Perth Family Health Centre Articles of Interest

A controversial subject for doctor’s, researchers and patients. Concussions are a traumatic injury that is of recent getting more attention, from movies to researchers, doctors, students and coaches all asking similar questions? Most recent the movie Concussion has us asking the question: Does a concussion lead to brain deterioration later on in life? It has been found that this can only be properly diagnosed by an autopsy that demonstrates a particular distribution of the Tau proteins in the brain, this being said Tau proteins can also be found in a “healthy” brain of most people over the age of 30. It is impossible for doctors or researchers to tell if this is caused by the head trauma or by genetic predisposition to degenerative brain disease. CTE (Chronic Traumatic Encephalopathy) has instilled a fear into parents that allow their children to participate in higher risk sports, however new evidence has proven that in fact “The largest study of NFL players shows that more than 90 percent don’t develop these problems”. “Childhood obesity is really out of control and causing all sorts of problems, every time we scare people away from participating in a sport we make that problem worse. Parents need to keep this in perspective. The benefits of that kind of activity far outweigh any potential risk.”

Read the full article.

Chiropractic management of patients with acute mechanical low back pain. A research article from The Spine Journal

This article uses evidence based clinical practice guidelines for the management of patients with acute mechanical low back pain. Its purpose was to determine if patients who received chiropractic care had greater improvement in functional outcomes then those that received family physician directed usual care for the acute(pain lasting less then 4-6 weeks) mechanical(source of the pain may be in the spinal joints, discs, vertebrae, or soft tissues) pain of the low back. This study was a blind study(the observer is unaware of which patient is receiving which intervention/treatment) All patients in the study were in acute pain 4-6 week period and ranged from ages 19-59 years old with no “red-flag” conditions that would contraindicate(be possibly detrimental) to spinal manipulations. Baseline testing was taken by patients initially through varying questionnaires that assess their pain scales/activities of daily living limitations and then again on weeks 8,16 and 24 to see if there were any notable changes.

The primary outcome of this study was that the patients seeing a Chiropractic Doctor for the low back pain had significantly noted higher improvements throughout the reassessment process of the study in comparison to those patients that sought out family medical doctor care. At the 24 weeks mark the improvements doubled in comparison to those not using chiropractic care and patients began noticing a significant change in the activities of daily living and what they were capable of completing themselves due to a decrease in pain in the low back.

In conclusion this study shows that yes those who seek out Chiropractic care during their mechanical low back pain show signs of recuperating faster, having decreased pain and being able to achieve tasks of daily living in a more functioning manner in a faster time frame. This article was posted on The Spine Journal as an abstract October 2010. Author disclosures include;MFSD, CGF.

To read the full study abstract please go.

Does maintained spinal manipulation therapy for chronic non-specific low back pain result in better long term outcome?

Low back pain(LBP)patients can be fit into one of three categories;those with 1.specific spinal pathology 2.nerve root pain/radicular pain or 3. non specific LBP . About 85% of patients who seek treatment do so for non-specific variety, it is known for its lack of underlying pathology and is considered chronic when it has been present for at least 12 weeks. This study focuses on using long-term care from chiropractic doctors for prevention of flare-ups or re-occurrence of the condition. Two purposes of this study were; 1. investigate the effectiveness of spinal manipulation therapy(SMT) for the management of chronic low back pain and 2.determine whether maintenance SMT is effective in reducing pain and disability levels associated with chronic low back pain over an extended period of time following an initial phase of treatment. 93 patients were selected to participate in this study patients had to be 20-60 years of age with chronic low back pain and had the condition for at least 6 months.which were then split into 3 groups matched for age and sex. The 3 groups comprised of a control group(sham manipulations were administered) and 2 treatment groups that received a standardized type of SMT(spinal manipulation therapy). All patients received 12 sessions of SMT or sham SMT over a 1 month period plus a prescribed back exercise. One group continued to receive SMT past the one month for 9 months bi-weekly. A baseline was achieved by an evaluation prior to commencing treatments that consisted of detailed health history, physical examination(full neurological and musculoskeletal)a complete blood count, Erythrocyte Sedimentation rate and c-Reactive Protein(CRP)as well as lateral radiographs and lumbar spine magnetic resonance imaging. Patients were evaluated at baseline and at 1,4 ,7 and 10 months by an examiner who was blinded(was unaware as to what the groups assignment was) The ongoing evaluations reveal that patients who received maintained SMT throughout the 10 months biweekly had significantly less pain then those that only received treatment for the initial one month period, both showed similar signs of progression in decreasing pain in the first month, but then most once stopped treatment returned to their base line scores of pain. This study shows that chiropractic care in the form of maintenance does have a positive effect in decreasing chronic low back pain symptoms.

This is a synopsis of the study Maintenance care using spinal manipulations for chronic LBP: randomized trial+ MP3 if you would like to access the full article.

Nearly 36% of people with COPD experience back pain; 13% experience neck pain; this is caused by the use of accessory muscles for breathing which adds stress to musculoskeletal(MSK)system. MSK conditions are twice as common in COPD patients and 35% of patients report that pain will stop them from engaging in most activities. Chiropractors can help patients with COPD address the MSK dysfunction which helps them breath easier and therefore allowing them to live more active lives again, increasing the quality of life!

This information was provided for use by Complex patients: Integrating care from the OCA(Ontario Chiropractic Association)

MSK pain is reported twice as frequently among people with Type II diabetes. Patients with Type II diabetes are more likely to suffer from shoulder, neck,(53% vs.31%) low back(60% vs 30%), arm, hand knee and hip pain(71% vs 34%) the numbers are drastically higher then the non-diabetes populations. 19.8% of patients with Type II diabetes did not engage in activity’s due to pain they were suffering from. Chiropractors can help patients with diabetes by addressing their MSK conditions therefore allowing the patient to feel less pain and engage in more activity that is proven to help and maintain diabetes. Chiropractors have extensive knowledge in exercise regiments as well and can usually advise you on how to start to slowly implement positive movement into your daily routine without overdoing it!

