influence of muscle strength and endurance on later functional limitations.

Nearly 4,000 men and women (aged 30 to 82) received a strength evaluation between 1980 and 1989, then completed a mail-in survey in 1990. Strength parameters included one-repetition lifts using bench press and leg press machines, and a sit-up test (maximum repetitions in one minute). Functional limitations addressed in the followup survey included the ability to perform specific physical activities and the incidence of "new health problems" - heart attack, diabetes, high blood pressure, cancer or arthritis.

Results: At five-year followup, seven percent of men and 12 percent of women reported at least one functional limitation. Subjects with greater measured strength and endurance at baseline had a lower incidence of functional limitations compared with subjects with lower strength/endurance at baseline.

These findings emphasize the value of strength maintenance throughout life. The authors recommend that adults increase aerobic physical activity and activities that increase muscular strength.

Reference: Brill PA, Maceral CA, Davis DR, et al. Muscular strength and physical function. Medicine & Science in Sports & Exercise 2000: Vol. 32, No. 2, pp412-16.

For more information on sports and fitness, go to https://www.chiroweb.com/tyh/sports.html

Smoking, Pregnancy Just Don't Mix

If the overwhelming evidence linking cigarette smoking to poor health hasn't convinced you to quit, perhaps recent research may help you consider the health of your child before taking a smoke during pregnancy.

Consider a study that appeared in the October 1999 issue of Pediatrics (www.pediatrics.org). Researchers utilized four questionnaires (two administered to the mothers of 1,974 children at 16 weeks' gestation, a third at 30 weeks, and the fourth at eight months postpartum) to gather data on the potential relationship between maternal smoking and hospitalization of the child during the first months of life.

Children whose mothers smoked 15 or more cigarettes per day (about 3/4ths of a pack) during pregnancy were twice as likely to be hospitalized during their first eight months of life, compared with children whose mothers refrained from smoking during pregnancy. Common reasons for hospitalization included respiratory, gastrointestinal and skin problems, and this risk associated with smoking was independent of the father's smoking habits or the child's gender.

Over the past two years, we've reported the results of numerous studies on the detrimental effects of smoking. If you're a former smoker who's managed to quit, or if you've always been a nonsmoker, bravo! You'll be healthier for it. If you're a current smoker who'd like to quit but can't seem to break the habit, your doctor can give you information on the most effective method for you.

Reference: Wisborg K, Henriksen TB, Obel C, et al. Smoking during pregnancy and hospitalization of the child. Pediatrics (online version), Oct. 1999: Vol. 104, No. 4, ppe46.

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