April 22, 2003 [Volume 4, Issue 9]
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In this issue of To Your Health:
Room to Move
What
is it about chiropractic care that makes it so effective? Patients swear
by the spinal adjustments they receive from their chiropractor, but often
don't know how the manipulation is helping, other than a general knowledge
that their backs have been "cracked." Adhesions in the hinge joints of
the vertebrae, called the facet joints, may be one reason for back pain.
Adhesions, or joints being improperly stuck together, can be caused by reduced mobility from injury or inactivity. Chiropractic spinal manipulation theoretically separates the facet joints and increases the space between them, breaking adhesions and restoring motion. One of the most common spinal adjustments performed by chiropractors - the side-posture adjustment - involves positioning a patient on his or her side, then rotating the upper body using the shoulder and hip as levers. From here, an adjustment is made with a slight twisting of the spine.
In a study in the journal Spine, 64 men and women ages 22-30 without back pain were divided into four groups for varying treatment interventions, involving placing patients in side-posture position only (without performing an adjustment), providing actual side-posture spinal adjusting, or leaving patients in a neutral position. MRI scans were taken before and after interventions, in side-posture position or with people lying on their backs, and compared for each individual.
People given side-posture adjustments followed by MRI in side-posture position showed the greatest separation in the facet joints. Those in side-posture position alone, without adjustments, showed the second-greatest separation before and during MRI. Side-posture adjusting clearly created greater separation than no adjustments. The average difference in separation between neutral group subjects' facet joints and the group receiving side-posture adjustments was only a few millimeters, but the authors called this amount "not only significant," but also "clinically relevant."
Reference: Cramer GD, Gregerson DM, et al. The effects of side-posture positioning and spinal adjusting on the lumbar Z joints: A randomized controlled trial with sixty-four subjects. Spine 2002:27(22), pp. 2459-2466.
To read more studies on back pain treatment, go to https://www.chiroweb.com/find/archives/musculoskeletal.
Deliver Yourself From Pelvic Pain
A Cesarean section is the surgical delivery of a baby through an incision made in the mother's abdomen. These surgeries, though sometimes the best option for delivery (e.g., when a very small woman is having a very large child), are increasingly being performed when unnecessary in the U.S., increasing risks for mother and child. Chronic pelvic pain, or persistent, long-term pain of the lower abdomen, is a condition that affects millions of women in their reproductive years and may be more prevalent in women who've had a C-section.
Conducted in Brazil, another nation where rates of Cesarean sections are rising, a study appearing in the International Journal of Gynecology and Obstetrics focused on about 200 patients averaging approximately 35 years old. The women provided detailed pain histories and information on previous deliveries. The mothers also underwent complete gynecological and abdominal examinations, including laparoscopy - a procedure that involves using a viewing instrument inserted through an incision in the navel to examine a woman's reproductive organs.
Women with chronic pelvic pain were significantly more likely to have undergone a C-section than women without pain. C-sections had been performed on over two-thirds of women with the condition, as opposed to just over one-third of women without chronic pelvic pain. Women with endometriosis, a condition characterized by uterine lining abnormally forming outside the uterus, were also at a high risk for the condition (nearly nine times more likely).
Chronic pelvic pain can be caused by other factors, such as depression or sexual trauma. The important point to consider from this study is that unlike endometriosis, C-sections are optional in many cases. Mothers-to-be can often choose to avoid this procedure, which may reduce their risk for chronic pelvic pain, as well as infection, blood loss and scarring.
Reference: Almeida ECS, Nogueira AA, et al. Cesarean section as a cause of chronic pelvic pain. International Journal of Gynecology and Obstetrics 2002:79, pp. 101-104.
For more women's health studies, go to https://www.chiroweb.com/find/archives/women.
Hip-Hip-Hooray!
A hip fracture, generally caused by a fall, is one of the most serious injuries elderly people face. Nursing home residents have a particularly high risk for these fractures, which often lead to extreme immobility and even death, despite corrective surgery for most sufferers. Wearing external hip protectors can reduce the impact of a fall, significantly lowering the odds for a hip fracture - but regular use of hip protectors is low.
To evaluate hip-protector usage following an educational intervention, almost 1,000 nursing home residents 70 or more years old and at a high risk for falling participated in a recent study published in the British Medical Journal. Staff at selected nursing homes in Hamburg, Germany, were educated about hip protector use in a single class, then instructed the residents and supplied them with hip protectors. Elderly patients provided with standard care were examined for comparison.
Over 18 months, the risk for hip fracture was reduced by 43% in seniors given free hip protectors and education about their usage, compared to their peers. Of those seniors who suffered a fall, hip protectors were used by 15% of people receiving standard care, versus 68% in the group given hip protectors and education.
This study may be cause for celebration. Some consider external hip protectors cumbersome and unsightly, but if you're a likely candidate for a hip fracture, they provide a safe, easy means of avoiding what can be a severe injury. Seniors who should consider wearing hip protectors are those with any of the following criteria: female gender; slight build; osteoporosis; poor balance or coordination; vision problems; general disorientation; or medication use that leads to dizziness or a weakened condition.
Reference: Meyer G, Warnke A, et al. Effect on hip fractures of increased use of hip protectors in nursing homes: Cluster randomized controlled trial. British Medical Journal 2003:326, pp. 76-80.
For more information about senior health issues, go online to https://www.chiroweb.com/find/archives/senior.
Better Ways to Fight a Cold?
The herb echinacea, utilized by Native Americans for centuries, is a popular remedy for preventing or reducing the severity of the common cold. Hundreds of studies, primarily conducted in Germany, have provided information on the herb's chemical and pharmacological characteristics, yet few studies have actually proven its ability to reduce cold severity.
To evaluate the effectiveness of dried, whole-plant echinacea capsules for early treatment of the common cold, approximately 150 students in the early stages of a cold were divided to take either a placebo or echinacea. The echinacea group took an encapsulated mixture of unrefined echinacea root and herbs in one-gram doses, six times on the first day of illness and three times per day on subsequent days, for up to 10 days. The placebo group took capsules containing alfalfa, which has no proven ability to boost the immune system, at the same frequency.
No difference was observed between the echinacea and placebo groups for any cold symptoms, including cough, sore throat, runny/stuffy nose or headaches. Average duration of the cold was approximately six days in both groups. Also, cold severity measures were "nearly identical" in those taking echinacea or placebo pills.
Although this is certainly not the last word on echinacea, since some previous research contradicts this study, it shows that otherwise healthy people might not obtain as much benefit from the herb as older adults who have frequent colds or viral illnesses. The best advice is to reduce your chances of getting a cold in the first place: wash your hands frequently with soap and water, and boost your immune system by eating lots of fruits and vegetables and getting plenty of sleep. Your doctor of chiropractic can outline specific steps toward optimal health.
Reference: Barrett BP, Brown RL, et al. Treatment of the common cold with unrefined echinacea: A randomized, double-blind, placebo-controlled trial. Annals of Internal Medicine 2002:137(12), pp. 939-946.
Read more about herbs and their potential health benefits at https://www.chiroweb.com/find/archives/nutrition.
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