Posts in Chiropractic News

Injecting fat into discs

Written By davecasey6719@gmail.com, On April 30, 2014

Surgeons are injecting the spine with fat from patient’s stomachs in ‘promising’ new treatment for chronic back pain

Damaged discs are one of the most common causes of chronic back pain

Surgeons are injecting fat cells into the discs in the spine, damaged discs are one of the most common causes of chronic back pain.

The fat stored around the abdomen is rich in stem cells, which have the ability to develop into different types of tissue, and the theory is that injecting them into the spine will help “repair” the discs. One of the biggest problems seen by chiropractors is degenerative disc disease.

Around one in four people will suffer disc problems at some time in their lives.We are always told the discs work as shock absorbers to cushion the spine during movement, but this is not true in fact they only allow flexibility and prevent the bones of the spine from rubbing together. They are very poor at absorbing “shock”.

The discs continue to degenerate throughout our lives, which means they provide less cushioning .

Chiropractors can control discomfort seen with damaged discs but often the damage is too extensive and then  surgical procedures are the last resort, all too often this ends up just fusing the discs together or trying to replace problem discs.

Over recent decades there has been the hunt for the surgical “holy grail” that surgery can replace or repair the discs. To date surgery has not succeeded in this quest.

This latest attempt hopes to stop the body’s immune system rejecting chemicals, that were once used in previous attempts at restoring the cushioning properties of the discs.

The new treatment is different, as it’s designed to repair any damage and protect against future degeneration.It involves first taking fat from the patient’s abdomen using liposuction. This can be done under local anaesthetic. Around 100 millilitres (a fifth of a pint) of fat is removed.

Until recently fat like this was discarded as surgical waste, but it is now known to contain many types of cells, including stem cells.The theory behind this new treatment is that the stem cells will be attracted to areas of damage and start repairing them.

Stem cells can be obtained from bone marrow, too, but extracting them involves an uncomfortable procedure which yields only 5,000 to 60,000 cells.

A 20-minute liposuction session from the abdomen can harvest 40 million cells.The stem cells are extracted from the fat in a laboratory and can then be injected into the damaged discs.

When researchers at the Mayo Clinic in the U.S. tested it on animals, they found that the height of the discs improved by 26 per cent compared with those injected with a placebo.

In addition, the water content of the inner section of the disc improved.A higher water content helps keep the gel-like middle moist and better at cushioning the spine from damage.

The treatment is being tested on 100 patients at three centres in the U.S., including Flower Hospital in Texas.

The patients will be monitored over the next few months. Jane Tadman, from Arthritis Research UK, says stem cells offer ‘a promising source of cells with which to treat degenerative disc disease.

However  we should focus on treatment that  attempts to maintain a healthy spine in the first place and avoid surgery completely. Even with new surgical techniques surgery will never be the main treatment for the vast amount of low back pain patients to date surgery is only used in a small number of back pain patients and does carry significant risks.

 

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BACK PAIN CLINIC MARKET HARBOROUGH

Written By davecasey6719@gmail.com, On March 29, 2014

HARBOROUGH BACK PAIN CLINIC

It is important that you follow up with regular sessions to ensure the back pain is kept under control.

Living a life without back pain is possible with the help of your  chiropractor.

About Back Pain Treatment in Market Harborough

Back pain is a common ailment. Most people suffer from simple or non-specific back pain, which is often put down to being caused due to minor injury or strain and this is simply not always true. Often back pain is due to accumulated damage and can never be completely cured.

Types Of Back Treatment in Market Harborough

There are various methods for relieving back pain such as mild activity, taking bed rest, heat therapy and ice therapy. Chiropractic has become the treatment of choice for back treatment that identifies the cause of back pain and then increases or restores the potential for movement to help overcome it. Many people find this is an effective way of easing joint and muscle pains.

 

 

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Lumbago

Written By davecasey6719@gmail.com, On March 21, 2014

Lumbago

Lumbago is just an old term used to describe pain in the lower back

Lumbago is another term for low back pain a condition experienced by up to 80% of people in the industrialised Western world at some point in their lives. The term first appeared in the 1600s, then used mainly by doctors. It became more popular amongst the medical profession and was widely used even in the 1960s and 70s. Lumbago is a meaningless term often used by GPs to give an instant diagnosis, just as the term slipped disc is meaningless, both terms have no place in the modern world and only serve to confuse patients even more.

