DCOA - Addison

11/17/2023

Low Back Pain and The Danger of Spinal Fusions

You may think it’s odd to discuss low back pain (LBP) from the perspective of spinal fusion because as chiropractors, we do not perform surgery and so, why discuss it? It is important that we discuss research such as this so we can make the informed treatment decisions with our patients after we’ve considered all the facts in each specific case. Now, there are certainly times when a surgical procedure for back and leg pain is necessary and appropriate for some patients; however, there are also some patients who have been told they need spinal surgery when, in fact, they may be better off NOT proceeding with surgery. Thus, the question is, what happens to those patients who elect not to proceed with surgery vs. those who do?

That question was addressed in a study where a total of 1,450 patients injured at work were followed over a two-year time frame. There were a total of 725 patients who proceeded with the fusion surgery and the other 750 elected NOT to have the surgery. A fusion surgery can be described as when two or more vertebra are fused together, usually because there are neurological problems such as shooting leg pain, weakness, and/or numbness in one or both legs. The conditions treated in this study included herniated disks, degeneration of the disk, and radiating leg pain. There were primarily three factors that were compared between the two groups: 1) ability to return to work; 2) disability (the inability to work), and 3) op**te (narcotic) drug use. Other factors compared included the need for re-operations, complications, and death.
The results showed, in general, those who proceeded with surgery had significantly more problems compared with those who did not have surgery. For example, only 26% of those who underwent surgery returned to work, compared with 67% in the non-surgery group. The total number of days off work were 1140 vs. 316 days, respectively. There were 17 vs. 11 deaths, respectively, and 27% of the surgical group required re-operations with a 36% complication rate. Also, there was a 41% increase in the use of narcotic medication with 76% continuing the use after surgery.

Again, there are times when surgery is absolutely the right choice. Those times include when there is a loss of bladder or bowel control, progressively worsening neurological symptoms in spite of non-surgical care, and of course, unstable fractures, cancer/tumor, and infections, but that’s about it! In other words, if you don’t have one of the before mentioned conditions which do require surgery, don’t be too quick to jump at the chance of “getting it fixed” with surgery. As the study suggests, the post-surgical results favor those who elected NOT to have surgery. Also, when in doubt, don’t trust the opinion of only one surgeon – always get a 2nd or even 3rd opinion. It is also very important to consider your current level of function or your ability to do your desired tasks and unless there is a significant loss in that ability, consider additional time with non-surgical treatment. The non-surgical treatment you can expect to receive from chiropractic includes (but may not be limited to) spinal manipulation, exercise training, physical therapy modalities (ice, heat, electrical stimulation, ultrasound, traction, etc.), dietary counseling, and job modification information.

Schedule a free consultation today by visiting www.AddisonBackandSpine.com

11/16/2023

Where Does Low Back Pain Come From?

“Where does the pain come from?” is probably the most commonly asked question we hear as chiropractors and frequently, the patient is not told the answer to this simple question. The problem is, the question is not so simple. This is because there are many structures in the low back that share a common nerve supply and hence, the pain arising from those structures is located in the same area of the back. For example, the back portion of the disk, the facet capsule, and some of the deep muscles in the spine are all innervated by the same nerve and therefore hurt in a similar location. In all honesty, the only way to try to isolate the pain generator is to inject a local anesthetic to block the pain for a short while. This is like when you go to the dentist and they “numb” your tooth so you don’t feel the pain while they work on it. After a few hours, you start to feel some “life” coming back to your mouth and soon it regains its full feeling. Of course, no one would consider “numbing” the back just to figure out exactly where the pain is arising as really, it’s not that important. This is because the chiropractic treatment approach is similar regardless of the exact tissue that is involved. However, it DOES matter in cases where a pain radiates down the leg caused by a herniated disk vs. a localized pain in the back that doesn’t radiate. Hence, we doctors of chiropractic will work hard to differentiate these two distinct types of conditions as the treatment is definitely different.

In 1995, the Quebec Task Force recognized the importance of this distinction and recommended all healthcare providers concentrate on differentiating the nerve root / herniated disk case from what is called “mechanical low back pain.” As noted in the model below, the arrow and pen point to the two most common structures that cause nerve root pain (the herniated disk) and mechanical low back pain (the facet joint).

