January 3, 2012, 11:00 am

For Neck Pain, Chiropractic and Exercise Are Better Than Drugs

By ANAHAD O'CONNOR

Tony Cenicola/The New York TimesWhat’s the best treatment for neck pain?

Seeing a chiropractor or engaging in light exercise relieves neck pain more effectively than relying on pain medication, new research shows.

The new study is one of the few head-to-head comparisons of various treatments for neck pain, a problem that affects three quarters of Americans at some point in their lives but has no proven, first-line treatment. While many people seek out spinal manipulation by chiropractors, the evidence supporting its usefulness has been limited at best.

But the new research, published in The Annals of Internal Medicine, found that chiropractic care or simple exercises done at home were better at reducing pain than taking medications like aspirin, ibuprofen or narcotics.

“These changes were diminished over time, but they were still present,” said Dr. Gert Bronfort, an author of the study and research professor at Northwestern Health Sciences University in Minnesota. “Even a year later, there were differences between the spinal manipulation and medication groups.”

Moderate and acute neck pain is one of the most frequent reasons for trips to primary care doctors, prompting millions of visits every year. For patients, it can be a difficult problem to navigate. In some cases the pain and stiffness crop up without explanation, and treatment options are varied. Physical therapy, pain medication and spinal manipulation are popular options, but Dr. Bronfort was inspired to carry out an analysis because so little research exists.

“There was a void in the scientific literature in terms of what the most helpful treatments are,” he said.

To find out, Dr. Bronfort and his colleagues recruited a large group of adults with neck pain that had no known specific cause. The subjects, 272 in all, were mostly recruited from a large HMO and through advertisements. The researchers then split them into three groups and followed them for about three months.

One group was assigned to visit a chiropractor for roughly 20-minute sessions throughout the course of the study, making an average of 15 visits. A second group was assigned to take common pain relievers like acetaminophen and — in some cases, at the discretion of a doctor — stronger drugs like narcotics and muscle relaxants. The third group met on two occasions with physical therapists who gave them instructions on simple, gentle exercises for the neck that they could do at home. They were encouraged to do 5 to 10 repetitions of each exercise up to eight times a day. (A demonstration of the exercises can be found at www.annals.org).

After 12 weeks, the people in the non-medication groups did significantly better than those taking the drugs. About 57 percent of those who met with chiropractors and 48 percent who did the exercises reported at least a 75 percent reduction in pain, compared to 33 percent of the people in the medication group.

A year later, when the researchers checked back in, 53 percent of the subjects who had received spinal manipulation still reported at least a 75 percent reduction in pain, similar to the exercise group. That compared to just a 38 percent pain reduction among those who had been taking medication.

Dr. Bronfort said it was a “big surprise” to see that the home exercises were about as effective as the chiropractic sessions. “We hadn’t expected that they would be that close,” he said. “But I guess that’s good news for patients.”

In addition to their limited pain relief, the medications had at least one other downside: people kept taking them. “The people in the medication group kept on using a higher amount of medication more frequently throughout the follow-up period, up to a year later,” Dr. Bronfort said. “If you’re taking medication over a long time, then we’re running into more systemic side effects like gastrointestinal problems.”

He also expressed concern that those on medications were not as empowered or active in their own care as those in the other groups. “We think it’s important that patients are enabled to deal with as much control over their own condition as possible,” he said. “This study shows that they can play a large role in their own care.”

Dr. Corey Matthews

Idaho Chiropractic Group

403 S. 11th #110

Boise, Idaho 83702

343-6900   Fax:  343-0642

Email:  cmatthews@idahochiropracticgroup.com

Website:  www.idahochiropracticgroup.com

Some of the world's finest athletes that choose chiropractic as a part of their approach to conditioning, training, and lifestyle:

	Emmitt Smith - NFL - Football When asked how he stays in such great shape, Emmitt Smith often responds, "a good chiropractor."
	Tiger Woods - Golf Many people don't know that Tiger Woods rode upon a Chiropractic Float in the 1995 Pasadena Tournament of Roses Parade.
	Lance Armstrong - Cycling 4 Time Winner of the Tour De France. Lance's chiropractor has traveled with him on every Tour De France.
	Terrell Owens - NFL - Football "Those are the guys that put me on the field when I didn't think I had a chance to be on the field. These are professionals, and God put them in my life for a reason."
	Arnold Schwarzenegger - Bodybuilding, Fitness Arnold has been a huge supporter of chiropractic for many years. One of his old muscle beach buddies, Dr. Franco Columbo, is a chiropractor in Southern California.
	Bill Romanowski - NFL - Football His opponents are not thrilled at his good health. Romanowski is considered among the dirtiest players in the NFL, a linebacker with a Dick Butkus mentality.
	John Stockton - NBA - Basketball Utah Jazz player says about chiropractic, "it's been great for me, and for my family."

