Dr. Glenn Hyman’s Denver Chiropractic Center: The Mysteries of Low Back Pain!

Most people don’t realize how complicated the low back region is when it comes to investigating the cause of low back pain (LBP)? There can be findings on an x-ray, MRI, or CT scan such as degenerative disk disease, arthritis, even bulging and/or herniated disks that have NOTHING to do with why the back hurts. Similarly, there are often other abnormal findings present in many of us who have NO low back pain whatsoever! Because of this seemingly paradoxical situation, we as clinicians must be careful not to over-diagnose based on the presence of these “abnormal findings” AND on the same hand, be careful not to under-diagnose them as well. Many of you know it can be quite tricky.

Looking further into this interesting paradox, one study reported findings that support this point. Investigators examined 67 asymptomatic individuals who had NO prior history of low back pain and evaluated them using magnetic resonant imaging (MRI). They found 21 of the 67 (31%) had an identifiable disk and/or spinal canal abnormality (which is where the spinal cord and nerves run). Seven years later, this same group of non-suffering individuals was once again contacted to see if they had developed any back problems within that time frame. The goal of the study was to determine if one could “predict” who might develop low back pain based on certain abnormal imaging findings in non-suffering subjects. A questionnaire was sent to each of these individuals, of which 50 completed and returned the questionnaire. A repeat MRI scan was performed on 31 of these subjects, and two neurologists and one orthopedic spine surgeon interpreted the MRI studies using a blinded approach (without having knowledge about the subject’s symptoms or lack thereof). Each level was assessed for abnormalities including disk bulging/herniation and degeneration. Those who had initial abnormal findings were defined as “progressed” (worsened) if an increased severity of the original finding was evident or if additional or new spinal levels had become involved over the seven-year time span.

Of the 50 who returned the questionnaire, 29 (58%) had NO low back pain, while 21 had developed LBP. In the original group that had the MRI repeated seven years later, new MRI findings included the following: twelve remained “normal,” five had herniated disks, three had developed spinal stenosis, and one had “moderate” disk degeneration. Regarding radiating leg pain, four of the eight had abnormal findings originally, two of the eight had spinal stenosis, one had a disk protrusion, and one an “extruded” (“ruptured”) disk. In general, repeat MRI scans revealed a greater frequency of disk herniation, bulging, degeneration, and spinal stenosis compared to the original scans. Those with the longest duration of LBP did NOT have the greatest degree of abnormalities on the original scans. They concluded that the original MRI findings were NOT PREDICTIVE of future development of LBP.

They summarized, “…clinical correlation is essential to determine the importance of abnormalities on MR images.” These findings correlate well with other studies, such as 50% or more of all asymptomatic people HAVE bulging disks and approximately 30% of us have herniated disks – WITHOUT PAIN. To be of diagnostic (clinical) value, the person MUST have signs and symptoms that agree with the imaging test, which is used to CONFIRM the diagnosis. Bottom line, If you have LBP, come see us, as we will evaluate and treat YOU, NOT your x-rays (or MRI) findings!

If you, a friend, or family member requires care for back pain, we would be honored to help. Simply call us at 303.300.0424, or use the “Make An Appointment” link on our website at denverback.com

Dr. Glenn Hyman’s Denver Chiropractic Center- the 1-Page Health News

“Family is not an important thing. It’s everything.” ~ Michael J. Fox

Mental Attitude: Let it Go.
Previous studies have shown that the inability to forgive one’s self for a wrong they’ve inflicted on another can be a factor in depression, anxiety, and a weakened immune system. The results of a new study shows that the more guilty a person feels, the less likely they are to self-forgive. However, attempting to make amends was shown to decrease those guilty feelings and make self-forgiveness easier.
The Journal of Positive Psychology, April 2014

Health Alert: Cholesterol Levels Linked to Fertility.
Couples having trouble getting pregnant may want to get their cholesterol levels checked. A study involving 500 couples found that conceiving a child took longer when both partners had high cholesterol levels than when both partners had cholesterol levels in the normal range.
National Institutes of Health, May 2014

