November 5, 2002 [Volume 3, Issue 22]
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In this issue of To Your Health:
"Back" to Normal
Common
sense used to dictate that a person recently suffering from low back pain
should spend a few days in bed, so as not to aggravate the injury or increase
the pain. But this recommendation has changed in the last decade, as studies
show that when it comes to back pain, bed rest can actually increase pain
and delay healing.
To compare two treatments for people suffering from back pain beginning in the previous three days, the authors of a recent study assigned patients to one of two groups for four days. One group of patients spent a minimum of 16 hours a day resting in bed and ceased activities, while the other group spent a maximum of 12 hours a day in bed and resumed normal daily activity. The patients, ages 18-65, were seen three times after the initial "treatment" phase: at day six or seven, at one month, and after three months.
Pain intensity, functional disability, and spine stiffness were similar for patients in both groups at all three appointments after treatment. However, a greater percentage of people in the "bed rest" group initially needed sick leave than people in the "normal activity" group (86% vs. 52%, respectively).
Normal activity has emerged as a better treatment option than bed rest for low back pain. Movement allows your muscles and spine to stay strong and flexible. Stay on your feet to prevent back pain and avert its progression to long-term, debilitating pain. Your chiropractor can recommend safe, effective activities to promote or regain a pain-free back.
Reference: Rozenberg S, Delval C, Rezvani Y, et al. Bed rest or normal activity for patients with acute low back pain: A randomized controlled trial. Spine 2002:27(14), pp. 1487-1493.
Learn more about back pain at https://www.chiroweb.com/find/archives/musculoskeletal/backpain/index.html.
Alcohol: Worse with Age?
Don't wait too long to drink that wine in the cellar. Unlike the way wine gets better with age, a recent study hints that the older you are, the worse alcohol may be for you.
The Japanese study, appearing in Gerontology, evaluated the relationship between alcohol consumption and cardiovascular health in over 12,000 male workers 20-69 years old. The men were divided into five age groups, then into three "subgroups" based on alcohol consumption levels: nondrinkers, light drinkers (up to two drinks per day), and heavy drinkers (two or more drinks daily).
Light drinking significantly raised blood pressure in middle-aged and elderly groups (ages 40-69), although not in younger subjects, and only significantly decreased unhealthy cholesterol levels in those younger than 60 years. Heavy drinking at all ages significantly increased blood pressure, despite positively affecting cholesterol levels. In all age groups, light drinking raised "good" HDL cholesterol.
This study raises the often-asked question: Should you drink to your health or not? The results imply that even light drinking may increase blood pressure in older adults, despite its beneficial ability to help prevent other cardiovascular risk factors. One to two drinks daily are acceptable in younger adults, as positive effects on cholesterol may outweigh negative side effects.
Reference: Wakabayashi I, Kobaba-Wakabayashi R. Effects of age on the relationship between drinking and atherosclerotic risk factors. Gerontology 2002:48(3), pp. 151-156.
To read more on senior health, check out https://www.chiroweb.com/find/archives/senior.
Do You Really Kneed Surgery?
Osteoarthritis is a painful condition caused by inflammation and cartilage breakdown in the joints. Over 600,000 knee-osteoarthritis patients undergo arthroscopic surgery each year because they are unable to find relief through other therapy. These $5,000 procedures - the most common orthopedic surgeries - have been shown to relieve pain in approximately half of patients, yet the basis for pain relief is unclear. In effect, this type of knee surgery may offer no real benefits.
In a recent study in The New England Journal of Medicine, 180 knee-osteoarthritis patients received one of two types of arthroscopic surgery (joint flushing or flushing plus surgical tissue removal) or placebo surgery, consisting of only skin incisions and simulated surgery, with no irrigation or insertion of instruments.
Neither surgery group reported less pain or greater function than the placebo group at any time over the two years after the procedure. Average scores on pain scales for each group were virtually the same at one year, and were in fact better for the placebo group. At two years, scores remained almost identical. Also, surgery groups did not experience greater improvements in function at any point, compared to the placebo group.
Billions of dollars are spent on arthroscopic knee surgeries every year, though they appear to provide no measurable benefits. The gains made by recipients may simply be due to a placebo effect; that is, surgery only helps them because they think it will. Factors known to contribute to knee osteoarthritis include obesity, injury, and overuse of the knees. Talk to your doctor of chiropractic about prevention and alternative treatment of this condition.
Reference: Moseley JB, O'Malley K, Petersen NJ, et al. A controlled trial of arthroscopic surgery for osteoarthritis of the knee. The New England Journal of Medicine 2002:347(2), pp. 81-88.
For extremity-pain studies, go to https://www.chiroweb.com/find/archives/musculoskeletal/extremities/index.html.
Avoid the Morning Train
The human body is known to go through rhythmic physiological cycles each day, as the body responds to ambient light, activity levels, mealtimes, and sleep. Similarly, our immune systems appear to be affected by the time of day, or by the time of day that we exercise, based on a recent study in the British Journal of Sports Medicine.
At 6 a.m., 14 competitive male swimmers performed a 400-meter crawl five times in a row, with one minute of rest between each 400-meter set. They repeated the same swim session on a separate day, but at 6 p.m. After each swim session, saliva samples were taken from the swimmers and measured for secretions of cortisol and IgA. Cortisol is a stress hormone that indicates a weakened immune system; conversely, IgA is a substance that helps the body fight respiratory tract infections.
Morning swims were associated with the production of significantly higher levels of cortisol and lower levels of IgA in the swimmers' bodies. In other words, swimmers who train in the morning may be at a higher risk for upper respiratory tract infections than those who train in the evening.
Don't misinterpret these findings, though. They don't necessarily apply to other sports, and working out in the morning is certainly better than not working out at all. If your schedule is flexible enough, however, consider swimming later in the day, rather than right after you wake up - especially if you're already feeling "under the weather."
Reference: Dimitriou L, Sharp NCC, Doherty M. Circadian effects on the acute responses of salivary cortisol and IgA in well-trained swimmers. British Journal of Sports Medicine 2002:36, pp. 260-264.
For more tips on working out, go to https://www.chiroweb.com/tyh/sports.html.
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