Healthy Life Newsletter, December 2018
VA Chiropractic Reduces Veterans’ Use of Opioids?
Utilization of pain medication – particularly opioids – has been massively high in among veterans for decades, but Veterans Administration guidelines that recommend nonpharmacological first-line treatment options create a greater opportunity than ever for VA chiropractors to make a dent in the opioid and overall pain-management crisis.
Based upon recent research, VA chiropractors can indeed do a great deal of good when it comes to reducing veterans’ reliance on opioid medications. Witness a 2018 study1 by Dr. Anthony Lisi, director of chiropractic services for the VA, and colleagues that examined opioid use among veterans before and after receiving treatment from VA chiropractors. The study examined opioid use among “Veterans of Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND) who receive chiropractic care” and explored “the relationship between timing of a chiropractic visit and receipt of an opioid prescription.”
Put simply, how many veterans of these conflicts take opioids, and how does chiropractic care impact their opioid use? Let’s review some of the key points from the study, as published in the September 2018 issue of Pain Medicine:
“We identified 14,025 OEF/OIF/OND veterans with at least one VA chiropractic visit. … In terms of health status, 56.2% reported moderate to severe pain intensity, 54.2% had been diagnosed with PTSD, 47.6% had a diagnosis associated with depression, 33.8% were current smokers, 19.8% had a substance use disorder diagnosis, and the sample generally was overweight.”
“Overall, 4,396 (31.3%) of these veterans received an opioid prescription within +/- 90 days of the initial chiropractic visit. The most commonly prescribed opioid was hydrocodone (42.7%), followed by tramadol (33.4%) and oxycodone (13.2%).”
“The percentages of veterans receiving opioid prescriptions tended to be higher in each of the 30-day windows before the index chiropractic visit than in any of the 30-day windows after the visit.”
“Factors associated with an increased likelihood of receiving an opioid around the time of a chiropractic visit included moderate to severe pain, diagnoses of PTSD and/or depression, and current smoking.”
Specifically, the percentage of veterans receiving opioids declined from 15.9 percent 31-60 days prior to their first chiropractic visit to only 11.5 percent 61-90 days following their chiropractic visit. While the authors note that their findings do not necessarily mean chiropractic care directly caused the reduction in opioid prescriptions / use, the timing is definitely food for thought and calls for further research.
According to the study, “A 2016 VA Health Services Research and Development State of the Art conference on nonpharmacological treatments for pain recommended broader uptake of a group of evidence-based nonpharmacological therapies. A key set of the recommend therapies – spinal manipulation, massage, acupuncture, exercise, and patient education – are the core components of multimodal chiropractic care in the VA.”
Reference: Lisi AJ, et al. Opioid use among veterans of recent wars receiving Veterans Affairs chiropractic care. Pain Medicine, 2018;19:S54–S60.
Growing Up with Antibiotics, Growing Up with Asthma?
In the latest (but probably not the last) research to associate antibiotic use during infancy with the development of asthma, three studies suggest exposure to antibiotics (either prescribed to the pregnant mother or the child during the first year after birth) increases the risk that the child will suffer from asthma.
The first study found that “both prenatal (before birth) and post-natal exposure to antibiotics was associated with an increased risk of asthma.” Building on this, the second study noted: “Antibiotic use in the first year life is associated with an increased risk of early-onset childhood asthma that began before 3 years of age. The apparent effect has a clear dose response” (the more you take, the greater the risk).
The third study compared babies born in urban areas with those born in rural areas. While a number of factors increased the risk of asthma, “the use of antibiotics” was one factor contributing to development of the condition, particularly in urban areas.
Talk to your doctor about the risk-benefit profile of any medication you’re prescribed / recommended (including over-the-counter products); then make an informed decision on whether it’s worth the risk.
One Mid-Back Adjustment Improves Breathing Function
A recent study took 36 stroke patients and gave them pulmonary function tests. Half the group then had a single thoracic spine adjustment and the other half had a “sham” (fake) adjustment. The breathing test was then immediately repeated. The group receiving the real adjustment demonstrated significantly increased pulmonary function compared to the findings before the adjustment and the sham group had no such improvement.
Details at jmptonline.org
Vitamin D Might Reduce Your Risk of Breast Cancer by as Much as 80%
Data from over 5,000 women was collected from three different studies and re-analyzed. The difference? This study looked at vitamin D level, not dosage or treatment group, and recorded breast cancer incidence. The result? Levels above 60 ng/ml (150 nmol/L), as compared to levels below 20 ng/ml (50 nmol/L) might reduce breast cancer risk by 80%.
Read more at grassrootshealth.net
Pain Pills Don’t Go Away After Back Fusion Surgery
We can debate the necessity of spine surgery until the proverbial cows come home, but a few concerning realities are becoming apparent: it’s performed far too frequently and it doesn’t mean your pain will go away. In terms of the latter point, a recent study in the peer-reviewed journal Pain found that patients who took prescription opioid pain meds before undergoing lumbar (lower back) fusion surgery were overwhelmingly likely to continue opioid use long term following surgery.
Among nearly 2,500 adult patients who underwent fusion surgery, almost half used opioids long term (at least four prescriptions filled in seven months) prior to surgery. Among those presurgical users, a whopping 77 percent continued use long term following surgery, while 14 percent continued use on a periodic basis. Only 9 percent discontinued opioid use or used them postsurgically for only a short period of time. Of the 77 percent who continued long-term use, 45 percent actually had their dosage increased following surgery. And to top it all off, 13 percent of patients who did not use opioids before surgery became long-term users after the procedure.
