November 8, 2000 [Volume 1, Issue 26]

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In this issue of To Your Health:

• When Work Hurts
• Pacifiers May Increase Ear Infection Risk
• The Do's and Don'ts of Stretching
• Keeping Bones Strong with Soy

Whether you're lifting boxes, operating heavy machinery, or sitting at a desk all day, back pain can strike at any time. Occupational low back pain (LBP) is a major cause of disability and missed work days, and evidence implicates psychosocial factors, perhaps more significantly than biomechanical workload, in the progression and persistence of acute and chronic LBP.

As a result, many treatment programs and management strategies are adopting a multidisciplinary approach toward LBP in the workplace. Early intervention involving light mobilization and information/recommendations on their condition may be the most cost-effective method of returning patients to normal levels of activity - a premise investigated in a recent study involving 457 LBP patients. All patients were suffering from 8-12 weeks of low back pain and were randomized into two groups: an intervention group given information and advice to stay active, and a control group treated with conventional primary health care, tending toward recommendations of bedrest and reduced activity.

Patients in the intervention group had higher rates of return to full work status than patients receiving conventional care. Specifically, 51.9% of patients in the intervention group returned to full-duty work within three months vs. 35.9% of controls, and this disparity was maintained at six and 12-months follow-ups (61.2% vs. 45% within six months, 68.4% vs. 56.4% within 12 months).

Your doctor of chiropractic can provide you with more information on the potential causes and most effective methods of managing low back pain.

Reference: Hagen EM, Eriksen JR, Ursin H. Does early intervention with a light mobilization program reduce long-term sick leave for low back pain? Spine 2000: Vol. 25, No. 15, pp1973-76.

For more information on low back pain, go to https://www.chiroweb.com/tyh/backpain.html

Pacifiers May Increase Ear Infection Risk

It's estimated that 75-85% of children in Western countries habitually use a pacifier during infancy and early childhood. Although pacifier use has long been considered a relatively harmless habit, recent evidence points to increased risks of oral/dental problems and recurrent ear infections (acute otitis media, or AOM).

A study in Pediatrics examined pacifier use as a potential contributor to AOM by pairing 14 well-baby clinics in Finland, with one clinic in each pair designated for intervention and the other clinic serving as the control. At intervention clinics, parents were instructed to limit their children's pacifier use during visits to the clinic; at control clinics, no such recommendation was offered.

Results showed that in 272 children at the intervention clinics, pacifier use decreased by 21% and the incidence of AOM decreased by 29% compared with children (212) at control clinics. Overall, children who did not use a pacifier continuously suffered 33% fewer episodes of AOM than children who did use a pacifier, leading the authors to suggest limiting pacifier use to "moments when the child is falling asleep."

Reference: Niemela M, Pihkari O, Pokka T, et al. Pacifier as a risk factor for acute otitis media: a randomized, controlled trial of parental counseling. Pediatrics, Sept. 2000: Vol. 106, No. 3, pp483-88.

The Do's and Don'ts of Stretching

If you're one of those natural athletes who finds it unnecessary to stretch or warm up before competition, you're probably setting yourself up for a serious muscle strain or tear. The proposed benefits of stretching include a direct or indirect decrease in muscle stiffness, and as any athlete will admit, muscle stiffness is a primary concern before, during and after strenuous physical activity.

Instead of ignoring the value of stretching and risking a painful, frustrating injury, why not take note of these recommendations on stretching that appeared in the August 2000 issue of The Physician and Sportsmedicine:

• Heat, ice and warmup all increase the effectiveness of stretching, although only warmup is likely to prevent injury.
  
  
• One 30-second stretch per muscle group is sufficient to increase range of motion in most healthy people.
  
  
• Contract-relax and hold-relax stretching techniques appear to be the most effective for increasing range of motion; however, the muscular contraction necessary for these techniques may increase the risk of injury compared with more static stretches.
  
  
• Individuals may be able to determine appropriate stretching duration and style by holding a stretch until no additional benefit is obtained.

Your doctor of chiropractic can tell you more about appropriate stretching techniques and outline a comprehensive exercise and wellness program suitable to your needs.

Reference: Shrier I, Gossal K. Myths and truths of stretching: individualized recommendations for healthy muscles. The Physician and Sportsmedicine, Aug. 2000: Vol. 28, No. 8, pp1-10.

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

Keeping Bones Strong with Soy

Why include soy in your diet? According to the Food and Drug Administration, consumption of 25 grams of soy protein daily may reduce the risk of cardiovascular disease, and recent research suggests other benefits. (See "Reducing Cholesterol with Soy Protein" in the October 2000 To Your Health.)

Recent animal experiments provide evidence that soy can also influence bone density, although the authors of this study from the American Journal of Clinical Nutrition believe they are the first to examine this potential association in women nearing menopause. Sixty-nine women were randomly assigned to receive soy protein isolate or whey protein for 24 weeks, and bone mineral density (BMD) and bone mineral content (BMC) were measured before and after treatment.

Results: Bone loss was observed in the control group but not in the soy group. The authors note that these results could translate into a decreased lifetime risk of osteoporosis, and suggest that soy supplementation could prove an effective alternative for hormone replacement therapy in postmenopausal women.

Soy milk, soy cheese, soy burgers and tofu are popular soy products, but the most convenient source may be soy protein isolate, a powder that can be mixed into drinks or combined with different foods. Your doctor of chiropractic can provide you with more information on soy and other foods key to a healthy diet and lifestyle.

Reference: Alekel DL, St. Germain A, Peterson CT, et al. Isoflavone-rich soy protein isolate attenuates bone loss in the lumbar spine of perimenopausal women. American Journal of Clinical Nutrition 2000: Vol. 72, pp844-52.

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