The term lumbago is derived from Latin – with lumbus meaning loin. Hence, lumbago means ‘weakness in the loins’ (which does conjure up a number of visions), or alternatively, ‘weakness in the lower back’ which is a more accurate description.

We commonly consider lower back pain to be a modern-day phenomenon and indeed, it appears that the sedentary lifestyle enjoyed in our civilised world may contribute to the problem. However, the fact that lumbago was described in the 1600s suggests that our ancestors also suffered back problems.

It is likely however, that in those days, it was not a lack of exercise or bad posture that contributed to the problem, but rather, degenerative conditions such as arthritis.

 

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Back pain test ‘aids diagnosis’

Written By davecasey6719@gmail.com, On March 10, 2014

Back pain test ‘aids diagnosis’

A simple technique could help differentiate patients with different causes of back pain.  Test commonly used by chiropractors in their offices are seen to be valuable aids to diagnosis. Researchers have devised bedside tests that distinguish between neuropathic pain (nerve damage) and other causes of pain. It said the tests are better than existing tests for neuropathic pain. The different causes of pain have different treatments and the researchers say, “if a diagnosis is wrong, patients may receive treatment, including surgery, that does not improve their pain”.

This study indicates that a simple, quick diagnostic procedure can distinguish between the most common cause of back pain (axial) and pain caused by nerve damage (neuropathic). As the treatment for these can be very different, this is potentially a very useful tool. As a chiropractor we see misdiagnosis all the time, most patients are just managed with pain relief without any attempt made to locate the actual cause ofr pain.

Where did the story come from?

The research was carried out by Dr Joachim Scholz from the Massachusetts General Hospital in Boston and colleagues from other institutions in the US, UK and Switzerland. The work was supported by a grant awarded by Pharmacia through The Academic Medicine and Managed Care Forum, with supplementary support from Pfizer. The study was published in the (peer-reviewed) medical journal PLoS medicine, a free journal from the Public Library of Science.

What kind of scientific study was this?

This was a diagnostic test validation study. It had two parts, the first of which involved the researchers devising a set of questions and bedside tests for distinguishing between two different types of back pain: neuropathic and axial. These diagnostic ‘tools’ were then tested on a separate group of participants to measure their accuracy.

Neuropathic pain is caused by damage to the nerves and is often difficult to formally diagnose. Sufferers commonly describe it as a ‘burning’ or ‘stabbing’ pain. A common form of neuropathic pain is ‘radicular’ low back pain, also called sciatica, which comes from a ruptured or bulging  disc and radiates from the back into the legs. The researchers compared this to the most common type of low back pain, ‘axial pain’, which is confined to the lower back and is non-neuropathic (not caused by nerve damage but is due to damage to joints, muscles or other tissue.

What does the NHS Knowledge Service make of this study?

Diagnostic studies such as these are rarely reported in the news, though they form an important part of developing any potential test.  There are a few points to consider about this study:

  • The researchers also looked at the accuracy of the individual examination signs that make up the tool and showed
  • that the best tests were tests for radicular pain known as a straight-leg-raising sign,
  •  a test for detecting cold, and a reduced response to pinprick test.

    These findings indicate that a simple, quick diagnostic procedure can distinguish between radicular (neuropathic) and axial (non-neuropathic) low back pain in the selected group tested. Because the two types of back pain are treated in different ways, this is important when deciding who to refer for further tests such as an MRI scan.

    The use of these tests routinely in chiropractic surgeries has been valuable and prevents over use of MRIs and surgery in the treatment of back pain.

     

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Do GP’s refer to chiropractors

Written By davecasey6719@gmail.com, On February 27, 2014

CHIROPRACTORS and GPs should  take a team approach to treating their patients to optimise treatment, according to experts.

A study published online today by the MJA on the clinical practices of chiropractors found patients had been referred to a chiropractor by a GP in 4% of consultations.  The Chiropractic Observation and Analysis Study (COAST), based on chiropractors in Victoria Australia, was the first of its kind in the world.

