Comox Valley Chiropractor – Tips for your Health

Health tips from your Comox Valley Chiropractor

Exercise for Chronic Pain August 10, 2009

For years research has been conducted into the benefits of exercise for chronic low back and neck pain. Even though we know exercise is good for us, we don’t really know a lot about how it is prescribed in real-life situations (practice).  Recently, a large survey was done of 2700 people who reported having chronic neck or low back pain. The results are published in an article in Arthritis & Rheumatism.

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Of these 2700 people, 48% had been prescribed exercise after visiting a physical therapist, chiropractor of family doctor in the past year. 33% of all people who visited a chiropractor were prescribed exercise for their pain, compared to 64% of PT patients and 14% of MD patients. Overall, the type of provider, as opposed to any characteristics of the patient was the greatest predictor of exercise prescription.

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With chiropractic specifically in this instance, the rate of exercise prescription seemed to increase with number of visits. This supports the common practice pattern of reducing pain and increasing function before commencing rehabilitation.

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This is a huge wake up call to all health care providers – exercise was prescribed to less than half the patients with chronic back pain, even though we know it is one of the most effective forms of treatment. We need to make sure we are getting our patients active, and helping them to stay that way!

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Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

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Exercises For Spine Stabilization July 20, 2009

Over the years, research has clearly shown that exercise and stabilization of the lower back are key to making a full recovery from back pain. Stu McGill, a leader in this field of research has consistently guided our thinking in terms of specific exercises that optimally stabilize the spine, while minimizing the amount of stress and strain on its structures (disc, joint, ligament etc.).

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An article published in the Archives of Physical Medicine and Rehabilitation further clarifies our knowledge when it comes to stabilizing exercises for the low back. This study focuses on the three main exercises recommended for back stabilization, and aims to help guide clinicians in determining how to progress patients through these exercises.

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Curl UpCurl Up: This classic curl-up involves keeping one leg straight, one leg bent, both hands under the back and curling the shoulder blades up off the ground. Progressions can involve pre-bracing, adding in arm movements (dead-bugs), and deep breathing during the exercise.

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Side Bridge

Side Bridge: This involves lying on your side with our elbow and knee on the floor, while lifting the hips up off the ground and holding. Progressions can involve using feet instead of knees as lower balance point and moving arm positions.

Bird DogBird Dog: This involves starting on all fours with hips and shoulders at a 90 degree angle. Progressions can involve raising one arm, one leg, opposite arm and leg together, and movements of the limbs while elevated.

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These three simple exercises are easy for clinician’s to prescribe, and can be done safely by a patient with little or no supervision. Its important for us to take the time to teach these exercises properly, so patients can attain the improvements they need with minimal stress on their spine.

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Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

 

Computer Causing Neck Pain and Headaches? July 6, 2009

I can’t tell you the number of patients I see on a daily basis who have serious neck pain and headaches from sitting at their computers all day. Many people have horrible set-ups with low chairs, high screens or laptops. Others simply sit in the position for hours on end without moving, only to go home and play video games or do more work on the computer. Returning to the same position day after day causes these problems to build up to a point where they just won’t go away.

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A growing proportion of these people in my office tend to be students. That is why I was very interested in an article that recently was published in the journal Cephalalgia. 1,073 students were evaluated for neck pain and headaches, computer use and other associated factors.

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Results showed that 26% of students reported suffering from headaches (interestingly, twice as many females as males). 20% reported neck pain and 7% reported both. The median computer use time per week was listed as 8.5 hours, with the overall range being 0-28 hours. When psycho-social factors were surveyed, females scored higher than males (more problems).

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The researchers found that high hours of computer work was positively associated with neck pain, but not with headache pain. Higher psycho-social scores were found to be associated with higher incidence of neck pain.

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This study not only shines light on the negative impact of computer use on adolescent health, it also shows that people of this age group do report a high amount of pain and headache symptoms. It suggests that in addition to manual treatment to relieve symptoms, that sufficient time be spent by the clinician educating the adolescent on ergonomics, posture and stretching.

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Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

 

Chiropractic Success in Hospitals June 22, 2009

A great article (which can be found here) recently appeared in the Toronto Star talking about academic research and collaborative practice amongst Chiropractic doctors. With new Chiropractic research chairs being added each year (University of British Columbia, University of Alberta, McMaster University to name a few), more and more people are realizing that Chiropractors have a valuable contribution to make to understanding the spine and its problems.

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One such contribution came in the form of a pilot project at St. Michael’s Hospital in Toronto, Ontario. This program saw chiropractors added as staff to treat patients in a collaborative way with other departments (such as the family medicine department). The project has been a huge success.

