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Chiropractic Care of Children…Is It Really Safe???

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In the late 1990s, an article published on the safety of chiropractic treatment of children also revealed significant benefits for children who received chiropractic treatment.

This article was written in response to safety concerns due to the increased utilization of chiropractic for various pediatric conditions.

One primary topic of discussion included the neurological and vascular complications associated with chiropractic treatment in pediatric patients.

This topic has been reviewed previously in adult patients and much of the same concerns can be associated with the pediatric patient.

The likelihood of a vascular injury in a pediatric case is certainly less than in the adult patient due to the pliability and flexibility of the neurovascular structures.

The incidence in the occurrence of stroke in teenagers (children under 15 years of age) is reportedly at a rate of 2.7 per 100,000 children was reported.

However, based on an extensive search dating back 32 or more years, only two reported cases of neurovascular complications related to pediatric patients who had received chiropractic care were found.

Based on the data derived from multiple sources, a conservative estimate of the number of pediatric visits to chiropractors in the United States over the same time frame amounted to over 500 million treatments.

THE REVIEW CONCLUDED THE CHANCE OF A NEUROVASCULAR COMPLICATION ARISING FROM THE CHIROPRACTIC TREATMENT WAS APPROXIMATELY 1 OUT OF 250 MILLION VISITS.

The article concluded the benefits outweigh the risks when applying cervical spine manipulation to any individual, including the pediatric population.

Based on their review, chiropractic care, as it relates to neurovascular complications, presents little risk to the pediatric patient. Even less than the general non-pediatric population which too, is extremely rare.

One other risk cited in its paper was potential damage to the growth plate (epiphysis – the growing ends of bones) of the growing child. However, in the 32+ year review, no reported research documentation could be found supporting this claim.

Another article reported ways in which parents might be able to detect spinal problems in children.

Unless an obvious trauma such as a trip and fall has occurred, it can be challenging in some cases to detect spinal issues, similar to the dentist discovering a non-symptomatic cavity.

More obvious findings parents can detect may include head tilt or leaning to one side, the child turning their whole body rather than their neck to converse or look at someone, sleep interruptions, a child rubbing their own neck, feeding /nursing difficulties on one side and crying/agitated behavior compared to the child’s “usual” behavior.

When children are able to communicate, they may complain of aches that many refer to as “growing pains.”

Less documented / anecdotal evidence that might suggest nervous system dysfunction include persistent earaches, sore throats, colic, headaches, bed-wetting, and others are conditions that parents may bring their children for chiropractic treatment.

From In Good Hands Magazine.

  1. http://www.chiroweb.com/mpacms/dc/article.php?id=37423 Dynamic Chiropractic – September 7, 1998, Vol. 16, Issue 19 Chiropractic — Is It Safe for Children? By Claudia Anrig, DC; Claudia Anrig, DC Clovis, California
  2. http://www.chiroweb.com/mpacms/dc/article.php?id=41406 Dynamic Chiropractic – July 29, 1994, Vol. 12, Issue 16
  3. A Parent’s Guide to Chiropractic Care for Children Peter Fysh, DC San Jose, California
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Do Spinal Curves In Your Neck, Mid Back and Lower Back Affect Your Health?

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Chiropractic was founded in 1895 after the hearing was restored in a patient following a spinal adjustment to the upper region of the spine.

Since then, our profession has been conducting research to help determine why spinal manipulation or adjustments work so well.

Many conditions have been studied, as well as the physiological responses to the adjustment including blood chemistry changes including hormone levels, blood pressure changes, circulation changes, and many other parameters of health.

Posture, bone alignment and spinal curves have been long been evaluated in patients presenting with muscle and joint complaints by most of the health care professions, including chiropractic.

But the question remains: how important are spinal curves in the overall health picture of the patient? Can alterations in the “normal” curve lead to future trouble or, be the cause of a current condition?

A recent study reported the results after conducting a “systematic critical literature review” where all research published on this subject was reviewed for quality and content.

They gathered 54 studies published between 1942 and 2008, which included over 20,000 patients and reported the association between the sagittal curve (curves when looking at a person from the side) and various health conditions.

