February 11, 2003 [Volume 4, Issue 4]
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In this issue of To Your Health:
Chiropractic: It Satisfies
Three times as many patients with low back pain visit a medical doctor as a chiropractor for treatment, despite studies that indicate chiropractic patients report greater satisfaction than those seeking medical care. Unlike general practitioners, doctors of chiropractic specialize in the management of back pain and other musculoskeletal conditions.
To
determine differences in patient satisfaction and communication with treatment
provider between chiropractic and medical back-pain patients, researchers
focused on members of a managed care organization in California. Members,
who suffered from low back pain, were divided to receive one of four forms
of care: medical; medical plus physical therapy; chiropractic; or chiropractic
plus therapeutic modalities (such as electrical nerve stimulation). Satisfaction
scores of 10-50 (50 indicating "most satisfied") after four weeks were
compared among treatment groups.
Satisfaction scores were significantly higher for chiropractic patients than for medical patients (36.1 vs. 30.6, respectively). Chiropractic patients also indicated receiving more advice on self-care and better explanations of treatment. One-quarter as many patients assigned to medical treatment reported being given an explanation of treatment, compared to patients assigned to chiropractic care (16% vs. 61%).
As this study in the American Journal of Public Health shows, chiropractic continues to outperform traditional medical care for back pain treatment. Talk to your doctor of chiropractic about the other health concerns he or she can address.
Reference: Hertzman-Miller RP, Morgenstern H, et al. Comparing the satisfaction of low back pain patients randomized to receive medical or chiropractic care: Results from the UCLA Low-Back Pain Study. American Journal of Public Health 2002:92(10), pp. 1628-1633.
For more on back pain, go to https://www.chiroweb.com/tyh/backpain.html.
Hurting for Answers
In today's world, computers, video games, pizza and extreme sports are the norms in our children's lives. Our habits, diets and hobbies all change as the world around us does. Unfortunately, another norm today may be adolescent neck, back and shoulder pain.
A recent study in the British Medical Journal analyzed instances of back and neck pain from 1985-2001, and cases of neck, shoulder and low back pain from 1991-2001, in Finnish adolescents. Every two years, postal surveys were gathered, representing 12-, 14-, 16- and 18-year-olds from a national sample of over 60,000 teens. Classroom surveys were also obtained for twice as many 14- to 16-year-olds. The researchers' goal was to determine the number of kids with pain at least weekly.
Back and neck pain prevalence was greater in the 1990s than the 1980s; it also increased steadily from 1993-1997. Neck, shoulder and back pain prevalence significantly increased from 1991 to 2001. Pain was most common in girls and older children.
Are our children more susceptible to musculoskeletal pain these days? The results of this and similar studies make for a convincing argument. Is it due to new information technology leading to increased computer use, which involves repetitive movements and static postures? Is it due to poor diets or lack of activity? There are no clear answers yet, but in the meanwhile, you can keep your kids active and on a healthy diet to help prevent chronic pain.
Reference: Hakala P, Rimpelä A, et al. Back, neck, and shoulder pain in Finnish adolescents: National cross sectional surveys. British Medical Journal 2002:325, pp. 743-746.
To read more about pediatric health, go to https://www.chiroweb.com/tyh/childhood.html.
It All Adds Up
The debate between the relative benefits of moderate vs. vigorous exercise is ongoing. Federal guidelines encourage a minimum of 30 minutes of moderate-intensity exercise most days of the week, while earlier guidelines suggested vigorous exercise for at least 20 minutes three or more times per week.
A study in The New England Journal of Medicine compared the incidence of heart attacks and strokes in approximately 75,000 women ages 50-79, based on total time spent doing any physical activity; walking; vigorously exercising; and sitting. Activity was determined by questionnaires, and classified as mild, moderate or vigorous.
The more physical activity completed by the women, the less likely they were to suffer from heart attack or stroke over the next six years, regardless of race, weight or age. Women who walked or performed vigorous exercise 2.5 hours or more per week reduced their total risk for cardiovascular conditions by approximately 30%. Brisker walking pace and less time spent sitting daily reduced the risk even more.
It all adds up: The more time you spend being active - a little here, a little there - the healthier you will be. Ideally, you should try to complete aerobic workouts at a moderate to vigorous pace, but don't give up altogether if you can't accomplish this. Simply be as active as you can, as often as you can.
Reference: Manson JE, Greenland P, et al. Walking compared with vigorous exercise for the prevention of cardiovascular events in women. The New England Journal of Medicine 2002:347(10), pp. 716-725.
Other studies on sports and fitness can be found at https://www.chiroweb.com/find/archives/sports.
One in Five Medication Doses in Error
Answering 20% of the questions wrong on tests taken in school is generally considered better than average, earning a student a B or C letter grade. But when it comes to hospitals providing medication to patients, would you consider dosage mistakes made 20% of the time acceptable?
Thirty-six hospitals accredited by the Joint Commission on Accreditation of Healthcare Organizations, nonaccredited hospitals, and "skilled nursing facilities" in Georgia and Colorado were observed for medication errors in a study published in the Archives of Internal Medicine. Fifty day-shift doses per hospital unit, or all doses for a single medication pass, were examined by a research pharmacist, with any medication errors reaching patients recorded.
One in five doses were incorrect; 7% of all dosages (or nearly 40% of errors) were deemed potentially harmful to the patient. In order of likelihood, the most frequent errors were: drugs given at the wrong time; omission of the correct medication; incorrect dosages; or unauthorized drugs given.
Nobody's perfect, but is this rate of drug errors acceptable? The authors of this study estimate that at an average of 10 doses per patient per day, each patient would be administered approximately two incorrect medication errors each day.
Reference: Barker KN, Flynn EA, et al. Medication errors observed in 36 health care facilities. Archives of Internal Medicine 2002:162(16), pp. 1897-1903.
For more about general health, go to https://www.chiroweb.com/find/archives/general.
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