April 11, 2001 [Volume 2, Issue 8]

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In this issue of To Your Health:

• Surgery for Back Pain? Think Again
• DASH Toward Good Health
• For Otitis Media, Try Patience Before Drugs
• Fiber-licious
• Acupuncture for Migraines
  

If you or someone you know is suffering from back pain, don't rush off to get surgery. There is considerable evidence supporting the value of conservative, nonsurgical treatments for back pain; further, a study in The New England Journal of Medicine asserts that surgery is overused for the treatment of back pain.

The study in question, which served to defined guidelines for low back pain (LBP) treatment, states that intervention is only recommended for back pain that persists beyond three weeks. Among the treatments recommended to minimize the recurrence of chronic LBP were intensive strengthening exercise and aerobic conditioning. Also, the study states that radiography and more advanced imaging procedures (i.e., MRI) are overused and should be considered only in cases of severe nerve pain, loss of function, or suspicion of underlying systemic disease. And here's the most important point: Surgery should only be considered after all conservative methods have failed.

Among these alternatives to medical intervention, the report finds chiropractic care to be effective and massage therapy to show promise. The study does not recommend bedrest for chronic LBP or pain from nerve involvement. The main recommendation, based upon this study's new guidelines, is a rapid return to normal activities, which includes a regular regiment of exercise to keep the back and leg muscles conditioned. For more information, consult your doctor and access online information at https://www.chiroweb.com/tyh/backpain.html.

Reference: Deyo R, Weinstein J, et al. Low back pain. The New England Journal of Medicine 2001:344(5), pp363-369.

DASH Toward Good Health

High blood pressure (hypertension) is dangerous because it causes the heart to work harder. When the heart works too hard, the strain can contribute to life-threatening conditions such as a heart attack or stroke. High blood pressure also damages arteries, leading to arterial disease.

It's well-established that sodium reduction is useful for people with hypertension, and for those trying to avoid it. But how much of a reduction is enough? A recent study published in The New England Journal of Medicine reports that salt reduction might have a greater effect on your blood pressure than you might think. In the study, 412 subjects were randomly assigned to consume a diet typical of the normal American diet, or the DASH (Dietary Approaches to Stop Hypertension) diet. The DASH diet is rich in fruits, vegetables and low-fat dairy. Within each group, subjects ate foods with high, intermediate and low levels of salt for 30 days.

The researchers discovered that reducing sodium intake from the highest to the intermediate level reduced average systolic blood pressure in the control group and the DASH group. The greatest reduction occurred in subjects who consumed the low-salt DASH diet.

Do you have too much salt in your diet? Chances are, the answer is yes. Talk to your doctor about the fundamentals of a low-sodium, low-fat diet rich in vitamins and minerals. Information on high blood pressure can also be found on the American Heart Association's website: http://www.americanheart.org.

Reference: Sacks F, Svetkey L, Vollmer W, et al. Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet. The New England Journal of Medicine January 2001:344, pp3-9.

For Otitis Media, Try Patience Before Drugs

Otitis media is an inflammation of the inner ear characterized by fluid buildup. The condition is one of the most common acute respiratory conditions managed in primary care, most frequently affecting children. In fact, otitis media ranks second to the common cold as the most common health problem in children.

espite its prevalence, treatment options for otitis media remain controversial. Most children are prescribed antibiotics, although considerable evidence suggests that the results are minimal at best. While antibiotics may have important benefits, there is little evidence suggesting that these prescriptions create positive differences in alleviating pain and distress associated with otitis media.

A study in the British Medical Journal investigated the utility of a 72-hour "wait-and-see" approach vs. antibiotics in managing otitis media in 315 children six months to 10 years of age. Children were randomly assigned to one of two protocols: antibiotics prescribed immediately, and prescriptions withheld for 72 hours. Results showed only minimal differences between the two groups, with no significant difference in school absence, pain or distress.

It's important to note that waiting for 72 hours while monitoring symptoms is safe, but a blanket approach of nonintervention may have dangers. However, these findings add to the considerable evidence espousing the value of conservative care in achieving positive health benefits. For more information on pediatric health, talk to your doctor and visit https://www.chiroweb.com/tyh/childhood.html.

Reference: Little P, Gould C, Williamson I, et al. Pragmatic randomized controlled trial of two prescribing strategies for childhood acute otitis media. British Medical Journal February 2001:322, pp336-342.

Fiber-licious

Although fiber is not considered an essential nutrient, numerous nutritional experts and organizations recommend consuming 25-30 grams of dietary fiber daily as part of a sensible diet. Despite such recommendations, and previous research suggesting the role of fiber in reducing the risk of several types of cancer, the average American consumes only about 10-15 grams per day.

If you haven't yet adopted a diet containing adequate amounts of fiber, perhaps these latest study results will do the trick. A recent study in the International Journal of Cancer compared 902 patients with cancer (271 with oral cancer, 327 with pharyngeal cancer, and 304 with esophageal cancer) with 1,950 control subjects. Results showed that individuals who consumed the most fruit, vegetables and whole-grain cereals (all high in dietary fiber) had a lower risk for cancers of the mouth and throat, compared with these on low-fiber diets. Soluble fiber, found in fruit, vegetables, and whole grain cereals, and insoluble fiber, found in seeds and the skin of fruit, were both protective. The results were also equal for both sexes.

The authors mention that high fiber intake may be a marker for a healthier lifestyle that includes lower intake of meat and other foods high in saturated fat and cholesterol, and higher intake of low-fat foods such as fruit and vegetables. Ask your doctor to help outline a comprehensive nutritional program suitable to your needs.

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

Reference: Soler M, Bosetti C, Franceschi S, et al. Fiber intake and the risk of oral, pharyngeal and esophageal cancer. International Journal of Cancer January 2001:91, pp283-287.

Acupuncture for Migraines

According to the National Headache Foundation, as many as 28 million Americans suffer from migraine headaches each year. Migraines can be caused by a variety of physical and environmental factors, including diet, stress, allergens, menstruation, and changes in the weather.

In one of the largest studies of its kind to date, a team of investigators in Italy examined the effectiveness of acupuncture versus a variety of pharmacological therapies in treating migraines. Their results, published in a recent issue of the Journal of Traditional Chinese Medicine, revealed that patients given acupuncture experienced fewer migraine episodes, missed fewer days from work, and suffered no side effects compared to patients on conventional drug therapy. They also found acupuncture to be more cost-efficient, estimating a savings of hundreds of millions of dollars in private and social health expenditures if it were used to treat headaches alone instead of drugs.

"Up to now, there has been neither precise data about these savings to the public, nor about the lack of risks for the patients treated with acupuncture for common diseases with a social cost," the investigators noted in their conclusion. "Today, thanks to this study, we have precise data which prove the exceptional usefulness of acupuncture."

Reference: Liguori A, Petti F, Bangrazi A, Camaioni D, Guccione G, Pitari GM, Bianchi A, Nicoletti WE. Comparison of pharmacological treatment versus acupuncture treatment for migraine without aura - analysis of sociomedical parameters. Journal of Traditional Chinese Medicine 2000; Vol. 20, No. 3, pp231-40.

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

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