August 29, 2001[Volume 2, Issue 18]

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In this issue of To Your Health:

• Say No to Surgery for Low Back Pain
• Diabetics Have Much Greater Risk of Hip Fracture
• Breast Cancer: Don't Depend on Self-Exams
• Reversing Heart Problems: The Benefits of Tea

Low back pain is the second leading reason for patient visits to their primary care physician; up to 90% of people suffer from it at least once in their adult lives. A recent review of related studies in the Journal of Back and Musculoskeletal Rehabilitation showed that the highest rate of back surgery in the developed world is in the U.S., with the most common surgical procedure of the lower spine being removal of disc herniation. Despite these statistics, the cause of low back pain remains elusive and there is conflicting evidence over the best form of treatment.

The authors of this literature review evaluated studies on current surgical and nonsurgical treatments for lumbar (lower back) disc herniations, to determine the short- and long-term results of each. Several different leading surgical approaches were discussed.

No statistical difference was noted in long-term outcomes between surgical and nonsurgical options for low back pain treatment. Only short-term relief of hip pain was shown as more successful through surgical intervention. (Note: Recent studies in the literature have shown comparable results between surgical and nonsurgical approaches to hip pain.) The authors recommend that aggressive rehabilitation combined with pain control may be the best treatment option for low back pain.

Surgery remains a controversial treatment option for low back pain. When you consider the costs and complications associated with surgery, almost any other option may be better. Talk to your doctor of chiropractic about nonsurgical approaches to managing low back pain, or visit https://www.chiroweb.com/tyh/backpain.html.

Reference: Memmo PA, Nadler S, Malanga G. Lumbar disc herniations: A review of surgical and non-surgical indications and outcomes. Journal of Back and Musculoskeletal Rehabilitation 2000: 14(3), pp. 79-88.

Diabetics Have Much Greater Risk of Hip Fracture

Diabetes sufferers have higher-than-normal levels of blood sugar because their body is unable to properly produce or utilize insulin, a hormone that helps remove excess sugar from the blood. Symptoms of diabetes include excessive thirst; frequent urination; weight loss; weariness; blurred vision; and recurrent infections.

A recent study in Diabetes Care sought to determine whether postmenopausal diabetic women were more likely to experience hip fractures than women without diabetes. A mail survey of over 30,000 women between the ages of 55 and 69 contained questions regarding diabetes status and risk factors; after 11 years, hip fracture incidents were recorded from a follow-up survey. Women were classified with type 1 diabetes if they developed the disorder at age 30 or younger, and with type 2 diabetes, the most common form, if developed after age 30.

Women with type 1 diabetes were over 12 times more likely to suffer hip fracture than women without diabetes; type 2 diabetics were nearly twice as likely to experience hip fracture. Other factors associated with higher hip-fracture rates were longer time periods since diagnosis, use of insulin, and use of diabetes medications.

If you suffer from diabetes, be sure to take precautions to avoid falling. Although you may require insulin and medication for the disorder, follow your nutritional guidelines as strictly as possible to minimize blood sugar extremes. Although a family history of the disease is the primary cause of diabetes, obesity, smoking, high cholesterol, and high blood pressure can all accelerate the development of this condition.

Reference: Nicodemus KK, Folsom AR. Type 1 and type 2 diabetes and incident hip fractures in postmenopausal women. Diabetes Care 2001: 24, pp.1192-1197.

Breast Cancer: Don't Depend on Self-Exams

Breast cancer is the second most common form of cancer among American women. Cases are relatively rare before age 40, but risk increases with age. Currently, many women perform self-examinations for early detection of cancer, a method that has been encouraged for years. Evidence suggests that while many tumors are self-detected, most are found accidentally (while bathing, etc.) - not during a self-exam.

A review published in the June 26, 2001 issue of the Canadian Medical Association Journal evaluated the effectiveness of self-exams in screening for breast cancer in a group of 40- to 69-year-old Canadian women. The review utilized seven breast cancer studies from different nations, including the U.S., to evaluate the effectiveness of self-exams in preventing death and providing early detection.

This research showed no evidence of the benefit from regular self-examinations. Neither regular performance nor education on the proper technique for self-examinations reduced the likelihood of breast cancer mortality or provided earlier detection. On the other hand, the studies showed the potential harm of self-exams, in the form of excessive visits to physicians for benign (safe) breast lesions and excessive rates of unnecessary biopsies (removal of breast tissue for analysis).

Don't depend on a home exam alone to warn you of developing breast cancer. Until more research is done on the effects of self-exams, though, you should continue to perform them as recommended by your physician. Also, report any changes you notice in the surrounding tissue and bring up any concerns you have about the condition. When it comes to beating breast cancer, early detection is vital.

Reference: Baxter N. Preventive health care, 2001 update: Should women be routinely taught breast self-examination to screen for breast cancer? Canadian Medical Association Journal, June 26, 2001: 164(13), pp. 1837-1846.

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

Reversing Heart Problems: The Benefits of Tea

People drink more tea than any other beverage in the world other than water. There are many varieties of tea, from the tiny cups of green tea you sip at Chinese restaurants to the pitchers of iced tea you gulp down on hot summer days. In addition to the taste so many enjoy, recent information adds to the results of previous studies that show tea decreases the risk of cardiovascular disease.

A recent study in Circulation evaluated if black tea reversed endothelial dysfunction in patients with coronary artery disease. Endothelial dysfunction is the impairment of blood vessels of the heart; it has been linked to coronary artery disease and is inhibited by the antioxidants found in tea, called flavonoids. Fifty patients with a history of coronary artery disease consumed either water or tea daily for four weeks. The effects of the tea were measured two hours after it was drank (for short-term effects) and at the end of the four weeks (for long-term effects). Tea consumption significantly reduced endothelial dysfunction in both the short and long term, while water had no effect on the patients.

This study indicates that black tea consumption may reverse the symptoms of coronary artery disease. It also supports the growing body of research that indicates that antioxidant flavonoids, found in tea and other natural sources like fruits (especially red grapes) and soy, may decrease cardiovascular dysfunction. Be sure to keep drinking tea for a healthier heart - and for general health. Tea also contains the vitamins riboflavin, thiamin, C, and B6, and is rich in potassium and manganese.

Reference: Duffy SJ, Keaney Jr JF, Holbrook M, et al. Short- and long-term black tea consumption reverses endothelial dysfunction in patients with coronary artery disease. Circulation 2001: 104, pp. 151-156.

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

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