Professor Marc Cohen, of the School of Health Sciences at RMIT University, said the lack of cross-referrals and communication between GPs and chiropractors  may lead to suboptimal care and reduce the effectiveness of the therapeutic relationship.” Professor Cohen said a lack of understanding across the many different health disciplines, along with real or perceived competition between them, hindered interdisciplinary communication. He said patients were likely to benefit from a coordinated care approach where they felt free to discuss all their treatments with their practitioners, and their treating practitioners collaborated to provide the safest and most appropriate care.

Professor Peter Brooks, director of the Australian Health Workforce Institute at the University of Melbourne and chair of the Australian Acute Musculoskeletal Pain Guidelines Group, said chiropractors should be part of the primary care team but all members of the team should espouse and practise evidence-based care. “At least an exchange of information between [GPs and chiropractors] would assist treatment and diagnosis”, he said.

The study authors said most people who saw a chiropractor also consulted a medical practitioner. They suggested further research “to maximise the patient benefit that can be gained through a team approach to primary care”.

Dr Liz Marles, president of the Royal Australian College of General Practitioners, said it was important for GPs to know if their patients were receiving chiropractic treatment to ensure treatment plans were not conflicting.  Chiropractors are encouraged  to refer to a GP when it was in the best interests of the patient and this should be a two way street, but all too often the best interests of the patient is ignored because of  ignorance about chiropractic treatment.

“Patients with musculoskeletal conditions will benefit from managed or integrative care, particularly where the patient wants a drug-free approach or wants to consider all options before surgery.”

Professor Cohen, who is past president of the Australian Integrative Medicine Association, said the snapshot of chiropractic practice provided by the study was useful to GPs.

“Knowing that many of their patients are seeing chiropractors may prompt GPs to open discussions about chiropractic care and communicate with chiropractors about reinforcing evidence-based lifestyle recommendations”, he said.

“Mind you, a lot of back pain will get better whatever we do”, is often the option of many Gp’s, however this attitude  has lead to the increasing cost of treating low back pain.  With many GP’s misunderstanding what chiropractors actually do it remains difficult to build professional bridges. Manipulation is not used to correct misalignment of bones, because that is impossible. As a chiropractor I spend hours trying to educate patients and correcting such myths, the biggest myth  is disc slipping out of place. It is totally impossible for disc to slip but everybody has heard about slipped discs and expects a chiropractor to be able to manipulate it back into place.

Here is a classic negative comment printed in medical journals of today which chiropractors have to endure.

“During my orthopaedic training I assisted my boss at the spinal unit to reduce a C5-6 unifacet dislocation. Despite general anaesthesia with muscle relaxant, image intensifier control, a patient with known acutely torn ligaments, and over 200 kg of orthopod hanging off his head; it was very difficult to manoeuvre the spine by 5 mm. My eminent spinal surgeon boss mused wanly on how the chiropractors managed to manipulate the spine under less favourable circumstances.”

Modern attitudes do prevail and common sense does prevail, comments such as this from a surgeon.

I am a surgeon who believed once that chiropractors were all quacks. But now, as a regular patient, I look forward to my visits and feel my chiropractor has a significantly better understanding of anatomy of the back than I do. I get her to explain her manipulations to me, and they make sense.

Chiropractors do not believe that all disease is caused by misalignment of the spine. This sort of disinformation only increases the gap between the professions. Regardless of what GPs say, people keep returning to chiropractors for back care because it works for them, otherwise the profession would decline instead of grow.

I am a medical practitioner and have found that chiropractic works best for me when I have acute lower back pain.  Medicine clearly does not have all the answers, so patients will continue to seek what works for them.Chiropractic care doesn’t deserve the bad reputation that organised medicine promotes. Certainly, more evidence for it’s efficacy would help chiropractic, but to vilify a profession the way that organised medicine does is unprofessional at least and smacks of turf grabbing at worst.

