March 14, 2001 [Volume 2, Issue 6]

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In this issue of To Your Health:

• Maximizing the Patient-Doctor Encounter
• Exercise for Back Pain: Just Do It
• Fish Reduces Women's Stroke Risk
• Dietary Supplements: Not Always Risk-Free
• Tai Chi Improves Strength and Endurance
  

Ancient Chinese, Greek and Egyptian literature document how physicians encouraged the use of touch for therapeutic and diagnostic purposes. Thousands of years later, touch still serves as the primary basis of healing. Touch is not a quaint ritual relegated to ancient beliefs or distant lands, but a vital part of everyday clinical skills.

From the first handshake to the last pat on your shoulder, your doctor touches you. You do not know your physician intimately, yet clinicians have privileged access to your intimate life. Such access is essential for good doctor-patient relationships. However, as a patient, it's important to maximize this relationship by establishing communication and trust with your doctor. Here are a few general guidelines to keep in mind when undergoing any type of clinical examination:

• Ask for explanation as to the purpose of any specific examination.
• Ask for specific requirements of examination.
• Expect permission of touch to be obtained.
• Require a third party if it is a sensitive exam.
• Require privacy for dress and undress.

The moral to this story is simple but important: Establish a relationship with your doctor, one based on a clear understanding by both parties of what is to be expected. The road to health is not always easy, but doctors are there to help us make the ride as smooth as possible.

Reference: Bowers LJ. Intimate strangers: issues of touch. Topics in Clinical Chiropractic 2000: Vol. 7, No. 3 pp 11-18.

Exercise for Back Pain: Just Do It

A variety of exercise guidelines are recommended for managing back pain. Exercise has long been regarded as an effective mechanism by which to cope with pain, mentally and physically.

It is generally agreed that the sooner you become active, the sooner your condition will improve. However, which specific exercises you perform may not be as important as the fact that you do exercise, according to a recent study in the Journal of the Neuromusculoskeletal System. The study noted that, although many specific forms of exercise have been suggested for dealing with lower back pain (especially in recent years, with the increasing popularity of "cure-all" exercise devices and regimens), the more pressing concern may be to focus on certain general objectives during your workout, such as:

• decreasing pain;
• strengthening muscles;
• decreasing structural stress;
• increasing fitness levels;
• stabilizing "moveable segments";
• improving posture; and
• improving mobility.

If you're suffering from back pain, schedule an appointment today with your doctor. For more information on back pain, go to https://www.chiroweb.com/tyh/backpain.html.

Reference: Hooper PD. Does it matter what exercises patients do for back pain? Journal of the Neuromusculoskeletal System 2000: Vol. 8, No. 2, pp49-52.

Fish Reduces Women's Stroke Risk

If you still haven't incorporated fish into your diet, now may be the time to reconsider. Higher fish intake has been associated with reducing the risk of certain types of stroke in middle-aged women. Several mechanisms may be involved, especially the high doses of certain fatty acids commonly found in fish.

According to an extensive study conducted among nurses, women with the highest levels of fish intake had a 49% reduction in the risk of blood clot related stroke. This positive relationship was incremental, in that each higher level of fish intake (i.e., one or less times per month vs. two or more times per month, and so on) correlated with less risk for stroke. It's important to note that among women who used aspirin on a regular basis, there was only a minimal change in stroke risk. However, these results provide evidence that consumption of fish, particularly the fatty acid component of fish, are associated with a reduced risk of total stroke and blood clot related strokes.

Your doctor can tell you more about the benefits of fish and other foods, and outline a complete nutritional program suitable to your specific needs. Additional information on nutrients can also be found on line at https://www.chiroweb.com/tyh/nutrients.html.

Reference: Hiroyasu I, Rexrode KM, Stamfer MJ, et al. Intake of fish and omega-3 fatty acids and risk of stroke in women. The Journal of the American Medical Association 2001: Vol. 285, No. 3, pp304-311.

Dietary Supplements: Not Always Risk-Free

For more than 5,000 years, the Chinese have made extensive use of ma huang, primarily for respiratory conditions. In the United States, ma huang and a variety of dietary supplements that contain ephedra alkaloids are widely promoted and used as a means of losing weight and increasing energy.

Alkaloids are chemical substances that contain nitrogen. Some of the more familiar members of the alkaloid family include caffeine, cocaine, morphine, and nicotine. As you've probably already guessed, alkaloids may not be the safest of ingredients, a suggestion investigated in a recent study in The New England Journal of Medicine. The study revealed that cardiovascular and central nervous system side-effects were frequently attributable to use of dietary supplements containing ephedra alkaloids. Hypertension was the single most frequent side-effect, followed by heart palpitations; tachycardia (an abnormally fast heartbeat - more than 100 beats per minute); stroke; and seizures.

The authors concluded that the use of substances that contain ephedra alkaloids may pose a health risk to individuals, and that a better understanding of the adverse effects of such dietary supplements is needed. These recommendations echo other recent advisements from the health care community on the safety of dietary supplements. Talk to your health care professional about the pros and cons of dietary supplements before you begin taking any specific product. For general information on herbal supplements, visit https://www.chiroweb.com/tyh/herbs.html.

Reference: Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. The New England Journal of Medicine 2000: Vol. 343, No. 25, pp 1833-1839.

Tai Chi Improves Strength and Endurance

Originally practiced as a form of martial arts, tai chi consists of breathing exercises performed in conjunction with a series of body postures. People who practice tai chi often report attaining feelings of inner peace and a heightened self-awareness.

In a recent issue of the Archives of Physical Medicine and Rehabilitation, researchers found that tai chi "may be beneficial to elderly individuals for muscular strength and endurance enhancement," and that it is safer, more cost-effective and easier to perform than other forms of exercise. Subjects participated in a voluntary six-month tai chi program, which took place every morning in a park near the university. Each session consisted of a 20-minute warmup period, 24 minutes of Yang tai chi training, and 10 minutes of cooldown exercises.

Both men and women appeared to show "significant" increases in muscle strength after participating in the tai chi program. The researchers note many advantages that tai chi may have over other conventional exercise routines. Unlike most physical activities, tai chi requires no specialized equipment and can be performed in a variety of locations, making it both practical and cost-effective.

Reference: Lan C, et al. Tai Chi Chuan to improve muscular strength and endurance in elderly individuals: a pilot study. Arch Phys Med Rehabil May 2000;81:604-607.

For more information on acupuncture and Oriental medicine, visit https://www.acupuncturetoday.com

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