This information was provided for use by Complex patients: Integrating care from the OCA(Ontario Chiropractic Association)

Did you know 29% of patients aged 65+ report having chronic back problems(not including those associated with arthritis and Fibromyalgia)? The most common site for pain is low back(22.3%) followed by the upper back(9.5%) Disability risks for older adults increases as more areas of the body start to feel MSK pain. This MSK pain has been shown to increase the risk of falls among older adults in fact over half of all reported injuries in this population were from falls. Each year one third of all older adults will fall at least once and 20% of all injury-related deaths can be tracked back to a fall. Weight loss and regular exercise to maintain strength and balance can help older adults remain functionally independent.

Chiropractors can help seniors manage their MSK disorders and related pain. They can offer guidance to increasing or maintaining active lifestyles which helps manage their conditions offering them a more independent quality of life!

Chiropractic doctors can also offer referrals to community programs that are geared to senior’s active lifestyles since they maintain a rapport with other health care practitioners within their communities.

This information was provided for use by Complex patients: Integrating care from the OCA(Ontario Chiropractic Association)

In the upper back there are 12 vertebrae numbered from T1 to T12, each of which is crucial to moving the spine and make up the thoracic or T-Spine. Is it hypothesized that the discs and joints at T4 are particularly prone to injury when the spinal column makes certain excessive or unnatural motions or is in extreme sustained postures(repetition such as desk work, electrical/mechanical work. new hobby’s etc.). This can lead to injury in the local nerves, and subsequent numbness or pain in the arms or back known as T4 syndrome. Other aspects not just T4 of the thoracic spine can be affected, this can be referred to as “upper thoracic syndrome”. Patients presenting with T4 syndrome are typically between the ages of 30-50 years and occurs more frequently in women by a 4:1 ratio. Because of the connections this area of the spine has with the sympathetic nervous system symptoms can be vast and are often confused for symptoms of cardiovascular, lung or abdominal conditions often causing the patients to have real concern and seek out medical assessment or treatment. Some of these symptoms include; Upper extremity parathesia (numbness) and pain with or without neck and/or head pain(often more in the left upper limb), parathesia in all five digits, whole hand, forearm/hand(glove-like distribution), hands feeling hot or cold, heaviness in the upper extremity, hands feel and appear swollen, non-dermatomal aches/pains in the arm/forearm, pain often described as crushing or like a tight band, pain and or stiffness around the chest wall, interscapular pain/stiffness, worse pain at night often waking from sleep and sometimes a creepy-crawly sensation or the feeling of water gushing into the arm. Management of these symptoms have been proven to decrease through cervical, thoracic spine and rib cage mobilization/manipulation, soft-tissue mobilization to hypertonic(tight)musculature in the cervicothoracic region, self-mobilization techniques to the upper t-spine, postural exercises and education, a strengthening program of the scapulothoracic musculature and finally stretching of the tight pectoral and other upper quarter musculature; all of which can be offered through your Chiropractic Doctor.

Several case studies have been reported in this literature. This study was taken from Here if you would like to read the full article. Edited by Ernest Gamble with contributions from Ernest gamble, Rachael Lowe and Oyemi Sillo

FODMAPS (Fermentable Oligo-Di-Monosaccharides and Polyols)are carbohydrates(sugars) that are found in our foods. Not all carbohydrates are considered FODMAPS. FODMAPS are osmotic(meaning they pull water into the intestinal tract)they may not be digested or absorbed well and could be fermented upon by bacteria in the intestinal tract when eaten in excess. Symptoms of diarrhea, constipation, gas, bloating and/or cramping may occur in people who are sensitive to the effects of FODMAPs. Lowering your intake of these carbohydrates/FODMAPs;foods high in fructose, lactose, fructans, galactans and polyols can help in reducing symptoms for some patients. Examples of these foods are; Fructose(fruits, honey, high fructose corn syrup) Lactose(dairy) Fructans(wheat, garlic, onion, inulin) Galactans (legumes such as beans, lentils, soybeans) Polyols(sweeteners containing isomalt, mannitol, sorbitol, xylitol, avocados, apricots, cherries, nectarines, peaches and plums). Some high fiber foods may also be limited because of the high content of FODMAPS in their makeup(whole grain’s, beans etc.) The low FODMAP diet is often recommended in those with irritable bowel syndrome(IBS) and those with inflammatory bowel disease. Reviewing food labels and following recommended serving portions can also help in decreasing your FODMAP intake.

For a full list of foods and where they stand on the scale of FODMAPS and to read this full article.

MdDS can be a long lasting and persistent disorder in which patients feel they are in a state of constant perceived motion and related imbalance which can be present after travelling either by boat, plane 0r land. It is rare but can be life altering for those who do end up the condition. The syndrome can have an array of symptoms listed below:

• Disequilibrium-unsteadiness, a decrease in balance
• Extreme or unusual fatigue
• Cognitive impairment, decrease ability to concentrate, confusion or even memory loss
• Anxiety and/or depression
• Sensitivity to flickering light’s, loud/sudden noises, fast/sudden movements, enclosed areas and busy patterns
• Headaches and migraines
• Heaviness or the feeling of gravitational pull of the head, body, feet
• Dizziness
• Ear pain/fullness, tinnitus
• Nausea

For access to the full brochure from The MDDS Foundation visit the website www.mddsfoundation.org