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For those of us who see the results of chiropractic care first hand, it makes perfect sense to have chiropractors on staff in a hospital. The few times I’ve been to the ER with a bad sprain or broken finger, I can’t believe how many people I see waiting 8 hours with back pain. Most of those people will simply be given an X-ray, pain medication and discharged in the same state in which they came in.

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I know that if they had come to my office instead, I could have at the very least made them feel better than when they arrived. More importantly, chiropractors are educated in differential diagnosis, which means we can determine when someone should go to the ER instead of being in our office. On two different cases this year I sent someone back to the ER or their family doctor only to find out that the diagnosis was ureter cancer and a tumor of the nerve sheath.

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Including chiropractors in a hospital setting is a great way to ensure patients get quick and effective relief from their pain, and also to save time and money on needless diagnostic tests or harmful medications.

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Dr. Debbie Wright is a practicing Comox Valley Chiropractor (soon).

 

Exercises for Knee Arthritis May 29, 2009

Osteoarthritis is the most common type of joint problem worldwide, with knee arthritis being the most prevalent. The chances of getting knee arthritis increase with age, weight, previous injury or heredity. There is mixed evidence to support various types of knee rehabilitation for osteoarthritis sufferers. A study in the Journal of Back and Musculoskeletal Rehabilitation set out to compare strength training to balance training in managing knee arthritis.

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At the beginning of the study, there were no differences between the 2 groups of participants. One group performed only strength training exercises, while the other group performed a combination of strength and balance exercises. Based on various outcome measures such as pain, disability, stiffness, depression and physical function; the balance group performed significantly better after one year.

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This study suggests that it is important to ensure that any rehabilitation program for knee arthritis should include simple balance exercises. Some of the exercises used in the study are as follows:

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  • 25 m backwards walk
  • 25 m heel walk
  • 25 m toe walk
  • 25 m eyes closed walk
  • 30-second one-legged stand (with leaning in all directions with eyes open and closed)
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Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

 

Chiropractic Care for Neck Pain – Is it Safe? May 13, 2009

A current study published in Spine set out to determine the relationship between benign adverse events (reactions to treatment) and outcomes (neck pain and disability, perceived improvement) in a group of people who received chiropractic care for their neck pain.

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529 patients participated in the study. 56% of the participants reported an adverse event during the first 3 treatments, and only 13% graded it as “intense”. Muscle or joint pain events were the most common types reported, and none of the events were considered serious.

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The researchers found that if someone reported an “intense” adverse event during any one of the first 3 visits, they were less likely to report recovery on the fourth visit. What is interesting about this is that they didn’t have significantly more neck pain or disability than those who didn’t experience an adverse event.

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At a follow-up 3 months later, those who had “intense” adverse events experienced the same recovery and pain reduction as those who didn’t have any adverse events.

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The bottom line here is that even if someone reports an adverse event or reaction after treatment, it did not negatively affect their outcomes or recovery at 3 months. Moreover, it was only those who had an “intense” adverse events that reported less recovery in the short term (13% of participants).

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It is also important to note that out of 4,891 treatments, no serious adverse events occurred. This adds validity to the current view that “the benefits of chiropractic care for neck pain seem to outweigh the potential risks.”

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Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

 

Easing Chronic Muscle Pain – What works? April 29, 2009

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Myofascial Pain Syndrome can be defined as chronic muscle pain. This pain originates around certain points of pain and sensitivity in your muscles called trigger points. A recent study was published in the Journal of Manipulative and Physiological Therapeutics that sought to identify and review the most common treatments for myofascial pain syndrome.

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This study identified many different types of treatment used, and some of them are as follows:

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  • Spray and Stretch – vapo-coolant spray followed by muscle stretch
  • Soft Tissue Massage
  • Ischemic Compression – compressing the trigger point in the muscle
  • Occipital Release Exercises – a form of massage and mobilization for the occiput (base of skull)
  • Strain/Counter-strain – stretching a muscle and then having the patient contract that muscle
  • Myofascial Release – compressing and tensioning the trigger point while stretching the muscle through its full range
  • Chiropractic Spinal Adjustments
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Immediate (after treatment) benefits were demonstrated with the chiropractic adjustments, spray and stretch, compression, massage and strain/counter-strain. The authors therefore concluded that there is moderately strong evidence to support the use of these manual therapies for the treatment of trigger point pain. These treatments, however, didn’t show as strong benefits as long term solutions.

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Recommendations for other types of treatment for trigger points and myofascial pain syndrome can be drawn from this review.  They are as follows:

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  • There is strong evidence that laser therapy is effective.
  • There is moderately strong evidence that electrical therapy is effective on a short term basis.
  • There is moderately strong evidence that acupuncture is effective for up to 3 months after treatment.
  • There is limited evidence for modalities such as muscle stimulation, interferential current, an other such stims.
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Dr. Debbie Wright is a practicing Comox Valley Chiropractor.