The facet joint, when sprained / injured, hurts worse when bending backwards and feels good bending forwards. This is exactly the opposite for the herniated disk where bending backwards helps reduce pain and often reduces the shooting leg pain as well, while bending over even a little can create a sharp stabling pain in the back that may shoot down the leg. Of course, there are variations of this and to make matters more complicated, BOTH the disk and the facet can generate pain at the same time, so it’s not always this cut and dry.

11/15/2023

Low Back Pain & Spinal Manipulation: How Does It Work?

For many years, Chiropractic has been at the forefront of treating low back pain (LBP) with both greater patient satisfaction and less lost time at work when compared with other non-surgical treatment approaches. There have been many explanations as to why chiropractic manipulation therapy (CMT) works but many of these studies include other treatment modalities or methods and the benefits are, therefore, not clearly derived only from CMT. A 2011 study attempted to clear this up and the results were very interesting!

This study included two chiropractors and two a physical therapists (PT) from Canada and the United States. What is unique about this study is that the researchers measured clinical or symptomatic improvement by tracking improvement in activity tolerance using a standard questionnaire commonly used by chiropractors and PTs all over the world, as well as changes in the spinal stiffness using a valid/reliable instrument both before and after CMT was utilized. The importance of these findings is that only CMT was utilized and hence, other forms of treatment commonly utilized by chiropractors did not cloud the findings. There were 48 patients included in the study and the initial two treatments were administered 3-4 days apart, followed by an assessment 3-4 days after the 2nd treatment. Assessments were also performed before and after each treatment. The assessments included use of the questionnaire and a stiffness measurement using the special instrument. Also, “recruitment of the lumbar multifidus muscle” (a muscle in the low back that helps stabilize the trunk or core) was measured by ultrasound. After each treatment, significant improvement was found in the overall pain level and in reduced spinal stiffness (which remained improved 3-4 days after the last/second treatment).

The study found that patients who received thrust manipulation (CMT) had immediate improvements with reduced pain, stiffness, and improved muscle recruitment measurements. However, this same effect was NOT obtained when non-thrust mobilization techniques were used. This means many non-thrust manual techniques such as mobilization, massage, and other soft tissue release methods do not create the immediate benefits that were produced by thrust manipulation. The authors of the study noted the greatest clinical improvement was found in those who had the most dramatic reduction in stiffness after each treatment.

With this new information, we are now able to explain with confidence to patients the reasons why they typically feel better after the spinal adjustment. The patient can then appreciate receiving an answer that makes clear sense and has been “proven.” It’s important to realize that the “bonus” of receiving chiropractic care for low back pain includes not only just pain reduction, but more importantly, improvement in tolerating activities such as vacuuming, washing dishes, golfing, walking, and of course, working.

11/14/2023

Neck Pain: Manipulation vs. Other Treatments?

Mechanical neck pain affects an estimated 70% of people at some point in life. Because many different treatment approaches are available for neck pain, it can be very difficult for those suffering from neck pain to know which treatment approach(es) to choose. Research on this topic has revealed some very interesting information that places chiropractic and spinal manipulation in a VERY STRONG POSITION—in fact, at the TOP OF THE HEAP!