So, is spine surgery failing to take away the pain, or is opioid use a hard habit to break? Both probably deserve equal blame. That’s why nondrug, nonsurgical options – such as chiropractic care – for back pain are landing front and center in the health care conversation. If you’re experiencing back pain, schedule a visit with a doctor of chiropractic as your first provider choice. Why? Because research suggests back pain patients who see a chiropractor first are far less likely to undergo spine surgery compared to patients whose first contact is with a spine surgeon. Less chance of surgery, less chance of addictive pain medication; now that’s a win-win for your health.
Catch Up on Sleep, Lower Your Risk of Obesity
We’ve been talking a great deal about sleep lately because, well, it’s that important when it comes to your health. Sleep dysfunction (not getting enough on a regular basis, insufficient quality in terms of waking up refreshed and revived, irregular sleep patterns, etc.) has been linked to various negative health outcomes including lower academic performance, high blood pressure and heart disease.
Fortunately, new research suggests even people who don’t get adequate sleep during the week can compensate for it by sleeping in on weekends - and the health benefit is a reduced risk of obesity (another negative attributed to chronic poor sleep). In the study, researchers evaluated more than 2,000 adults ages 19-82 to determine sleep habits (weekday vs. weekend) and various health conditions including obesity.
Nearly 50 percent of study subjects slept approximately 2 hours longer per weekend night compared to weeknights - but that extra weekend sleep time meant they slept more overall than subjects who didn’t get any “catch up” sleep on weekends. The results: People who slept longer on weekends had a lower body-mass index (BMI), and the more catch-up sleep they got, the lower their BMI was, according to researchers.
So, what’s the takeaway? First, sleep is important when it comes to your health. Second, you can reduce your risk of obesity (and perhaps other health issues related to inadequate sleep, we can speculate) by catching up on sleep, rather than trying to “fight through” those sleepless or reduced-sleep nights.
Even Pre-Diabetes Is Risky
Don’t have type 2 diabetes? That’s good news. The bad news is your blood sugar may still be high enough to cause heart and kidney disease. Both conditions have been associated with a diabetes diagnosis, but new research suggests even non-diabetes sufferers whose blood sugar levels are elevated have a greater risk of developing either disease.
Researchers evaluated a national sample of more than 27,000 adults over four survey periods from 1988-2014 as part of the National Health and Nutrition Examination Surveys (NHANES). By 2014, people with pre-diabetes (fasting blood glucose of 100-125 mg/dL or 5.7-6.4 percent hemoglobin A1c) also had risk factors for heart and kidney disease, including high blood pressure, high cholesterol, reduced kidney blood filtration and elevated urinary albumin. Findings were published in The Lancet Diabetes & Endocrinology.
Pre-diabetes is on the rise, and as you might expect, so is diabetes. In the vast majority of cases, diet and exercise are both the cause and the solution: improper diet and lack of exercise lead to fasting high blood sugar and eventual diabetes, while a healthy diet and consistent exercise keep blood sugar in the safe range. Your doctor can tell you more about risk factors for type 2 diabetes and how to keep your blood sugar balanced throughout the day – every day.
Read the below article on line with links and more info
Fennel Seeds vs. Ginger for Menstrual Cramps and PMS
By Michael Greger M.D.
Ninety percent of women report having painful menstrual cramps at least some of the time. Around the Mediterranean, fennel seeds have been traditionally used to relieve painful menstruation. It’s hard to create placebo seeds, so researchers used fennel seed extract to put it to the test. The women started out rating their pain as six out of ten, which then went down to a four within an hour after the taking the fennel seed extract. Fifty-two percent of the women rated the fennel seed treatment as excellent, compared with only 8 percent of those in the placebo group who were just unknowingly given placebo capsules just containing flour.
But women don’t take flour for cramps; they take drugs such as ibuprofen. Mefenamic acid is in the same class of nonsteroidal anti-inflammatory (NSAID) drugs and may actually work better than ibuprofen, but it is not available over the counter. How did it do against an extract of fennel seeds? In a head-to-head study, most women started out in severe pain but ended up pain-free after treatment, and the fennel worked just as well as the drug class considered the treatment of choice––but without the drug’s side effects, which include diarrhea, rashes, autoimmune anemia, and kidney toxicity.
The drug also doesn’t help with the other symptoms of bad periods. During menstruation, women can feel nauseated, out of sorts, weak, achy, and diarrheic. But when put to the test, fennel seeds seemed to help; however, the control group wasn’t given a placebo, so we don’t know how much of that was a placebo effect.
One downside of taking fennel is that women bleed about 10 percent more. Menstrual cramps are caused by the uterus contracting so hard its blood supply is compromised, and we think fennel works through muscle relaxation. It also helps with infant colic, which is thought to be due to intestinal spasms. The advantage of fennel there, too, is the lack of side effects, unlike the drug commonly used for colic. Indeed, dicyclomine hydrochloride can work a little too well to get your baby to stop crying––by developing side effects like death.
Ginger is effective for cramps and reduces bleeding when an eighth of a teaspoon of ginger powder is taken three times a day during one’s period. This is important since up to 18 million young women in the United States experience iron deficiency anemia due to heavy menstrual bleeding. In a study, the amount of blood loss was estimated using a scoring system that gave points for level of saturation and clot size. On ginger, they went from half a cup per period down to a quarter cup. Ginger appears to be a highly effective treatment for the reduction of menstrual blood loss. It is cheap, at only about 6 cents a month, easy to use, and may have fewer side effects than medications and invasive approaches, even sometimes fewer than placebo! The researchers used lactose (milk sugar) for the sugar pills, which may have caused the reported flatulence.
Ginger may also work better for premenstrual syndrome (PMS). An eighth of a teaspoon twice a day of ginger powder for a week before one’s period yields a significant drop in PMS mood, physical, and behavioral symptoms, whereas fennel may help with PMS anxiety and depression but not with the emotional or physical symptoms.