Healthy Life Newsletter, November 2018
A Little More Chiropractic, a Lot Less Pain
Why should I visit a doctor of chiropractic when I’m not experiencing pain or other symptoms? That’s the question many patients still ask themselves, despite the growing body of research supporting the value of chiropractic maintenance care. Here’s why. The latest study on maintenance care for low back health suggests receiving chiropractic care periodically dramatically reduces the number of days low back pain (LBP) patients experience “bothersome” low back pain over the course of a year.
Published in the multidisciplinary open-access journal PLOS One, the investigator-blinded, two-arm, randomized, controlled trial included 328 consecutive patients ages 18-65 with nonspecific low back pain who experienced a favorable response to chiropractic care during their initial course of treatment. Patients were recruited from 40 chiropractic clinics between 2012-2016. Patients were then randomly allocated to one of two groups for one year: a maintenance care group that received periodic chiropractic care or a control group that returned to their chiropractor only when LBP symptoms were present.
Every week, researchers assessed subjects’ low back pain with a single question: “On how many days during the past week were you bothered by your lower back (i.e., it affected your daily activities or routines)?” During the 12-month tracking period, members of the maintenance care (MC) group made an average of 6.7 visits to the chiropractor, compared with 4.8 visits by members of the control group. Those additional visits correlated with 12.8 fewer days of bothersome low back pain, on average, for MC group members compared to control group members.
How important is 12.8 fewer days of bothersome LBP a year? For anyone who’s experienced LBP, particularly in chronic / recurring fashion, we like to think it’s well-worth a few “extra” visits to the chiropractor every year.
As mentioned, this also isn’t the first study to investigate maintenance care for low back pain. For example, in 2011 we reported on a study in Spine titled, “Does Maintained Spinal Manipulation Therapy for Chronic Non-Specific Low Back Pain Result in Better Long-Term Outcome?” Patients suffering from chronic LBP (six months or longer) received one month – 12 visits – of spinal manipulative therapy and then were randomized to receive either maintenance SMT visits every two weeks for nine months or the initial 12 visits only.
After 10 months, only the group receiving maintenance care reported significant improvement, while pain and disability scores had returned “near to their pretreatment level” in the group receiving one month only of SMT.
Interested in learning more about either study? You can see summaries here:
Ideally every obstetrician would have a chiropractor in their office to evaluate and adjust most or all of their pregnant patients. And they would test all their patients for vitamin D and ensure they have optimal levels. Meanwhile, seeing a chiropractor experienced in working with pregnancy is a great idea for pregnant folks and those planning pregnancy. ..Dr. Mha Atma
5 Conditions Chiropractic Care Can Improve During Pregnancy
By Amy Kochersberger, DC
A recent study found that more than 75 percent of pregnant women experience pregnancy-related low back pain, pelvic pain, or a combination; and that this pain increases as pregnancy progresses.1 Chiropractic care is a safe, effective, and drug-free way to manage these and other musculoskeletal symptoms during pregnancy.2,3
Normal biomechanical changes during this time can result in discomfort and pain during pregnancy and labor. These changes include weight gain, anterior shift in center of gravity, increased lumbar lordosis, and laxity of lumbopelvic ligaments; as well as postural changes and altered gait pattern.4 Many obstetric providers are unaware that the resulting musculoskeletal conditions and their related symptoms can be managed and improved with chiropractic care and patient education.5 Following are some of the musculoskeletal conditions that occur:
Low Back Pain
Low back pain during pregnancy is caused by increased stress on the lumbar spine by an anterior shift in center of gravity. Compensatory muscle tightness and altered gait patterns also contribute, and this pain ranges from mild to severe depending on the patient’s activity level, daily activities and work duties.2,6 Low back pain is also very common during the postpartum period.7
Sciatic Nerve Pain
Hypertonicity in the gluteal muscles and deep external rotators can irritate or compress the sciatic nerve during pregnancy. Some studies suggest the baby’s growth contributes to uterine pressure on supporting vasculature or direct compression of the sciatic nerve, which results in low back pain with radiation into the legs.8
Sacroiliac Pain
Ligament laxity caused by hormonal changes during pregnancy allows these traditionally stable and primarily weight-bearing sacroiliac joints to move and shift. This increased mobility puts stress on the surrounding ligaments and muscles, which may cause pain.4 Patients sometimes incorrectly describe their discomfort as “hip pain,” however they indicate the sacroiliac joint as the area of complaint.