There were many different types of studies and methods used to evaluate the sagittal curves of the lumbar (low back) (38 studies), thoracic (mid back) (34 studies) and cervical (neck) (6 studies) spine.

These methods included plain x-ray (25 studies), MRI (1 study), photographs (3 studies) visual analysis or, by the eye (5 studies) and those using a variety of instruments (21 studies).

A strong association was reported in five studies with an increased angle in the midback/thoracic spine (kyphosis – sometimes referred to as “humpback”) with lung disorders causing breathing problems.

Poor physical function and pelvic organ prolapse were also strongly associated with kyphosis.

A moderate association was found when the low back curve (lordosis) was reduced, which was associated with an increase in low back pain.

Similarly, future osteoporotic midback/thoracic compression fractures were moderately associated with kyphosis or “humpback” deformity.

Kyphosis was also moderately associated with heavy household activity, uterine prolapsed and death in three other studies.

No association was found in many studies.

The conclusion of the article reports most of the studies did not fulfill the basic requirements for this type of study or had design flaws.

They encouraged researchers to use new/better approaches to study this association between spinal curves and health and disease.

From In Good Hands Magazine. 
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Chiropractic… Natural, Safe, and Effective!

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The mission of chiropractic is to help sick people get well, as well as to help healthy people function better in the absence of drugs or surgery.

When people are asked, “…what do chiropractors do?” the frequent response is, “…they crack your neck and/or back.”

Chiropractic spinal manipulation (frequently called an adjustment), often produces an audible popping or cracking noise.

This sound is known as joint cavitation and it is reported to be caused by the release of pressure created by gases (nitrogen, oxygen, and carbon dioxide) within the joint.

It is the same noise produced when one cracks their knuckles. One common myth is that cracking or cavitating a joint will produce arthritis in the joint – this is simply not true.

Several scientific studies of joint cavitation dispel this old wives tale. In fact, studies demonstrated that joint manipulation actually benefits patients with arthritis of the spine.

There have been a number of studies published on the topic of unwanted reactions to spinal manipulation.

In general, side effects, if any, are mild and transient.

When they do occur, they typically happen shortly after the first or second session of spinal manipulation, similar to the post-exercise soreness that occurs when first introducing a new sport or activity.

Unpleasant side effects may occur in between 10% and 30% of patients. They occur more often in women than men, and as previously stated, they seem to occur more often after the first session of spinal manipulation.

The most commonly reported unpleasant reaction is temporary and transient increased pain or stiffness. This reaction usually resolves in 24 hours or less.

More rare reports of tiredness, light headedness, and occasional nausea have been infrequently reported.

The type and nature of these reactions may be associated with the severity and nature of the condition being treated.

It seems self evident that more severe problems have the potential to produce short term increases in symptoms. The use of ice, ultrasound and or other modalities can help to minimize any irritation that may occur due to spinal manipulative treatment.

SPINAL MANIPULATION HAS BEEN FOUND TO BE SAFE AND EFFECTIVE FOR UNCOMPLICATED SPINAL PAIN SYNDROMES. MORE IMPORTANTLY, IT MAY ALSO BE A VIABLE ALTERNATIVE TO SURGERY FOR LUMBAR OR CERVICAL DISK HERNIATIONS.

There are many reports on both sides of this subject, with some stating spinal manipulation can increase compression of the spinal nerves in patients with disk herniations as well as the opposite – that it reduces nerve root pressure.

The good news is that the rate of occurrence is only about 1 in 1- 3 million cases, making spinal manipulation for disk problems an extremely safe treatment option for patient with herniated disks.

Chiropractors will often use low-force manipulation methods for treating herniated disks that do not require a standard type of manipulation thrust.

These spinal methods are sometimes preferred over traditional manipulative techniques for the treatment of herniated spinal disks, but this is case dependent.

To make an educated decision about any type of care you may be considering, you must consider “relative risks”. Simply put, relative risks compare the risk of one procedure with the risk of a second procedure for the same condition.

For example, if you are taking medications to relieve your pain, how do the risks of the medications compare with the risks of an alternative treatment, like chiropractic care?

An example is chiropractic treatment versus drugs known as non-steroidal anti-inflammatory drugs (NSAIDs), which include aspirin, Aleve and Advil (TM).

