March 25, 2003 [Volume 4, Issue 7]

To Your Health is brought to you by:

This issue features a number of articles you will want to share with your family, friends and co-workers. Please feel free to forward this newsletter to them via e-mail. If you have received this e-mail newsletter from someone else, you may subscribe free of charge and begin receiving your own copy by going to:

https://www.chiroweb.com/newsletter/TYH/subscribe.php

In this issue of To Your Health:

• A Neck Above the Rest
• Is Your Baby at Risk?
• Hot-Flash Treatments Lukewarm
• Persistent Problems, Big Bills

A Neck Above the Rest

Neck pain afflicts almost three-quarters of adults at some point; for nearly one in six, pain is chronic. If you suffer from neck pain, many different forms of therapy are available, including spinal manipulation, drug regimens and exercises - but which form is best?

To compare the effectiveness of three forms of neck pain therapy, researchers followed approximately 200 people suffering from chronic neck pain over 11 weeks of treatment, and recorded their progress over the next two years. The patients were randomly divided to receive 20 one-hour treatments, in one of the methods listed below:

• spinal manipulation and light soft-tissue massage from experienced chiropractic clinicians;
• chiropractic spinal manipulation plus rehabilitative exercise from trained exercise therapists, including stretching and dynamic neck exercises; or
• rehabilitative neck exercises using a variable resistance, neck extension and rotation machine.

Patient-rated pain was lower for both exercise groups than for manipulation alone, and the exercise groups benefited more regarding pain, disability, improvement and health status. Spinal manipulation plus exercise provided greater satisfaction than manipulation alone or rehabilitative exercises, however. The advantage of both manipulation plus exercise and machine exercises over manipulation alone continued over the two-year follow-up period.

If you suffer from chronic neck pain and don't know where to turn, your local chiropractor is the best place to start. Cervical manipulations along with regular neck exercises can help end the pain and get you headed in the right direction. Online, you can read more about neck pain at https://www.chiroweb.com/tyh/neckpain.html.

Reference: Evans R, Bronfort G, et al. Two-year follow-up of a randomized clinical trial of spinal manipulation and two types of exercise for patients with chronic neck pain. Spine 2002:27(21), pp. 2383-2389.

Is Your Baby at Risk?

The potential for dangerous drug side-effects in infants and young children exceeds that for adults because their bodies detoxify chemicals less effectively than adults, and their body sizes range widely in these years - making correct dosages more difficult to administer. Prescribing drugs to infants or children is additionally dangerous due to a lack of testing in this age group.

In a recent study in the journal Pediatrics, researchers examined over 7,000 adverse drug reactions in infants under age 2, all submitted to the Food and Drug Administration (FDA) between 1997 and 2000. The authors also determined whether the suspected drugs were transmitted from mother to infant during pregnancy, or if the infant was administered the drug directly.

Less than 1% of the nearly 2,000 drugs identified in the study were associated with over half of all serious or fatal side-effects. Deaths linked to side-effects were far more likely in the first few months after birth (41% in the first month). In a full quarter of cases, drugs were administered to the mother, not the infant, and then passed to the child through the womb or through breastfeeding. Included in the list of the drugs most likely to cause dangerous side-effects in children were ibuprofen and acetaminophen (drugs more commonly known by such brand names as Advil and Tylenol).

In many cases, more risky drugs may be needed to avoid even worse health emergencies. However, the authors of this study note that only about 10% of the actual total of deaths and serious complications from drugs may be reported, based on FDA data. Talk to your doctor about which drugs are safe for young children, and always exercise extreme caution when considering any type of medication for them, or administering it to yourself while pregnant - even if your doctor has approved its use.

Reference: Moore TJ, Weiss SR, et al. Reported adverse drug events in infants and children under 2 years of age. Pediatrics 2002:110(5), p. e53.

For more pediatrics studies, go to https://www.chiroweb.com/find/archives/pediatrics.