Chiropractic Care for Spinal Whiplash Injuries

By David BenEliyahu

Studies on the efficacy of chiropractic care for patients suffering with pain secondary to whiplash injury are appearing in the literature. In 1996, Woodward et al. published a study in Injury on the efficacy of chiropractic treatment of whiplash injuries.¹ The authors of this study were from the Department of Orthopedic Surgery in Bristol, England. In 1994, Gargan and Bannister published a paper on the recovery rate of patients with whiplash injuries and found that if patients were still symptomatic after three months, there was almost a 90% chance they would remain so.² No conventional medical treatment has been shown to be effective in these established chronic whiplash injury patients.^3,4 However, most DCs treating whiplash injury patients have empirically found high success rates in the recovery of these types of patients.

In the Woodward study, 93% of the 28 patients studied retrospectively were found to have a statistically significant improvement following chiropractic care.¹ Chiropractic care in this study consisted of spinal manipulation, PNF and cryotherapy. Most of the 28 patients had prior treatment with NSAIDs, soft collars and physiotherapy. The average length of time before the patients began chiropractic care was 15.5 months post-MVA (range of 3-44 months).

This study clearly documented what most DCs experience in clinical practice: that chiropractic care is an effective modality for patients injured in a motor vehicle accident. Symptoms ranging from headaches to neck pain, back pain, interscapular pain and related extremity pain with parasthesias all respond to quality chiropractic care.

The literature has also suggested that cervical disc injuries are not uncommon after whiplash injury.⁵ In a study published on chiropractic care for disc herniations, I demonstrated that not only do patients improve clinically, repeat MRI imaging demonstrates decreased size or resolution of the disc herniation in many cases.⁶ Of the 28 patients studied and followed, several had post-MVA disc herniations that responded well to chiropractic care, with good clinical and anatomical outcome.^6,7 In a recent retrospective study by Khan et al., published in the Journal of Orthopedic Medicine, on whiplash injured patients with respect to cervical pain and dysfunction, patients were stratified into groups based on degrees of good outcome to chiropractic care:⁸

Group I: Patients with neck pain only and restricted neck ROM. Patients had a "coat hangar" distribution of pain with no neurologic deficits; 72% had a good outcome.

Group II: Patients with neurological symptoms or signs and restricted spinal ROM. Patients had tingling, numbness and parasthesias in the extremity; 94% had a good outcome.

Group III: Patients had severe neck pain with full neck ROM and bizarre pain distributions in the extremities. These patients often described blackouts, nausea, vomiting, chest pain and visual dysfunction; 27% had a good outcome.

The results of this study showed that in group I, 36/50 patients (72%) responded well to chiropractic care: in group II, 30/32 patients (94%) responded well to chiropractic care; and in group III, only 3/11 cases (27%) responded well to chiropractic care. There was a statistically significant difference in outcomes between the three groups (p < .0001).

This study provides new evidence that chiropractic care is effective for whiplash injured patients. However, the study did not take into account those patients who also had back injuries, extremity injuries and TMJ injuries, and did not identify which patients had disc injuries, radiculopathy and concussive brain injury (most likely group III patients). In my experience, these types of patients respond better than 27% of the time with a more extensive model of chiropractic care, in conjunction with multidisciplinary providers.

These studies show what most DCs have already experienced that the doctor of chiropractic should be the primary care provider in these types of cases. It is my further opinion that in cases like the group III patients, care should be multidisciplinary so as to achieve the best possible outcome in difficult clinical cases.

References

1. Woodward MN, Cook CH, Gargan MF, Bannister GC. Chiropractic treatment of chronic whiplash injuries. Injury 1996;27(9):643-645.

2. Gargan MF, Bannister GC. The rate of recovery following whiplash. Eur Spine J 1994;3:162.

3. Barnsely L, Lord S, Bogduk N. Whiplash injury, a clinical review. Pain 1994;58:283.

4. Bogduk N. Post whiplash syndrome. Aust Fam Phys 1994;23:2303.

5. Schofferman J, Wasserman S. Successful treatment of Low back pain and neck pain after MVA despite litigation. Spine 1994;9:1007-1010.

6. BenEliyahu DJ. Chiropractic management and manipulative therapy for MRI documented disc herniations. JMPT 1994;17:177-185.

7. BenEliyahu DJ. MRI and clinical followup study of 27 patients receiving chiropractic care for cervical and lumbar disc herniations. JMPT 1996;19(9):597-606.

8. Khan S, Cook J, Gargan M, Bannister G. Symptomatic classification of whiplash injury and the implications for treatment. J Of Orthopedic Medicine 1999;21(1):22-24.

Acupuncture Eases Migraine Headache Pain

March 15, 2004 -- Acupuncture may provide lasting relief from the pain of chronic headaches, such as migraines, according to a new study.

Researchers found that compared with standard medical care, acupuncture offers substantial benefits in preventing headaches and improving the quality of life for people who suffer from frequent headaches, especially migraines.