One such study looked at benefits of spinal manipulative therapy (SMT) in patients with acute and subacute neck pain. This study compared three study groups: 1. SMT only; 2. medication only; and 3. home exercise and advice (HEA). This study randomized 272 neck pain patients suffering from neck pain for 2 to 12 weeks into a twelve-week treatment period using 1 of the 3 treatment approaches tracking the results with the participant-rated pain as the primary treatment outcome measure. Secondary outcome data was obtained from other approaches. The results showed that the group treated with SMT, “…had a statistically significant advantage over medication after 8, 12, 26 and 52 weeks. HEA also had a statistical advantage over medication. Lastly, similar benefits were calculated between the SMT and exercise group. The conclusions support SMT and exercise/advise to be the choice over medication for acute and subacute neck pain patients. Regarding exercise, a similar study showed that “high-dosed supervised strengthening exercise” with and without SMT, was superior to a “low dose home mobilization exercise and advice group at 4, 12, 26, and 52 weeks.”
Regarding chronic neck pain patients (that means pain that has been present for greater than 3 months), another study evaluated the changes that occurred in 191 patients. These patients were randomly assigned to 1 of 3 treatment groups for eleven weeks and evaluated 3, 6, 12, & 24 months after treatment. The 3 treatment options included: 1. Spinal manipulative therapy (SMT) only; 2. SMT with low-tech neck exercises; or 3. a form of exercise using a MedX rehab machine. The results show the highest level of patient satisfaction was found in the 2nd group (SMT with low-tech exercise), suggesting that when individuals present for treatment, spinal manipulation with low-tech exercises results in the most satisfied patient. These findings are important as this study evaluated the LONG-TERM benefits among patients who have had neck pain for a long time (i.e., “chronic”), where as most studies only look at the short-term benefits.
Similar conclusions were reported from perhaps the largest scale study on neck pain based on research from 1980 to 2006 on the use, effectiveness, and safety of non-invasive treatment approaches for neck pain and associated disorders. This review that looked at over 350 published articles found manual therapy (manipulation and mobilization) and supervised exercise to again, SHINE when compared with other treatment options.

What is important is that ALL these studies support what chiropractors do: manipulate the neck and give supervised exercises!

Schedule a free consultation today by visiting www.AddisonBackandSpine.com

11/14/2023

Neck Pain: Manipulation vs. Mobilization – What’s Better?

Does mobilization (MOB) get less, the same, or better results when compared to spinal manipulative therapy (SMT) when it comes to treating neck pain? To answer this question, let’s first discuss the difference between the two treatment approaches.

Mobilization (MOB) of the spine can be “technically” defined as a “low velocity, low amplitude” force applied to the tissues of the cervical spine (or any joint of the body, but we’ll focus on the cervical region). This means a slow, rhythmic movement is applied to a joint using various methods such as figure 8, side-to-side, front-to-back, and /or combinations of any of these movements. In the neck, gentle to firm manual traction or pulling, when applied to the cervical spine, stretches the joint and disk spaces and can be included during MOB.

Spinal Manipulative Therapy (SMT) can be defined as a “high velocity, low amplitude” type of force applied to joint which is often accompanied by a audible release or “crack,” which is the release of gas (nitrogen, oxygen, and carbon dioxide). Some joints “cavitate” or “crack” while others are less likely to release the gas. Studies that date back to the 1940s report that an immediate improvement in a joint’s range of motion occurs when the joint cavitates. Many people instinctively stretch their own neck to the point of gas release, which typically, “…feels good.” This can become a habit and usually is not a big problem. However, in some cases, it can lead to joint hypermobility and ligament laxity. As a rule, if only a gentle stretch is required to produce the cavitation/crack, it’s typically “safe” verses the person who uses higher levels of force by grabbing their own head and twisting it beyond the normal tissue stretch boundaries. The latter is more likely to result in damage to the ligaments (tissue that strongly holds bone to bone) and therefore, should be avoided. Since SMT is usually applied in a very specific location (where the joint is fixated or “stuck” or partially displaced), it’s obviously BEST to utilize chiropractic, as chiropractors do this many times a day (for years or even decades) and know where to apply it and can judge the amount of force to utilize, especially the neck where there are many delicate structures.

Back to the question: Which is better, MOB or SMT? Or are they equals in the quest of rid of neck pain? A 2012 study that included over 100 patients with “mechanical neck pain” (strain/sprain) found that those who received SMT had a significantly better response than the MOB group as measured by a pain scale, a disability scale, and two tests that measure function!

Learn more by visiting www.AddisonBackandSpine.com

11/03/2023

Low Back Pain or Hip Osteoarthritis: Which One is it?