Pubic Symphysis Pain
During pregnancy, the hormone Relaxin allows the ligaments stabilizing the pubic symphysis joint to relax, and therefore allows the joint to move and separate. Also called Symphysis Pubis Dysfunction, or SPD, this condition produces pain and limitation of mobility. It also may contribute to instability of the bony pelvis.9
Round Ligament Pain
The round ligaments of the uterus contain contractile fibers, and suspend and connect it to the anterolateral abdominal wall on either side. As the uterus grows, the round ligaments also stretch and can cause a sharp pain on either side of the abdomen or at the attachment sites of the ligaments near the pubic bones or labia.10
Mayo Clinic study indicates that seeing a chiropractor first for neck pain reduces the possibility of later opioid use--An article published in the December 2017 edition of Mayo Clinic Proceedings described a study which analyzed records of 1700 patients who sought treatment for a new episode of neck pain. They found that if the first health care provider a patient saw was a doctor of chiropractic, or to a lesser degree a physical therapist, the chance that within a year they would wind up being prescribed opioids, undergo expensive advanced imaging (like MRI) or get injections was significantly less than if their first encounter was with a medical doctor.
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Vitamin D and Cancer
Using data from two randomized controlled trials and the GrassrootsHealth prospective cohort, it was found that breast cancer rates (black line) were lower with higher vitamin D levels. There was an 82% lower rate of breast cancer for women with vitamin D levels at or above 60 ng/ml (150 nmol/L) compared to those with levels less than 20 ng/ml (50 nmol/L) (P=0.006).
A randomized controlled trial found that higher vitamin D levels were significantly associated with a lower risk of all cancers combined (P=0.03), of which 36% were breast cancer. From 30 to 55 ng/ml (75 to 138 nmol/L), the range with tight confidence bands, there was a 35% reduction in cancer risk. Extrapolating to a wider range, a 50% reduction in cancer risk is observed from 20 to 60 ng/ml (50 to 150 nmol/L).
Using data from a randomized controlled trial and the GrassrootsHealth prospective cohort, it was found that cancer risk decreased with increased vitamin D levels. Women with vitamin D levels at or above 40 ng/ml (100 nmol/L) had a 67% lower risk of cancer than women with levels less than 20 ng/ml (50 nmol/L) (P=0.03). Breast cancer accounted for 43% of cases.
5 Common Causes of Neck Pain (and How Chiropractic Can Help)
Neck pain can be acute (short term) or chronic (recurring or persisting for months and even years), but regardless, when you’re in pain, relief is the first thing on your mind. Just as important as relief, of course, is finding the cause and ensuring you avoid the behavior / action that brought the pain on in the first place.
Here are five common causes of neck pain – and why doctors of chiropractic are well-suited to relieve the pain and determine the underlying cause.
\1. Poor Posture: Leaning over a desk all day or slouching in your office chair? You’re bound to develop neck pain eventually, if you haven’t already. Do this quick test: In an upright or seated position, round your shoulders and back (poor posture). Does it impact your neck as well? Exactly!
\2. Monitor Madness: Staring at the computer screen for hours at a time? That’s not good for your health (or sanity), but from a neck pain perspective, it’s madness, particularly if the screen height forces you to crane your neck up (too high) or extend it down (too low).
\3. Sleep Issues: Ideally, we spend a third of our day sleeping, so your sleep habits – for better or worse – can have a dramatic effect on your health. With regard to neck pain, anytime you sleep in an uncomfortable position, particularly one that stresses your neck musculature (think about side-sleeping while grabbing your pillow tightly, sleeping on your stomach with your arms out in front of you, or even sleeping on your back, but with a pillow that doesn’t adequately support your neck), you risk neck pain.
\4. Technology Overload: We may spend a third of our day sleeping, but we increasingly spend the other 16 hours typing, texting, tapping and otherwise interacting with our smartphones, tablets, etc. Bottom line: bad for your neck. One doctor has even coined the phrase, “text neck,” to describe the neck pain that can result from this constant technology interaction.
\5. The Wrong Movement: Twisting, turning, stretching and stressing your neck is an easy way to cause neck pain. While the muscles in the neck are strong, they can be strained, sprained and even torn, just like any other muscle.
It’s important to note that beyond these common causes, various other health issues can also contribute to or directly cause neck pain, including fibromyalgia, cervical arthritis or spondylosis (essentially spinal arthritis), spinal stenosis (narrowing of the spinal canal), infection of the spine, and even cancer. The good news is that a doctor of chiropractic can help identify which of these or the above causes is to blame.