Diet: Three Ideas for Overcoming Childhood Obesity.
To combat childhood obesity, Dr. Kristopher Kaliebe of the Louisiana State University Health Sciences Center has developed three simple ideas that parents and their children can follow: 1) Eat Food — Not too Much, Mostly Plants. Eating mostly raw, natural, unprocessed food eliminates the need to count calories, a large reason most diets fail. 2) Get up and move. Be active whenever possible and avoid sedentary behavior. 3) Honor silence. Avoid sensory overload from TV, the internet, gadgets, and video games and focus on the more important matters like academics, sleep, family, and hobbies.
Journal of the American Academy of Child & Adolescent Psychiatry, April 2014

Exercise: Bursts of Intense Exercise Before Meals Helps Control Blood Sugar.
Brief bursts of intense exercise before meals helps control blood sugar in individuals with insulin resistance better than 30 minutes of moderate exercise performed once per day. Researchers found that distributing the same amount of exercise into three ten-minute, high-intensity, pre-meal exercise periods resulted in a 12% reduction in the average post-meal glucose level, an effect that was also sustained the ensuing day.
Diabetologia, May 2014

Chiropractic: Conservative Care for Lumbar Disk Injuries.
A 31-year-old male with left-sided low back pain and left leg pain received a trial of chiropractic care that included soft tissue therapy, manual mobilization, pelvic blocking, and extension exercises. His pain was almost completely resolved by his third treatment. This finding supports the ability of chiropractic care to reduce pain and improve mobility in patients with a lumbar disk herniation.
Journal of Canadian Chiropractic Association, September 2012

Wellness/Prevention: Calcium Supplementation Does Not Increase Cardiovascular Disease Risk in Women.
While recent studies have indicated that calcium supplementation may increase a woman’s risk for cardiovascular disease, a review of two decades worth of data on over 74,000 female nurses reveals that calcium supplementation is not associated with an increased risk for heart attack or stroke. Lead study author Dr. Julie Paik explains, “Our study has several distinct strengths compared to prior studies including the large number of participants, long-term follow-up, large number of cardiovascular events that were confirmed by medical record review, detailed information about diet and other cardiovascular disease risk factors, and repeated assessment of calcium supplement use over the 24-year follow up period.”
Osteoporosis International, May 2014

Dr. Glenn Hyman’s Denver Chiropractic Center: Thirty Seconds on Thursday Video

Kacee is back with this week’s (approximately) Thirty Seconds on Thursday video. Just click on the video below and it will take to our youtube channel where it will play. We’re talking about Foam Rolling to prevent back pain this week. Hope you enjoy it.

Dr. Glenn Hyman, Kacee Reinisch, Natalie Aceves, and Erin Young, Denver Chiropractic Center

 

 

Dr. Glenn Hyman’s Denver Chiropractic Center: Car Accident Injuries (Whiplash) Self-Care: Part 2

 

Last month, we started the discussion of self-care options in the management of car accident injuries: whiplash or CAD (cervical acceleration-deceleration) or WAD (whiplash associated disorders). In this series, we are describing various treatment methods that you can be taught to help facilitate in the management process during the four stages of healing (acute, subacute – discussed last month; remodeling and chronic – addressed this month).

 

Like in the acute and subacute stages, many of the same self-care techniques can be applied here as well. You will NEVER “hurt” yourself with ice or ice/heat combinations (done properly), so they can be continued indefinitely. Many patients find this helpful. Using the analogy of a cut on the skin, in the acute stage, the cut is fresh and new. It is quite pain sensitive and unstable and it will continue to bleed if you don’t take it easy. After 72 hours (entering the subacute stage), the wound has an immature scab on it and it can still easily be re-injured, and if this occurs, especially by NOT self-managing properly, the recovery time can be significantly prolonged. So, “DON’T PICK AT YOUR CUT!!!” As we enter the later subacute phase (fourteenth week), the wound’s scab is quite mature, and self-care can be appropriately more aggressive. Think strengthening and activity restoration!