When patients say, “…I have low back pain,” they may point to anywhere between the lower rib cage and their hip area. In other words, everyone interprets where their low back is located differently. So, when differentiating between low back pain and hip pain, one would think that the patient would either point to their low back or their hip, right? Well, where does hip osteoarthritis usually hurt? That’s what makes it so hard! The pain location can vary and move around in the same patient anywhere in the pelvic region including the groin (which is common), to the side of the pelvis, to the buttocks, the sacrum, and in the low back. To make it even more challenging, degenerative or injured disks in the lower lumbar spine can refer pain directly into the hip area and also create localized low back pain. In fact, patients often have BOTH conditions simultaneously! Usually, during examination, we move the hip joint feel for reduced motion and watch for pain patterns in certain positions. An osteoarthritic (OA) hip is comparably more tight and painful with rotation movements. For example, the patient is seated with their leg crossed, trying to touch their knee to their opposite shoulder. In the OA-hip patient, they may only be able to get it half way there compared to the other side and often complain of groin pain. The “ultimate test” is the x-ray that reveals the loss of the joint space—the “cartilage interval”—which narrows on the side with OA.
Learn More By visiting www.AddisonBackandSpine.com

11/02/2023

Low Back Pain or Hip Osteoarthritis: Which One is it?

When patients say, “…I have low back pain,” they may point to anywhere between the lower rib cage and their hip area. In other words, everyone interprets where their low back is located differently. So, when differentiating between low back pain and hip pain, one would think that the patient would either point to their low back or their hip, right? Well, where does hip osteoarthritis usually hurt? That’s what makes it so hard! The pain location can vary and move around in the same patient anywhere in the pelvic region including the groin (which is common), to the side of the pelvis, to the buttocks, the sacrum, and in the low back. To make it even more challenging, degenerative or injured disks in the lower lumbar spine can refer pain directly into the hip area and also create localized low back pain. In fact, patients often have BOTH conditions simultaneously! Usually, during examination, we move the hip joint feel for reduced motion and watch for pain patterns in certain positions. An osteoarthritic (OA) hip is comparably more tight and painful with rotation movements. For example, the patient is seated with their leg crossed, trying to touch their knee to their opposite shoulder. In the OA-hip patient, they may only be able to get it half way there compared to the other side and often complain of groin pain. The “ultimate test” is the x-ray that reveals the loss of the joint space—the “cartilage interval”—which narrows on the side with OA.
Learn More By visiting The Neck & Shoulder Pain Relationship

Given the close anatomical proximity between the neck and shoulder, it’s no wonder the two are intimately related. With our hectic lifestyles that include driving, hunching over computers and electronic devices, and talking on the phone (not to mention stress arising from multiple sources), sometimes it seems like the muscles in the neck, upper back, and shoulders tighten up and hurt at the same time. The question is, when it comes to pain in the neck and the shoulder, which one is the “chicken” and which is the “egg?”

The neck gives rise to the nerves that innervate the head (C1-3 nerve roots), the shoulders (C4-5), and the arms (C5-T2). Hence, there are 8 sets of nerves in the neck, 12 sets in the thoracic (middle back region), 6 sets in the lumbar or low back region, and 5 sets in the sacrum, all of which travel to a specific destination allowing us to move our muscles and to feel hot, cold, sharp, vibration, and position sense. When these nerves get pinched or irritated, they lose their function and the ability to feel, making it challenging to button a shirt, thread a needle, or pick up small objects. It can also make it difficult to unscrew jars, squeeze a spray bottle, or lift a milk container from the refrigerator. Hence, the nerves arising from the neck, when pinched, can have a dramatic effect on our ability to carry out our desired activities in which shoulder, arm, and hand use is required.
On the other hand, when the shoulder is injured (such as a rotator cuff tear), this can also result in neck problems. There are several ways pain from the neck affects the shoulder and vice versa. When the shoulder is injured, pain “information” is relayed to the brain starting at the nerve endings located in the area of the shoulder injury, transmitting impulses between the shoulder and the neck, and finally from the neck to the sensory cortex of the brain. That information is processed and communication to the motor cortex prompts nerve signals to be sent back to the shoulder through the neck and to the injured area (in this case, the shoulder). A reflex muscle spasm often occurs as a result, serving as kind of an “internal cast” as the spasm tries to protect the injured shoulder. This can become a “vicious cycle” or never-ending “loop” until the reflex is interrupted (perhaps by a chiropractic adjustment). Another means by which both areas become injured has to do with modifications in function. We tend to change the way we go about our daily chores when an injury occurs to the shoulder, such as putting on a coat differently by leaning over to the opposite side. These functional changes can also give rise to neck pain. Because of this reflex cycle, as well as the close anatomic relationship between the neck and shoulder—not to mention the “domino effect” of soft-tissue injuries which seem to change the function at the next joint level—it’s not surprising that both the neck AND the shoulder require simultaneous treatment for optimal treatment benefit. However, the good news is, regardless which one is the “chicken or the egg,” chiropractic treatments of shoulder injuries will almost always include the neck and vice versa.