Hot-Flash Treatments Lukewarm

To combat the symptoms of menopause, many women have used hormone replacement therapy (HRT) for decades. These hormones were recently linked to chronic health problems, though, prompting women to seek alternatives to HRT. Alternative therapies like herbs, soy products and meditation are now being used to prevent the hot flashes, sleep problems, joint pain, fatigue and forgetfulness of menopause. But which ones actually work?

In a review of 29 studies of complementary and alternative medicine (CAM) therapies for menopausal symptoms, the authors of this study in the Annals of Internal Medicine compared the effectiveness of various alternative treatments for menopause symptoms.

Black cohosh, an herb traditionally used by Native Americans to treat gynecological conditions, won out as the most beneficial treatment for mitigating hot flashes in three out of four studies. Black cohosh appears to effectively treat menopausal symptoms, but there is a lack of long-term safety research, so caution is in order if considering long-term use. Also, soy or isoflavone supplementation appeared moderately beneficial for treating hot flashes, but evidence was less conclusive - only three of eight studies involving treatment of at least six weeks resulted in significant improvements.

Disappointingly, nearly all the other alternative menopause treatments in the study - acupuncture; vitamin E; evening primrose oil; wild yams; ginseng; dong quai; and red clover - do not appear to offer any benefits for treating hot flashes, based on existing clinical studies. Now is a good time to talk with a doctor of chiropractic about where you can turn for the best, and safest, options for dealing with the frustrating effects of menopause.

Reference: Kronenberg F, Fugh-Berman A. Complementary and alternative medicine for menopausal symptoms: A review of randomized, controlled trials. Annals of Internal Medicine 2002:137(10), pp. 805-813.

Find additional women's health topics at https://www.chiroweb.com/find/archives/women.

Persistent Problems, Big Bills

Chronic health conditions can lead to significant health problems if left unchecked, and their incidence is rising: By 2020, 157 million Americans (or nearly half the population) are expected to suffer from one or more chronic conditions. The elderly are particularly prone to having multiple chronic health problems.

Utilizing a national sample of over 1 million people age 65 or older and enrolled in Medicare in 1999, data were obtained on chronic conditions including hypertension and diabetes. Data showed that 82% of the Medicare beneficiaries had at least one chronic condition, increasing in prevalence with age to nearly 90% in those 85 and older. On average, there were more than two chronic conditions per person. Over half of the subjects had a circulatory system-based chronic condition. Also, two-thirds of all individuals 65 or older had two or more chronic conditions; 43% had three or more; and 24% had four or more.

This study in the Archives of Internal Medicine additionally found that individuals with four or more chronic conditions were approximately 100 times more likely to have been hospitalized for a condition that could have been averted through proper primary care. Per-person Medicare expenditure increases coincided with the number of chronic conditions, from about $200 for seniors with no chronic conditions to nearly $14,000 for beneficiaries with four or more.

What does all this information mean to you? Heed these numbers to avoid major health problems and big bills as you age, by simply maintaining wellness, through exercise, a good diet and doing nothing to excess.

Reference: Wolff JL, Starfield B, Anderson G. Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Archives of Internal Medicine 2002:162(20), pp. 2269-2276.

Check out https://www.chiroweb.com/find/archives/senior for more on senior health.

This edition of the To Your Health newsletter is co-sponsored by:

Thank you for subscribing to To Your Health. If you have received this newsletter in error or wish to unsubscribe, you may remove your name from our e-mail subscription list at https://www.chiroweb.com/newsletter/TYH/unsubscribe.php.

Visit Dynamic Chiropractic's "Ask a Doctor of Chiropractic" forum at https://www.chiroweb.com/find/ask.html, where 15 doctors of chiropractic are waiting to answer any of your health questions.

If you have any questions regarding your subscription, please complete this form at https://www.chiroweb.com/newsletterhelp/TYH.

This newsletter conforms to the requirements set by Bill S 1618 Title III, passed by the 105th U.S. Congress.