 

Stage 3 – REMODELING phase (14 weeks to 12 months or more): In this stage, we are now three months to a year out from the injury date and hence, we SHOULD now be more “aggressive” with care. During the late acute and subacute stages, you would have been performing exercises focused on movement restoration (range of motion / ROM exercises with LIGHT resistance) in addition to self-applied myofascial release techniques using foam rolls, tennis balls, TheraCane, and/or the Intracell (and possibly others). It is NECESSARY to continue the use of these methods, as they help reduce the chances for any scar tissue to become permanent. In this stage, we will guide you into more advanced exercises that include aerobics (walking, walk/run combinations, etc.) as studies show that whole body aerobic exercise helps MANY specific area injuries, including WAD/CAD injuries.

 

Stretching short/tight muscles, working on balance-challenging exercises (rocker or wobble boards, balance beams, gym balls, eyes closed specific action movements) are VERY IMPORTANT, as they retrain your neuromotor system and reintegrate neural pathways that have been disrupted by the injured tissues and retrain faulty movement patterns you’ve developed from compensating due to pain. Strengthening exercises will include the core since the head sits on the neck, the neck on the trunk, the trunk on the legs, and ALL of this sits on the feet (so we’ll even consider stabilizing the sub-talar joint at the ankle and if pronation is excessive, foot orthotics can help whiplash patients)!

 

Stage 4: CHRONIC (Permanent): ALL OF THE ABOVE can be employed after the one to two year point to “maintain” your best level of function. If you still have pain, try to “ignore it” and KEEP MOVING, stay active, stay engaged in work, family activities, and DON’T let the condition “win.” AVOID CHRONIC DISABILITY by staying active and fit!

 

We realize you have a choice in whom you consider for your health care. If you or someone you know needs help recovering from car accident injuries, call us at 303.300.0424, or use the “Make an Appointment” function on our website www.denverback.com.

Protein Followed by Exercise Leads to More Effective Calorie Burning.

A new report finds that women who consume a high-protein meal before moderate exercise burn calories more effectively than women who exercise on an empty stomach. Study author Dr. Ashley Binns writes, “We found that with exercise, there is a trend for a continued increase in caloric expenditure with higher protein consumption. Additionally, the consumption of the high- or low-protein meals resulted in greater energy expenditure than the fasted state. That means that eating prior to exercise does provide fuel to burn, making us more like an energy-burning machine.”
Journal of Science and Medicine in Sport, March 2014

Low back pain causes more global disability than any other health problem studied.

Low back pain is something that almost all people experience at some point in their lives. It is something common across sexes, age groups, countries, socioeconomic groups, education levels and occupation,” said Damian Hoy, Senior Research Fellow at the University of Queensland’s School of Population Health, in Australia.

Back pain is the number one cause of lost work days in the U.S,” said Dr. Anders Cohen, Chief of Neurosurgery and Spine Surgery at the Brooklyn Hospital Center, in New York City.
Hoy and his colleagues reviewed 117 published studies that included information on low back pain prevalence. They also reviewed surveys done in 50 countries on back pain prevalence and severity. Compared to 291 other health conditions, the researchers found that low back pain causes more global disability than any other health problem studied.

The second study — done by researchers in Australia and the United States — looked at data from 187 countries from 1990 and 2010. Just over one-third of all work-related disability was related to low back pain, the study found.

“With aging and growing populations, low back pain is an enormous burden in developing countries,” lead author, Hoy said. “This is predicted to grow substantially over coming decades and will likely have an enormous impact on individual livelihoods, health care systems and economies.”

Both studies were published online on March 24 in the Annals of the Rheumatic Diseases.

If you, or someone you care about, have back pain, we would love to the opportunity to help. Just call us or email us through the website.

Denver Chiropractic Center’s Health News for You…

Courtesy of:
Denver Chiropractic Center
1780 S Bellaire St #710
Denver, CO 80222
(303) 300-0424

“Face your life, its pain, its pleasure, leave no path untaken.”
~ Neil Gaiman

Mental Attitude: Advanced Math & Reading in Kindergarten Improves School Performance.
Regardless of economic background, a new study finds that exposing kindergarteners to more challenging math and reading content during their early education results in better performance in those subjects later in childhood.
American Educational Research Journal, March 2014

