Comox Valley Chiropractor – Tips for your Health

Health tips from your Comox Valley Chiropractor

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.

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Disc Degeneration – Is It Genetic? September 21, 2008

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In my view, disc degeneration is somewhere along the lines of death and taxes – inevitable and it affects everyone. However, while everyone may show the signs of disc degeneration (on X-ray), what that actually means in terms of pain, quality of life and disability varies from person to person.

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Intervertebral discs (IVDs) are crucial when it comes to support, stability and proper motion in the spine. They are also prone to breakdown and degeneration which can contribute to low back pain. How much contribution IVDs make to low back conditions, and how to treat them, are hotly debated issues.

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A recent review article in the Journal of Orthopaedic & Sports Physical Therapy states that surprisingly, the biggest predictive factor for disc degeneration is genetic factors as opposed to lifestyle factors (heavy lifting, smoking, vibration exposure). Even weight lifting, when performed properly, did not lead to an increase in the presence of degeneration.

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I can’t count the number of times someone has come into my office after receiving the diagnosis of “disc degeneration” from a set of X-rays recently taken. This is always a misleading diagnosis, as patients will often assume it is a permanent condition which is causing their pain and that there is nothing to be done about the irreversible process. This Comox Valley Chiropractor has become quite adept at communicating to them that this is a normal process of aging and rarely does it lead to serious disease. The best ways to combat the progression is through a healthy lifestyle including cardiovascular exercise and strength training. It should also be made clear that lumbar traction (or decompression) has not been consistently shown to help disc problems, even if practitioners do have great marketing campaigns with expensive machines!

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Knee Surgery Ineffective September 14, 2008

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A research study published this week in the New England Journal of Medicine states that Arthroscopic surgery for osteoarthritis of the knee provides no additional benefit to optimized physical and medical therapy.”

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Researchers followed two groups of patients with knee arthritis randomly assigned to receive either knee surgery or physical therapy plus over the counter medication. A follow up at two years showed no difference in pain level and quality of life between the two groups.

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This study is not the first to demonstrate the ineffectiveness of knee surgery for osteoarthritis. A study in the July 2002 edition of the New England Journal of Medicine demonstrated that the outcome after knee surgery was no different than that of placebo treatment (incisions but no surgery).

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Knee surgery is a common procedure recommended for arthritis sufferers for the simple reason that it has always been done. Now, there is mounting evidence that conservative care is just as effective as the surgery, never mind being less invasive, safer and less of a cost on the health care system.

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It is my opinion that as responsible health care consumers, we must make smart informed choices on treatment options. Practically speaking, for most conditions it is wise to choose the most conservative form of therapy first and save the most invasive (surgery) for later. The worst thing that will happen with most conservative therapies is that you don’t improve. Conversely, the worst consequences for surgery include infection, sepsis and death (especially with all the drug resistant bacteria in hospitals such as c. difficile).

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The effectiveness of many common surgical procedures (including those for low back pain) is starting to be questioned. If you would like to learn more about what your options are for conservative therapy, please contact your Comox Valley Chiropractor.

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