THE RISK FOR SERIOUS SIDE EFFECTS FROM ANTI-INFLAMMATORY DRUG IS FROM 6000-9000 TIMES GREATER THAN THE RISK FOR SERIOUS SIDE EFFECTS FROM SPINAL MANIPULATION, MEANING THAT CHIROPRACTIC CARE IS A MUCH SAFER ALTERNATIVE THAN ASPIRIN OR OTHER NSAID DRUGS FOR TREATING INFLAMMATORY BACK OR NECK PAIN.

Further, there is no significant increased risk to add chiropractic care to an existing regime of NSAIDs, thus treating the condition with two different strategies.

Interestingly, studies have reported that patients receiving chiropractic care were able to reduce their intake of drugs, thus, reducing the risks of drug reactions/interactions.

If you are trying to avoid surgery for a spine related problem, your condition is more serious and potential side effects of surgery should be compared with chiropractic.

You should understand any patient who is a potential candidate for spine surgery has a serious medical condition. There is pressure on a nerve and the potential for permanent damage to that nerve exists. Studies show that chiropractic care often can reduce the pressure on a compressed nerve in the lower back or neck, without surgery.

The following references were utilized in the preparation of this information.

References

  1. The audible release associated with joint manipulation. JMPT. 1995 Mar-Apr;18(3):155-64.
  2. Does knuckle cracking lead to arthritis of the fingers? Arthritis Rheum. 1998 May;41(5):949-50.
  3. Efficacy of treating low back pain and dysfunction secondary to osteoarthritis: chiropractic care compared with moist heat alone. JMPT 2006 Feb;29(2):107-14.
  4. Comparison of human lumbar facet joint capsule strains during simulated high velocity, low-amplitude spinal manipulation versus physiological motions. Spine J. 2005 May-Jun;5(3):277-90.
  5. Safety of spinal manipulation in the treatment of lumbar disk herniations: a systematic review and risk assessment JMPT. 2004 Mar-Apr;27(3):197-210.
  6. Side posture manipulation for lumbar intervertebral disk herniation. JMPT. 1993 Feb;16(2):96-103.
  7. Magnetic resonance imaging and clinical follow-up: study of 27 patients receiving chiropractic care for cervical and lumbar disc herniations. JMPT 1996 Nov-Dec;19 (9):597-606.
  8. Prospective investigations into the safety of spinal manipulation. J Pain Symptom Manage. 2001 Mar;21(3):238-42.
  9. Risks associated with spinal manipulation. Am J Med. 2002 May;112(7):566-71.
  10. A risk assessment of cervical manipulation vs. NSAIDs for the treatment of neck pain. JMPT 1995 Oct;18(8):530-6.
  11. J Side effects of chiropractic treatment: a prospective study. JMPT. 1997 Oct;20(8):511-5.
  12. Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study. Spine. 2005 Jul 1;30(13):1477-84.
  13. Complications of spinal manipulation: a comprehensive review of the literature. J Fam Pract. 1996 May;42(5):475-80.
  14. Dissection of cervical arteries Presse Med 2001 Dec 15;30(38):1882-9
  15. Vertebral artery occlusion after acute cervical spine trauma. Spine. 2000 May 1;25(9):1171-7.18. Spine Journal
  16. Internal forces sustained by the vertebral artery during spinal manipulative therapy. JMPT 2002 Oct;25(8):504-10
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Patient Satisfaction with Boise Chiropractic Care

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At a time where patients are constantly being forced to go to different health care providers each year due to their prior doctor “…not being on the list,” are patients truly satisfied with the care/treatment they receive?

If so, what exactly are the reasons and factors that drive patient satisfaction with Chiropractic?

The process of measuring patient satisfaction can be viewed from several different angles.

One study looked at the improvement of the patient’s condition and only 57% of the satisfaction score was based on improvement.

Because the concept of measuring satisfaction is multifactorial, more important methods of measuring patient satisfaction had to be considered.

A recent study did just this – they measured parameters that included pain, disability (activity tolerance), satisfaction with information received, effectiveness of care, caring, and quality of care.

The information was obtained by two different interviewers with similar information received regardless if it was the doctor or a third party.