11/01/2023

Low Back and Leg Pain – Is it Sciatica?

We’ve all heard of the word “sciatica” and it (usually) is loosely used to describe everything from LBP arising from the joints in the back, from the sacroiliac joint, from the muscles of the low back, and even from a pinched nerve caused by a ruptured disk. The symptoms of sciatica include low back pain, buttocks pain, back of the thigh, calf, and/or foot pain and/or numbness-tingling. If the nerve is compressed enough, muscle weakness can occur making it hard to stand up on the tip toes creating a limp when walking.

The GOOD NEWS is that Non-Surgical Spinal Decompression can resolve this problem, thus helping avoid unnecessary surgery! So, check alternative treatments FIRST, before electing for surgery!!!

Visit www.AddisonBackandSpine.com to learn more.

10/31/2023

Medical Doctors Recommend Non-Surgical Spinal Decompression Care for Back Pain Relief

Harvard Study: Low Back Pain Patients Significantly More Satisfied with Chiropractic Than Conventional Medical Care.

In 2002, at the 17th annual North American Spine Society meeting, three medical doctors defended chiropractic by citing a Harvard study that found low back pain patients were significantly more satisfied with Chiropractic treatments compared to conventional medical care.

After researching “myths,” co-author , Dr. Jack Zigler, MD found chiropractic education is more similar to medical education than it is dissimilar.

Dr. Zigler had integrated chiropractors into his multi-disciplinary spine center where the chiropractors screen patients for surgical versus non-surgical care.
Another co-author, Dr. Andrew Cole, MD, stated, “overall, manipulation* has the advantage of reducing pain, decreasing medication, rapidly advancing physical therapy and requiring fewer passive modalities.” (*Manipulation is one of the primary treatment techniques used by Doctors of Chiropractic.)

He also recommends spine surgeons refer their patients to chiropractors for Non-Surgical Spinal Decompression Therapy.

Learn More about Non-Surgical Spinal Decompression Therapy by visiting www.AddisonBackandSpine.com

10/30/2023

How Do MD’s View Chiropractic?

In the mid-1980s, a political event spurred a change regarding the medical community’s outward disrespect of chiropractors when the AMA (American Medical Association) was sued for anti-trust violations and the chiropractors won!
For the first time, the public, open anti-chiropractic slander that appeared on billboards, in magazine articles, and in TV/radio advertisements against the chiropractic profession was prohibited.

In fact, prior to this, it was against the AMA by-laws for a Medical Doctor (MD) to publicly socialize with a chiropractor! This all seems pretty extreme but was truly occurring prior to the mid-1980s… BUT NOT ANYMORE!

In 1994, the United Kingdom and the United States almost simultaneously published official guidelines for the treatment of acute low back pain.
BOTH DOCUMENTS REPORTED THE USE OF SPINAL MANIPULATION, A PRIMARY FORM OF CHIROPRACTIC TREATMENT, AS A FIRST CHOICE IN THE TREATMENT FOR ACUTE LOW BACK PAIN.

Now, for the first time, a non-chiropractic group had recommended chiropractic based on researched data that overwhelmingly supported spinal manipulation as an effective, safe, and less expensive form of care when compared to all the other treatment approaches that the healthcare consumer can choose from.
Research has continued to pour in and recently, similar recommendations were made in the treatment of chronic low back pain. Also, when reviewing the research pool, continued support of the 1994 guidelines for acute low back pain was again found to be valid with little change required.
According to the published guidelines, ALL patients with acute AND chronic low back pain should see chiropractors FIRST.

If this guideline was followed by everyone, there would be such a shortage of chiropractors, it would become one of the most desirable professions to seek vocationally.

