Healthy Life Newsletter, June 2022
Chiropractic vs Physical Therapy: Two Studies
By Ronald Feise, DC
Over the past decade, independent health care researchers have investigated the treatment effects of physical therapists vs. doctors of chiropractic when it comes to spine care. Let’s examine a couple of those research papers to see why it’s no contest.
Example #1
The first study was a cost-effective analysis of patients with low back pain that compared head-to-head the costs of physical therapists vs. the costs of chiropractors.1 This study assessed the medical records of 14,787 patients and was published in the Journal of the American College of Occupational and Environmental Medicine. The research team consisted of four PhDs, two PharmDs and one MD.
Study participants were employees of a heavy equipment manufacturer who were mostly male, in their late 40s, and with an above-average middle-class income. Subjects were divided into two main categories, depending upon their presenting symptoms: low back pain with neurological symptoms and low back pain without neurological symptoms.
Total costs, as defined for this study, included imaging, health care professional visits, medications, injections, surgery and disability payments.
Total costs for low back pain patients with neurological findings were $6,983 for chiropractors vs. $17,194 for physical therapists. Total costs for low back pain patients without neurological findings were $6,768 for chiropractors vs. $13,449 for physical therapists. That is an enormous difference!
This study also examined why chiropractors are more cost-effective. It determined that chiropractors are less likely than physical therapists to recommend incongruent health care services for patients with low back pain, such as imaging, medications, injections and surgery.
Example #2
The second study examined the recurrence rate of back pain after a back injury among three types of health care providers: medical doctors (who served as the reference group), chiropractors and physiotherapists.2 The study was conducted by four PhDs and one Doctor of Science, and was published in the Journal of Occupational Rehabilitation. This research team analyzed data from a cohort of 5,511 workers with an initial episode of back injury.
The type of health care provider first visited for back pain was a determinant of recurrence. Chiropractic patients experienced the fewest recurrences (-19 percent compared to MDs), while physiotherapy patients experienced the most (49 percent). These differences raise concerns regarding the use of physiotherapists as gatekeepers for spinal injuries.
The Bottom Line
These two studies represent the tip of the research iceberg. There are more than two dozen studies that point in one direction: Chiropractic services are more economical than physiotherapist services, and chiropractors are more effective in the treatment of spinal conditions than physiotherapists.
References
Allen H, Wright M, Craig T, et al. Tracking low back problems in a major self-insured workforce: toward improvement in the patient’s journey. J Occup Environ Med, 2014;5:604-20.
Blanchette MA, Rivard M, Dionne CE, et al. Association between the type of first healthcare provider and the duration of financial compensation for occupational back pain. J Occup Rehabil, 2017;27:382-392.
Natural Pain Relief
Nonsteroidal anti-inflammatory drugs (NSAIDs) remain all too common for pain relief of any kind; think aspirin, ibuprofen (Advil, Motrin, etc.) and more. New research provides more evidence suggesting it’s time to ditch the NSAIDS – and try this instead for natural pain relief; in this case, for pain caused by knee osteoarthritis.
Exercise therapy appears to be just as effective as NSAIDS and opioids – an even more powerful, more dangerous class of pain relievers that’s been in the news lately for contributing to a virtual epidemic of misuse, abuse, addiction and death – for relieving knee OA pain. Findings appear in the Journal of Orthopaedic & Sports Physical Therapy and are based on a review of 13 previously conducted studies.
Osteoarthritis is the most common joint disorder in the U.S., and symptomatic knee OA occurs in 10 percent of men and 13 percent of women age 60 or older. As you can imagine, having osteoarthritis or knee pain alone is bad enough; having them in combination, particularly as you age and preserving mobility becomes ever more important, is a real problem.
So, if a natural pain reliever works as well as a pain medication, which should you choose? It’s no content, considering that all drugs (yes, all) come with a long list of potential side effects, from mild to moderate to severe – to even deadly. Talk to your doctor for more information.
4 Perils of Poor Posture
Slump away at your desk, scrunch your shoulders to type another text message, bend and lift without protecting your back – what harm can it do? Actually, the health consequences of poor posture, whether temporary or chronic, are numerous and life-changing.
Here’s a short list that will hopefully prompt you to stand / sit straight and tall from this point forward:
Pain: The No. 1 consequence of poor posture is pain,
and it can manifest anywhere from the neck down to
the low back / pelvis and even further.
Attitude: Try this quick test and you’ll immediately notice how poor posture can impact your attitude / mood: First, in a standing position, roll your shoulders in toward your chest, letting your spine “round.” How do you feel? Now do the opposite - expand your chest, pull back your shoulders and stand up tall. Which feels better? Which makes you feel confident, ready to take on the world?
Stress: Poor posture compresses your lungs / organs, leading to shallow breathing, which leads to stress. It makes perfect sense: What’s the first rule when you’re stressed out? Take a deep, full breath or two.
Major health issues: Stress isn’t the only consequence of shallow breathing; reduced lung function means vital organs including the heart and brain don’t receive adequate oxygenated blood, especially over time. The long-term result: an increased risk of heart / cardiovascular disease.Pain: The No. 1 consequence of poor posture is pain, and it can manifest anywhere from the neck down to the low back / pelvis and even further.
How’s your posture? Have you checked it lately? Chances are you’re letting your posture slip – and negatively impacting your physical and mental well-being in the process. Your doctor of chiropractic can evaluate your posture and recommend strategies to have you standing straight and tall in no time.
Say No to Migraine Medication and Yes to Natural Care
If you’ve ever experienced a migraine headache, you know how debilitating it can be. According to the Mayo Clinic, “a migraine headache can cause intense throbbing or pulsing in one area of the head and is commonly accompanied by nausea, vomiting, and extreme sensitivity to light and sound.