Acupuncture is commonly used to treat other types of chronic pain, but researchers say this is the first large-scale study to examine the effectiveness of acupuncture under real-life conditions. They say the results indicate that health insurance coverage of acupuncture services should be expanded to include the treatment of chronic headaches and migraine.

Pins and Needles Ease Migraine Pain

In the study, published in the March 15 issue of the British Medical Journal, researchers randomly divided 401 adults aged 18-65 years old with chronic headache (at least two headaches a month) -- into two treatment groups. Participants had a history of having mostly migraine headaches.

One group received up to 12 acupuncture sessions during a three-month period in addition to standard medical care, and the other group received standard care alone.

A year later, researchers found those who received acupuncture:

• Experienced 22 fewer days with headaches
• Used 15% less medication
• Made 25% fewer visits to their doctor
• Took 15% fewer days off sick from work than the control group

Researchers say one limitation of their study is that the control group did not receive a sham acupuncture intervention. Therefore, some of the benefits found among the acupuncture group may have not been caused by the actual treatment but because of the "placebo effect," which is based on the patient's expectations of benefit from treatment rather than the effectiveness of the treatment itself.

But researchers say previous placebo-controlled studies have already shown that acupuncture is superior to placebo in treating migraine.

In a related study published in the same journal, British researchers found that acupuncture improves the quality of life for people with chronic headaches at a small additional cost. They say the findings show that acupuncture is a relatively cost-effective headache therapy compared with other treatments covered by the National Health Service of the United Kingdom.

Facial Rejuvenation

Beauty cannot be obtained simply by slapping on colors and textures to the skin, because the skin reflects and reacts to your entire being –physical, intellectual, emotional and spiritual. To keep you skin looking beautiful, wrinkle free, youthful and smooth on the outside, you must work on the inside of your body as well. Specific areas of the face indicate internal health, because the face is connected to your internal organs, and as Chi (vital energy) moves and circulates, it strengthens the functioning of organs connected to that area. Beautiful skin begins with good Chi, and blood circulation. Chi is the invisible envelope that revitalizes/lifts your energy. You can lift your face by lifting Chi. This can been done with acupuncture, as well as good herbal medicine. We recommend following:

Facial Rejuvenation Acupuncture

Facial Rejuvenation Acupuncture / Acupuncture facelift is becoming a more popular, non-surgical method for those who want not only to maintain beauty, radiance and vitality in the face, but also improve their overall health and well being. Acupuncture facelifts have even been featured in the mainstream media, such as on ABC Television’s “Good Morning America” and Public Broadcasting System’s “Healthweek.” Studies show that among 300 cases treated with facial acupuncture, 90 % had marked beneficial results with only one course of treatment (International Journal of Clinical Acupuncture, 1996).

Acupuncture for facial beauty is a wonderful, holistic, alternative approach to fighting the aging process:

Increasing the flow of energy, blood and lymph circulation improves the face’s natural, healthy color, diminishes wrinkles and eliminates fine lines.

Promoting collagen production increases muscle tone and elasticity helping to firm the skin, fill out wrinkles, and reduce bags and sagging.

Stimulating the formation of body fluids nourishes the skin and encourages it to be moister, softer, smoother, and more lustrous Chinese herbs work excellently in replenishing Yin energy (body fluid), which is extremely beneficial in the prevention and/or improvement of wrinkles resulting from menopause or cigarette smoking.

Healing physical, emotional and spiritual issues to reduce stress and improve overall health and well being. Since the body/mind/spirit are all connected, negative emotions reflect in the face and change the appearance of skin texture, color, and tension. Acupuncture can eliminate stress and bring out the innate strength, vitality and health. In addition to enhancing skin appearance, most people are pleased to find that their sinus problems, headaches, toothache, TMJ, PMS and menopause have either disappeared or their symptoms are distinctly improved! You will not only look younger but also most certainly feel younger.

Excellent alternative approach without surgery and injection. Acupuncture is far less expensive, more natural, non-invasive and safer than plastic surgery or botox injection(s), and has no side effects, toxicity, inflammation, or recovery time.

Non-steroidal anti-inflammatory drugs (NSAIDs) account for more deaths in the United States than AIDS or Cervical Cancer.”

The pain and inflammation of arthritis is crippling America, but our pharmaceutical companies are killing the uninformed consumer. This double-edged sword of pain and death is unchecked in our modern Western medical model. Non-steroidal anti-inflammatory drugs (NSAIDs) account for 20% of NSAID patients experiencing dyspepsia and NSAID-associated upper gastrointestinal adverse events are estimated to result in 103,000 hospitalizations and 16,500 deaths per year in the United States, and represent 43% of drug-related emergency visits. These drugs cause more deaths in the US than AIDS or cervical cancer. Small intestine problems can be easily undiagnosed or misdiagnosed, thus it is important to be aware of the risks associated with long term NSAID use.