THE RESULTS SHOWED ALL PATIENTS REPORTED HIGH LEVELS OF SATISFACTION AND THOUGH THE CLINICAL OUTCOMES REGARDING PAIN AND DISABILITY WERE MOST IMPORTANT, THE INFORMATION RECEIVED THAT HELPED PATIENTS UNDERSTAND WHAT WAS WRONG WITH THEM, AND, WHAT COULD BE DONE (BY BOTH DOCTOR AND PATIENT) TO SPEED RECOVERY AND PREVENT FUTURE EPISODES WERE VERY IMPORTANT FACTORS IN THE OVERALL SATISFACTION SCORE.

Patients also wanted timely information so they were kept up-to-date with what was being done at various points in time during care.

The information had to be understandable and informative and explained in “layman’s terms” so that they “learned something” from the information received.

Caring included four questions:

  1. Does the doctor believe what the patient tells them?
  2. Does the doctor understand the patient’s concerns?
  3. Was the doctor comfortable dealing with the patient’s pain?
  4. Was the doctor concerned about the patient after they left the office?

The information gathered included treatment, doctor confidence, and prognosis (how long it might take to get better). Also, effectiveness was further divided into listening, knowledge, experience, and the use of an active management approach.

The conclusion of the study emphasizes the importance of using a mixed-method approach when examining patient satisfaction.

This includes quantitative “scores” from questionnaires as well as qualitative information about the encounter including information, caring, and effectiveness.

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Chiropractic Care…Safe and Cost Effective and…

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“Ever since I was in my early teens, I’ve had muscle and joint problems that would come and go but never put me down where I couldn’t function. I was very active and played basketball, tennis, and ran in track but over the last 10 years I’ve avoided a lot of activity due to my problems. Now, after having a couple of children and gaining some weight, I notice more frequent and intense back problems and I’m getting quite concerned over the changes that have been taking place and afraid to do things. I talked about this with my family and friends and some have recommended chiropractic, some recommend physical therapy, others suggest medication and one even suggested shots! Quite frankly, I’m totally confused as to what to do!”

This scenario may sound familiar to many people.

The choice of health care provision is a personal one, often influenced by those around you – family, friends, teachers, and more!

It seems like everyone is an “expert” with different opinions and their advice, often conflicting, can lead to confusion about what is best for you.

There are many ways to approach back trouble, regardless of the diagnosis or condition.

First, all health care providers are biased in that they naturally focus on their specialty. If you choose to consult with a surgeon, s/he will look at your condition from a surgical perspective. Various surgical options may be discussed, tests are usually recommended and the process begins.

When consulting with a family physician, the typical approach is pharmaceutical or drugs such as anti-inflammatory medications (Advil, Nuprin, Ibuprofen, Aspirin, Aleve, Tylenol, etc.), heat or ice, activity modifications (possibly rest or mild/moderate activity), and possibly referral for chiropractic or physical therapy.

In reviewing the various guidelines, it is recommended to start with the least invasive, safest, most cost effective approaches first.

Unless “red flags” like cancer, fracture, infection or progressive severe neurological losses are present, surgery is not a logical initial approach.

Chiropractic has been recommended as a first or initial choice as it has been found to be safe, highly satisfying, non-invasive, and cost effective.

The typical approach includes a thorough history, an examination that includes an analysis of posture, motion, function and includes the whole body.

For example, if one leg is short, the pelvis will tilt and spine is often crooked. That needs to be corrected for both long and short term results.

If the feet pronate and the arches are flat, the effects on gait/walking on the ankle, knee, hip and back can lead to trouble or perpetuate current problems.

Deconditioning or, being out of shape is an important aspect included in the chiropractic management process.

If these methods fail to bring about satisfying results, referral for more invasive approaches will be considered.

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What Type of Doctor Should You See In Boise For Back Pain?

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Have you ever considered who is the best in Boise suited to treat back pain?

Since there are so many treatment options available today, it is quite challenging to make this decision without a little help.

To facilitate, a study looking at this very question compared the effectiveness between medical and chiropractic intervention.

Over a 4-year time frame, 2780 patients were followed with questionnaires. Low Back Pain patients were treated using conventional approaches by both MDs (Medical Doctors) and DCs (Doctors of Chiropractic).

