Category Archives: Chiropractic Lifestyle

What is the Chiropractic Lifestyle? It is the extension of not just chiropractic adjustments but also learning about the other things your body need to stay healthy. These include proper nutrition, proper posture, healthy exercise, learning healthy ways to release stress, creating or accepting you support network, and last but not least getting the right amount of rest.

The Bacterial Link Between Crohn’s Disease and Arthritis

Elizabeth Hofheinz, M.P.H., M.Ed. • Mon, March 6th, 2017

A team of researchers from New York has filled in the blanks as to how Crohn’s disease and spondyloarthritis are related. The work, published February 8, 2017 in Science Translational Medicine, revealed a type of E. coli bacteria found in Crohn’s patients that can trigger inflammation associated with spondyloarthritis.

According to the February 9, 2017 news release, “The researchers used fecal samples from patients with inflammatory bowel disease IBD to identify bacteria in the gut that were coated with antibodies called immunoglobulin-A (IgA) that fight infection. Using flow cytometry, in which fluorescent probes are used to detect IgA-coated bacterial species, the researchers discovered that IgA-coated E. coli were abundant in fecal samples from patients with both Crohn’s disease and spondyloarthritis.”

“The investigators found that patients with Crohn’s disease and spondyloarthritis had higher levels of Th17 cells, and that a protein called IL-23 triggers their activity. With the recent FDA approval of an anti-IL-23 medication for Crohn’s disease called ustekinumab, the findings may help physicians select therapies that target symptoms of both the bowels and the joints in these patients.”

Randy Longman, M.D., Ph.D., a gastroenterologist at the Jill Roberts Center for Inflammatory Bowel Disease at Weill Cornell Medicine and NewYork-Presbyterian, led the translational study along with co-author Ellen Scherl, M.D., director of the Roberts Center at NewYork-Presbyterian and Weill Cornell Medicine and the Jill Roberts Professor of Medicine at Weill Cornell Medicine. They worked in collaboration with Hospital for Special Surgery rheumatologists and co-authors Drs. Lisa Mandl and Sergio Schwartzman.

Dr. Longman told OTW, “A critical clinical question for orthopedic surgeons is to differentiate inflammatory from non-inflammatory arthritis, since the treatment options—medicine vs. surgery—could be very different. While a diagnosis of rheumatoid arthritis, for example, will often trigger evaluation of inflammatory musculoskeletal pain, an existing diagnosis of inflammatory bowel disease (IBD) may not.”

“Our current data suggest that microbiome characteristics may identify Crohn’s patients with inflammatory arthritis. These findings highlight the need for careful evaluation of these symptoms in patients with IBD in order to identify the most appropriate therapeutic approach.”

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Spinal Cord Manipulation Reduces Opioid Use

Elizabeth Hofheinz, M.P.H., M.Ed. • Fri, March 10th, 2017

 

New research from Thomas Jefferson University in Philadelphia is giving new hope to those suffering with chronic pain. The research, sponsored by Abbott Laboratories, involved the examination of opioid usage in more than 5,400 patients both prior to and after receiving a spinal cord stimulation (SCS) system implant. According to the January 20, 2017 news release, the researchers found that “opioid use declined or stabilized in 70% of patients who received an SCS system.”

 

“As our society has been seeking ways to stem opioid abuse and [in] addition, our company offers treatment options that can reduce their exposure to opioid medication,” said Allen Burton, M.D., medical director of neuromodulation at Abbott. “Data like these are critical to helping us demonstrate that spinal cord stimulation can reduce exposure to opioids while giving patients comprehensive pain relief.”

 

Morphine equivalent dose (MED) in patients with effective SCS (blue) and those who had their SCS explanted (gray) before and after SCS implant (dashed line). Left: solid lines are median and shaded areas are interquartile ranges. Right: solid lines are mean and shaded areas are SE./Courtesy of Congress of Neurological Surgeons

 

Ashwini Sharan, M.D. is director of Functional and Epilepsy Surgery at Vickie and Jack Farber Institute for Neuroscience at Jefferson. He told OTW, “I have always felt that spinal cord stimulation works very effectively in managing patients’ pain but did not know if the therapy helped reduce medication use, as well. We had to complete a population-based study using thousands of patients to find out what is happening with their medication management. We wanted to see if there was a secondary benefit and how it can be measured objectively.”

 

Asked why this hasn’t been demonstrated previously, Dr. Sharan noted, “The problem is in the process; unless doctors go out and collect data then there will be no compiled evidence. The doctor has to have a passionate about it in order to make the study happen. Also, companies don’t do post-marketing studies. It’s just not the culture. It comes down to time and resources.”