When neck pain strikes, most people turn to a temporary solution first: pain-relieving medication. But that’s not a permanent solution, of course, and it doesn’t address the cause of the pain at all, which could be something relatively minor – or more serious. What’s more, research suggests chiropractic spinal manipulation is actually more effective than over-the-counter and prescription medication for relieving both acute and subacute neck pain.
Suffering from neck pain? Then give your doctor of chiropractic a call. They’ll help you relieve your pain and determine the cause so it doesn’t return.
How Many Servings of Fruits and Vegetables to Improve Mood?
Written By Michael Greger M.D. FACLM
“Thousands of papers have been published on the important topic of what determines people’s subjective well-being and psychological health,” but what about the potential influence of the different kinds of foods people eat? I explore this in my video Which Foods Increase Happiness?.
“The rising prevalence of mental ill health is causing considerable societal burden. Inexpensive and effective strategies are therefore required to improve the psychological well-being of the population….A growing body of literature suggests that dietary intake may have the potential to influence psychological well-being.” Dietary intake of what? Well, given the strong evidence base for the health benefits of fruits and vegetables, researchers started there.
Cross-sectional studies from all over the world support this relationship between happiness and intake of fruits and vegetables. Those eating fruits and vegetables each day have “a higher likelihood…of being classified as ‘very happy,’” suggesting “a strong and positive correlation between fruit and vegetable consumption and happiness” and perhaps feelings of optimism, too.
The largest such study was done in Great Britain, where “a dose-response relationship was found between daily servings of [fruits and vegetables] and both life satisfaction and happiness,” meaning more fruits and veggies meant more happiness. People who got up to seven or eight servings a day “reported the highest life satisfaction and happiness,” and these associations remained significant even after controlling for factors such as income, illness, exercise, smoking, and body weight, suggesting fruit and vegetable consumption didn’t just act as a marker for other healthy behaviors.
But how could eating plants improve happiness on their own? Well, many fruits and veggies contain higher levels of vitamin C, which is “an important co-factor in the production of dopamine,” the zest-for-life neurotransmitter. And, the antioxidants in fruits and vegetables reduce inflammation, which may lead “to higher levels of eudaemonic well-being.”
Eudaemonic? What’s that? “Aristotle’s notion of eudaemonia…described the highest of all human goods as the realization of one’s true potential,” which was the aim of a study: Researchers wanted to know whether eating fruits and vegetables was “associated with other markers of well-being beyond happiness and life satisfaction.” So, they tested whether consuming fruits and veggies was associated with “greater eudaemonic well-being—a state of flourishing characterized by feelings of engagement, meaning, and purpose in life.”
The researchers followed a sample of about 400 young adults for 13 days, and, indeed, the young adults who ate more fruits and veggies “reported higher average eudaemonic well-being, more intense feelings of curiosity, and greater creativity.” This could be followed on a day-by-day basis: greater well-being on the days they ate healthier. “These findings suggest that [fruit and vegetable] intake is related to other aspects of human flourishing, beyond just feeling happy.”
Not so fast, though. Instead of eating good food leading to a good mood, maybe the good mood led to eating good food. Experimentally, if you put people in a good mood, they rate healthy foods, like apples, higher than indulgent foods, like candy bars. Given a choice between M&M’s and grapes, individuals in a positive mood were more likely to choose the grapes. The results of these studies “lend support to a growing body of research that suggests that positive mood facilitates resistance to temptation.” Who needs comfort foods when you’re already comforted? It’s like which came first, the stricken or the egg? Yes, eating eggs may increase our likelihood of chronic disease, but maybe chronic disease also increases our likelihood of eating unhealthy foods. Which came first, the mood or the food?
If only there were a study that, instead of looking at well-being and diet on the same day, looked to see if there’s a correlation between what you eat today and how you feel tomorrow.
There is. In the study, researchers found the same “strong relationships between daily positive [mood] and fruit and vegetable consumption.” Additionally, “[l]agged analyses showed that fruit and vegetable consumption predicted improvements in positive [mood] the next day, not vice versa…On days when people ate more fruits and vegetables, they reported feeling calmer, happier and more energetic than they normally do…[and] also felt more positive the next day.” So, eating fruits and vegetables really “may promote emotional well-being.” Single bouts of exercise can elevate one’s mood, so why not the same with healthy food?
How many fruits and vegetables? Seems we “need to consume approximately 7.2 daily servings of fruit or 8.2 servings of vegetables to notice a meaningful change” in mood.