Health Alert: Drug-Resistant Bacterial Infections on the Rise.
Researchers report that antibiotic-resistant bacteria are infecting an increasing number of children in the United States. Though this type of infection is still rare, the researchers say it is increasingly found in children, predominantly those between the ages of one and five years old. Lead author Dr. Latania K. Logan adds, “These antibiotic-resistant bacteria have traditionally been found in health care settings but are increasingly being found in the community, in people who have not had a significant history of health care exposure.”
Journal of the Pediatric Infectious Diseases Society, March 2014

Diet: Does Diet Cause Depression?
Like heart disease, depression is associated with low-grade inflammation, endothelial dysfunction, and worse lipid profiles that suggest a poor diet as an underlying cause. Existing research has shown increased fast food consumption is associated with a greater risk for depression. On the other hand, the Mediterranean diet has been observed to reduce depressive symptoms. According to researcher Dr. Almudena Sanchez-Villegas, “It is difficult to be sure that the diet is responsible for depression – it could be that depressed people make bad food choices. Other study problems include ‘confounders’ which may influence dietary habits, such as marital status, exercise, alcohol (or smoking), medical conditions and social networks. Or simply genetics. To address these issues we need long-term, randomized clinical studies similar to ones successfully conducted for diet and cardiovascular disease risk. Only then will we really understand the impact of diet of depression.”
BMC Medicine, January 2013

Exercise: Kids Should Play More Than One Sport!
A report published by the American Medical Society for Sports Medicine recommends children avoid early sport specialization as it may increase their risk for overuse injuries and burnout. Overuse-related injuries account for 50% of sports injuries among youth athletes.
American Medical Society for Sports Medicine, January 2014

Chiropractic: Maintenance Care Recommended.
Chiropractors often recommend periodic visits to identify joint dysfunction and make corrections with skilled spinal manipulation or Active Release Techniques (if the doc is certified, of course;). These maintenance treatments are thought to prevent disease of both neuromusculoskeletal and visceral causes.
Journal of Manipulative and Physiological Therapeutics, January 2000

Wellness/Prevention: Vitamin A Intake During Pregnancy Affects Child’s Immunity.
An animal study involving mice has found that vitamin A deficiency during pregnancy leads to smaller lymph nodes and Peyer’s patches in offspring. Lymph nodes and Peyer’s patches are important components of the immune system and as a result, the vitamin A-deprived offspring in the study were more susceptible to viral infections later in life. The researchers further noted that giving vitamin A to deprived offspring failed to reverse the impact of deficiency during pregnancy.
Immunology, March 2014

Chiropractic: Upper Back Adjustments Help Neck Pain?

Spinal manipulation applied to the upper thoracic spinal region of sixty non-specific neck patients was found to improve cervical mobility and decrease neck pain.
Manual Therapy, March 2014

Back from the USAT certification

I just finished up at the USA Traithlon Coaching
Certification clinic in Colorado Springs. Had a great
room for 2 nights at the Broadmoor. What a place.

But that’s not why I’m writing. During one of the breaks,
a coach from New York asked if I could take a look at
her shoulder. Somehow she had been googling Active
Release and found my website. It was kind of strange that
she knew who I was.

Anyway, she had been dealing with shoulder pain while
swimming for over a year. It hurt to raise her arm
over her head, hurt to put a shirt on, hurt at night,
etc.

Fear of needing surgery had kept her from saying
anything about the pain to anyone. She was hoping
maybe I could give her an opinion.

I put her through some ranges of motion and her
problem was obvious. Scar tissue in her subscapularis
was keeping that muscle from firing. This was causing
her humerus to ride a little too high in the joint.
Classic impingement syndrome.

I treated her during the first two days at the clinic,
mostly breaking up the scar tissue in the subscap.
On the third day she swam and reported it was
about 90% better. I referred her to an ART doc in
NY to finish up. She was so excited that she cried.
I love that kind of case.

This was no miracle. Many shoulder problems start in
the subscap. They can usually be fixed. The first step
is finding the right person to help. I’ve treated
hundreds, probably over a thousand.

So, I’m back in the office after the certification.
If you or anyone you know is having shoulder pain,
I can probably help. Call 303.300.0424.

You can read more about shoulder pain here:
http://www.denverback.com/q_shoulder.html