As I chiropractor I work hard to keep up to date with recent research regularly exceeding the CPD requirements for the profession. I am saddened by the apparent lack of up-to-date commenters. There is a mountain of research linking nerological benefit of normal range of motion. There is evidence that GP and physio care actually makes back pain outcomes worse and some that shows it improves outcomes. Most of my patients have been to their GP first and usually have had NHS physio, which often delays treatment for months and not uncommonly years in some cases. There are much better ways to assist your patients than we had in the past and improved outcomes is the main objective right?

Chiropractors don’t push bones in that have moved out of place

Is it not plausible that a joint may demonstrate abnormal motion following sustained poor posture, trauma, degeneration or other abnormal load?

As a result of the abnormal motion at the joint, it is not plausible that this could result in some local pain?

Where there is pain at the joint, is it not plausible that putting a high velocity force into that joint might elicit a stretch reflex, fire the golgi tendons in the muscle spindle?

Can pain modulation result from direct inhibition of the anterolateral system though mechanoreceptor stimulation of interneurons in lamina II and V thereby synapsing with other nociceptive afferent axons?

Would that not release met-enkephalins thereby inhibiting nociception presynaptically?

I wonder if there could be any result from spino-thalamic activiation releasing endorphins?

I wonder if such stimulation of those afferents, the periductal grey matter and nucleus raphe magnus could excite interneurons through the descending serotonergic pathways to cause post-synaptic inhibition of the preganglionic sympathetic neurones of lamina VII thereby restoring vasomotor control?

Could that sympathic inhibition reduce nociceptor stimulation and decrease substance P release?

For the benefit of patients, health care providers should collaborate and coordinate care.  I suggest that interested medical doctors attempt to work with chiropractors that are patient-centered and evidence-based providers.

 

 

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Market Harborough Chiropractor

Written By davecasey6719@gmail.com, On January 27, 2014

Curved soles ‘no better than flats’ for back pain

“Shoes with curved unstable soles are no better than traditional trainers for reducing low back pain,” BBC News reports, after a small but well-designed study found no significant benefit in people wearing “rocker sole” shoes.

The study involved 115 adults with chronic lower back pain who were randomised into two groups: rocker sole trainers or normal trainers. They were asked to wear these trainers for at least two hours a day over the course of a year. They were also asked to exercise once a week for four weeks and wear their trainers to these sessions.

For a number of measures the rockers actually fared worse than their flat sole counterparts, including satisfaction with the trainers and a clinically important reduction in self-reported disability Larger studies assessing pain and disability over a longer period of time would be able to confirm or refute these findings, but initially  and in light of the strengths mentioned above – they appear reliable.

Market Harborough Chiropractor Dr David Casey agrees with these findings. He says that the majority of back pain is the result of many years of accumulated damage, not just muscular dysfunction. Years and years worth off overstressing the spine causes ligament damage resulting in joint stiffness. Just trying to stimulate spinal muscles with “wobbly trainers” simply misses the point.

Where did the story come from?

The study was carried out by researchers from UK-based hospitals and universities in collaboration with international partners. It was funded by Masai GB Ltd, a footwear manufacturer specialising in rocker sole ranges. Because of the largely neutral findings of the study, it is clear the funders had no influence on the study design or reporting.

The study was published in the medical journal, Spine.

Also the BBC provided coverage of the study that  was balanced and factually accurate.

  • Rocker sole shoes seem to be no more beneficial than flat sole shoes in affecting disability and pain outcomes in people with chronic lower back pain.
  • If a person’s chronic lower back pain is predominately aggravated by standing or walking, it may be more beneficial to wear flat sole shoes than rocker sole shoes.
  • A greater proportion of participants who wore the flat sole shoes reported a clinically important change in self-reported disability at six months.
  • At both six and 12 months, participants in the flat sole shoe group were more satisfied with the shoe they received than the participants in the rocker sole shoe group.

This study indicates that rocker sole-style footwear is no more beneficial than flat sole trainers in reducing disability and pain outcomes in adult chronic lower back pain sufferers.

For a number of measures, such as satisfaction with the trainers and a clinically important reduction in self-reported disability, the rockers fared worse than their flat sole counterparts.

However, chronic back pain sufferers are the group most likely to try the shoes, so this was a realistic approach to take.

 

 

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