Unfortunately, many MDs do not know enough about chiropractic to strongly recommend it to their inquiring patients. That is why this office goes out of its way to educate MDs in our community about the benefits of Chiropractic care.
Also, some programs at medical schools are now including “alternative medicine” courses in the curriculum of the undergraduate MD programs and, rotations in alternative or complimentary health services currently offered at some university / hospital settings as a post-graduate option.

This is reflected by an increasing population of MDs who actively seek out chiropractors to work with when their patients present with conditions like acute or chronic low back pain, neck pain, and/or headaches.

The MD/DC relationship is truly improving as noted by the inclusion of chiropractic into hospital programs, integration into the military bases and VA hospitals, routine coverage by most insurance companies, etc.

Schedule a free consultation today by visiting www.AddisonBackandSpine.com

10/27/2023

NFL Great Says, "Chiropractic Was The Key To Keeping Me In The Game."

If the greatest player in the history of the National Football League said, “Chiropractic was the key to keeping me in the game,” do you think chiropractic care could help you with your back pain and other aches and pains?
Well, that’s exactly what happened.

Jerry Rice, who on November 4, 2010 was named the greatest player in NFL history by NFL Network’s NFL Films production The Top 100: NFL’s Greatest Players, said:

“I believe in Chiropractic and I know that it works.

“You probably know about my long and successful career in football. I’m flattered by the testimonials to my durability.

“Football is a very rough and vigorous sport. Many of the pass patterns in a game either long or short require a maximum effort.

“I took some vicious hits from players nearing twice my size. Thankfully, I had the durability to withstand these tackles - or I never would have succeeded or lasted for as long as I did.

“Chiropractic was the key to keeping me in the game.

“My first experience with Chiropractic care was right before the 49ers were to play the Bengals in Super Bowl 23. A couple of our players were injured and a Chiropractor turned things around.

“I quickly became a believer and ever since, I have had the benefit of Chiropractic care.

“Dancing with the Stars was every bit as exhausting and challenging - though not nearly as brutal as football - it required many hours of practice… I had aches and pains that I never had before. Again, Chiropractic made the difference and kept me dancing and in the competition.”

The average NFL career is extremely short… lasting only 2-4 years. Injury prematurely ends many young player’s hopes and dreams. Jerry Rice played an astounding 20 years in the NFL.

If Chiropractic can help Jerry Rice play for 20 years in the NFL, just imagine what it can do for the rest of us!

Click Below to see Jerry speak about the benefits of Chiropractic…

https://www.youtube.com/watch?v=_CAsGNlQEnI

No one would claim celebrities have all the answers. However, it would seem that with all the options celebrity affords them, the fact they seek chiropractic care to meet their healthcare needs says something about the value of chiropractic for optimum health!

http://www.YourSpine.com"Chiropractic care has been instrumental in my life, both on and off the field, and I am excited to share this with the American publ...

10/26/2023

Low Back Pain and Sleep

Low back pain (LBP) can arise from a lot of causes, most commonly from bending, lifting, pulling, pushing, and twisting. However, there are other possible causes, including sleep. This not only includes sleeping in a crooked or faulty position, such as falling asleep on a couch, in a chair, or while riding in a car, but also from the lack of sleep. So the question is, how much sleep is needed to feel restored and how much sleep is needed to avoid low back pain?

Learn More and schedule a free consultation today by visiting: www.AddisonBackandSpine.com

10/25/2023

Neck and Headache Pain and Posture

Neck pain is one of the most common complaints for which patients present to chiropractic offices. Headaches are also another very common problem and often go hand-in-hand with the presence of neck pain. So, the question that is frequently asked is, “…why do headaches and neck pain often occur together?”

The relationship between neck pain and headaches is strong! In fact, in some cases, headaches will occur ONLY when the neck hurts. One reason is because the first three nerves that exit out from the top of the cervical spine (C1, C2, and C3) have to travel through the thick group of muscles that insert onto the back/base of the skull along the occipital rim. Because we carry a lot of stress in the neck muscles, when they tighten up, they squeeze or pinch those 3 nerves and pain then radiates into the back of the head and sometimes up and over the vertex to the eyes or behind the eyes.

Schedule a free consultation today by visiting: www.AddisonBackandSpine.com