 

“If they see that patients are taking more and more pain killers then they have to identify that something is wrong. There should be a correlation between the patients’ pain and anxiety levels. An increase in the use of narcotics often just means that patients are developing a tolerance. Narcotic use is almost never a solution to chronic pain.”

 

“The study needs to be replicated. We need to be able to provide tools to physicians to help identify when patients are developing this narcotic tolerance and identify earlier when patients are candidates for these types of therapies. Right now these tools don’t exist.”

WHERE DOES THAT BACK PAIN REALLY COME FROM?

Elizabeth Hofheinz, M.P.H., M.Ed. • Thu, February 16th, 2017

Ah, the pain that travels…so fun. There are loads of patients who live with low back pain that radiates to the buttock, groin, thigh, and even knees. But where does the pain start? A new article published in the February Journal of the American Academy of Orthopaedic Surgeons (JAAOS) describes the identical symptoms associated with hip and spine pain and discusses the diagnostic steps and tests required to treat them appropriately. The article is entitled, “Differentiating Hip Pathology From Lumbar Spine Pathology: Key Points of Evaluation and Management.”

“In these instances, similar or overlapping symptoms may delay a correct diagnosis and appropriate treatment,” said article author Afshin Razi, M.D., an orthopedic surgeon and clinical assistant professor at New York University Langone Hospital for Joint Diseases, in the February 6, 2017 news release.

“Plain and advanced imaging studies and diagnostic injections also can be used to further delineate the primary problem and guide the appropriate sequence of treatment,” said Dr. Razi.

“Focusing on both the spine and the hip as potential causes of pain and disability may reduce the likelihood of misdiagnosis, and the management of conditions affecting the spine and/or hip may help reduce the likelihood of persistent symptoms,” said Dr. Razi.

Dr. Razi told OTW, “As an orthopaedic surgeon specializing in spine surgery I encounter many patients who present with concomitant back and hip pain. Many of these patients are also referred to me by surgeons who solely take care of hip problems such as total hip replacement or sport medicine specialist who treat younger patients with hip pain. It can be very difficult to properly diagnose the main issue and as such some patients go on to have unnecessary treatments, including surgery, because of their persistent symptoms.”

“It was our goal to try to educate physicians, including orthopaedic surgeons, on the common differential diagnoses, appropriate clinical history and physical examination, diagnostic tools and their evaluations appropriately, as well as treatment options and priorities of which one to be treated first. More recently, it has been noted that some patients who have undergone total hip replacement with significant curvature of the spine had postoperative dislocation of the hip after reconstruction of the spinal malalignment. This article also talks about this newly seen problem.”

“We did an extensive literature search and through our two previous seminars on this topic we were able to gather information to aid our colleagues on best ways of differentiating causes of hip and back pain.”

“There is a major need for obtaining a thorough clinical history, performing a complete physical examination, and ordering with analyzing appropriate diagnostic tests followed by diagnostic and therapeutic injections can differentiate between hip problems versus back related pathologies. There also should be patient education with regard to complex hip-spine problems to make sure they’re aware that despite addressing one problem the other problem may also need to be addressed at some point.”

Tension headaches and sciatic pain – by Dr. David Greif

Imagine you have a muscle tension headache, or sciatic pain going down your leg. Is the headache or the sciatic pain the problem or the symptom? I run into people every day that would identify these things as the problem, yet when you look closer they’re the symptoms.

 

Muscle tension headaches are caused by the spine moving improperly in the upper neck, causing the nerves in the area to become irritated and cause the symptom of the headache. Taking a pain reliever, like Tylenol, is the equivalent to ignoring the problem. Even though it alleviates the pain the problem persists in the long run.

 

The same concept applies to sciatic nerve pain. A lot of healthcare practitioners like to state sciatica as if it’s the diagnosis when in fact it’s the sciatic pain in the symptom. A lot of times they ignore probable causes of the sciatic pain and just label the pain as sciatica. What’s causing the inflammation to the sciatic nerve? Wouldn’t treating the cause rather than the symptom make more sense?

 

If you answer “yes”, then your thought process is moving into the realm of chiropractic medicine. Chiropractors work on removing nervous interference by stimulating better ergonomics within the skeletal system and restoring better movement to areas of the spine that are moving improperly.

 

Going back to the Tylenol example for muscle tension headaches and sciatic pain, you should remember that pain is your body’s way of telling you something is not right within your body. By restoring normal movement to the spine, you can lessen the pain by removing the nervous interference. The choice is yours; you can choose to mask the pain with drugs or you can choose to correct the problem.