Chiropractic treatments included spinal manipulation, physical therapy, an exercise plan, and self-care education.

Medical therapies included prescription drugs, an exercise plan, self-care advice and about 25% of the patients received physical therapy.

The study focused on present pain severity and functional disability (activity interference) measured by questionnaires mailed to the patients.

It was reported that chiropractic was favored over medical treatment in the following areas:

  • Pain relief in the first 12 months (more evident in the chronic patients)
  • When LBP pain radiated below the knee (more evident in the chronic patients)
  • Chronic LBP patients with no leg pain (during the first 3 months)

Similar trends favoring chiropractic were seen for disability but were of smaller magnitude.

All patient groups saw significant improvement in both pain and disability over the four year study period.

Acute patients saw the greatest degree of improvement with many achieving symptom relief after 3 months of care.

This study also found early intervention reduced chronic pain and, at year 3, those acute LBP patients who received early intervention reported fewer days of LBP than those who waited longer for treatment.

While both MDs and DCs treatment approaches helped, it’s quite clear from the information reported that chiropractic should be utilized first.

These findings support the importance of early intervention by chiropractic physicians and make the most sense for those of you struggling with the question of who to see for your LBP.

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NFL Great Says, “Chiropractic Was The Key To Keeping Me In The Game.”

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If the greatest player in the history of the National Football League said, “Chiropractic was the key to keeping me in the game,” do you think Chiropractic care could help you with your back pain and other aches and pains?

Well, that’s exactly what happened.

Jerry Rice, who on November 4, 2010 was named the greatest player in NFL history by NFL Network’s NFL Films production The Top 100: NFL’s Greatest Players, said:

“I believe in Chiropractic and I know that it works.

“You probably know about my long and successful career in football. I’m flattered by the testimonials to my durability.

“Football is a very rough and vigorous sport. Many of the pass patterns in a game either long or short require a maximum effort.

“I took some vicious hits from players nearing twice my size. Thankfully, I had the durability to withstand these tackles – or I never would have succeeded or lasted for as long as I did.

“Chiropractic was the key to keeping me in the game.

“My first experience with Chiropractic care was right before the 49ers were to play the Bengals in Super Bowl 23. A couple of our players were injured and a Chiropractor turned things around.

“I quickly became a believer and ever since, I have had the benefit of Chiropractic care.

“Dancing with the Stars was every bit as exhausting and challenging – though not nearly as brutal as football – it required many hours of practice… I had aches and pains that I never had before. Again, Chiropractic made the difference and kept me dancing and in the competition.”

The average NFL career is extremely short… lasting only 2-4 years. Injury prematurely ends many young player’s hopes and dreams. Jerry Rice played an astounding 20 years in the NFL.

If Chiropractic can help Jerry Rice play for 20 years in the NFL… just imagine what it can do for you.

If you would like to see Jerry speak about the benefits of Chiropractic… go to: http://www.youtube.com/watch?v=_CAsGNlQEnI.

No one would claim celebrities have all the answers. However, it would seem that with all the options celebrity affords them, the fact they seek chiropractic care to meet their healthcare needs says something about the value of chiropractic for optimum health!

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Chiropractic for Professional Athletes and Boise Weekend Warriors Alike!

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Chiropractic Care Keeps Minnesota Twins Pitchers Kyle Gibson and Trevor May on Top of Their Game. But they’re not the only ones of course. It’s well known that nearly all professional football, hockey, baseball and basketball teams have chiropractors on staff. You’ve heard many pro golfers and olympians talk about how chiropractic care has kept their performance level high and their injury rates down.

And that’s just it…optimal performance is the most important thing to many people, but when your body is pushed to the limit like professional athletes day in and day out, it’s easier to see weaknesses in performance. Remember, these guys are worth millions of dollars and they have the best doctors on the planet helping them with injury care. They don’t need chiropractors for that. The role of the chiropractor is to keep these athletes performing at the highest level.

So whether your game is gardening on the Boise bench, chasing your kids around a North End park, biking on the Boise Greenbelt, or running a local business down at Saturday Market, chiropractic care will ensure you’re on the top of your game all year long.

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