Migraine attacks can cause significant pain for hours to days and be so severe that all you can think about is finding a dark, quiet place to lie down.”
Nearly 30 million American suffer migraine headaches, with women more than three times as likely as men to be victims. Too often, medication is the first-line treatment strategy to control symptoms – particularly the pain – despite the fact that natural options are being shown to be just as, if not more, effective.
Case in point: a recent study that divided 91 adult migraine sufferers into three groups for comparison. One group received topiramate (brand name: Topamax), an anti-convulsant also approved by the Food and Drug Administration for the treatment and prevention of migraines; a second group exercised 40 minutes a day, three times a week; and the third group performed relaxation exercises over the course of the study period. After three months, results showed no significant differences between the three groups: all three interventions reduced the frequency of migraine occurrence.
If you suffer from migraines, your doctor of chiropractic may recommend exercise or relaxation techniques to help treat your problem without having to resort to drugs, all of which come with a substantial list of side effects that can make you feel even worse. For example, among the potential side effects of topiramate are nausea, diarrhea and fatigue – just what you don’t need when you’re dealing with a debilitating migraine.
Of course, your chiropractor may also perform chiropractic adjustments, which have been shown to be effective for headache symptoms. One study showed spinal manipulation to be as effective as amitriptyline for migraine symptoms; another study showed a significant reduction in frequency, duration and severity of migraines, as well as need for medication, following chiropractic manipulation. And nutritional support, such as magnesium supplementation, has also proven to be effective.
If you suffer from migraines, talk to your doctor of chiropractic about the drug-free options. Say no to medication and yes to natural care.
Here is a good illustration why part of providing for your health and that of your family is to contact your elected representatives and other policymakers regularly to demand better environmental regulations. News like this does not need to make you depressed–you can use it as an inspiration to get active and demand change…. –Dr. Mha Atma
Pollution Responsible for One in Six Deaths Across Planet, Scientists Warn
Toxic air, water and soil are ‘existential threat to human and planetary health’, says global review
Tue 17 May 2022
Pollution is killing 9 million people a year, a review has found, making it responsible for one in six of all deaths.
Toxic air and contaminated water and soil “is an existential threat to human health and planetary health, and jeopardises the sustainability of modern societies”, the review concluded.
The death toll from pollution dwarfs that from road traffic deaths, HIV/Aids, malaria and TB combined, or from drug and alcohol misuse. The researchers calculated the economic impact of pollution deaths at $4.6tn (£3.7tn), about $9m a minute.
The overall impact of pollution has not improved since the first global review in 2017, since when 45 million lives have been lost to it. Prevention was largely overlooked in the international development agenda, the researchers said, with funding increasing only minimally since 2015.
Deaths from toxic air and chemicals have risen by 7% since the previous review and 66% since 2000, driven by increased fossil fuel burning, rising population numbers and unplanned urbanization. This rise was offset by improvements in the “ancient scourges” of water polluted by pathogens and poor sanitation and indoor smoke from cooking fires.
The researchers said pollution, the climate crisis and the destruction of wildlife and nature “are the key global environmental issues of our time. These issues are intricately linked and solutions to each will benefit the others. [But] we cannot continue to ignore pollution. We are going backwards.”
Prof Philip Landrigan, at Boston College in the US and a lead author of the analysis, said: “Pollution is still the largest existential threat to human and planetary health. Preventing pollution can also slow climate change – achieving a double benefit for planetary health – and our report calls for a massive, rapid transition away from all fossil fuels to clean, renewable energy.”
Awareness of pollution was key, said Richard Fuller, at the Global Alliance on Health and Pollution (GAHP) in Switzerland, another lead author. He said action plans have been presented to 11 national governments to date: “Ministers are just gobsmacked at how big an impact pollution is having in their country.” Measuring pollution and making it public also drives change, he said: “It switches on communities to want to do something and yell and scream at their politicians. Everything can roll from that.”
The new review, published in the journal Lancet Planetary Health, analysed data from the 2019 Global Burden of Disease project, the most recent available, and found air pollution caused almost 75% of the 9 million pollution deaths.
Toxic chemicals resulted in 1.8 million deaths, including 900,000 deaths from lead pollution, which is more than from HIV/Aids. Lead poisoning could significantly reduce intelligence across large populations, Fuller said, sources of which include water pipes, paint, backyard car battery recycling, as well foodstuffs such as contaminated turmeric.
The number of deaths from chemical pollutants was likely to be an underestimate, the scientists said, as only a small proportion of the 350,000 synthetic chemicals in use had been adequately tested for safety. The cocktail of chemical pollution that pervades the planet has passed the safe limit for the stability of global ecosystems upon which humanity depends, researchers reported in January.
More than 90% of pollution deaths occur in low- and middle-income countries, such as India and Nigeria. While high-income countries, such as the US and members of the EU, had controlled the worst forms of pollution, the researchers said, few less affluent nations had been able to make pollution a priority.
Pollution also crossed international borders, carried on winds or in food exports, said Fuller: “If we’re going to keep everyone safe, we need to help countries that have these toxic problems to stop the pollution at the source.”
Unsafe water causes 1.4 million early deaths a year but this has been falling due to improvements in sanitation and healthcare, particularly in Africa. However, the UN estimates more than 2 billion people still do not have access to clean drinking water.
The researchers called for increased funding for pollution control from governments and donors, better monitoring and a new independent scientific body to assess the problem, modelled on the Intergovernmental Panel on Climate Change, whose influential reports are agreed by all governments.
“Pollution has typically been viewed as a local issue,” said Rachael Kupka, also at GAHP, which includes the UN Environment Programme and the World Bank. “However, it is clear that pollution is a planetary threat. Global action on all major modern pollutants is needed.”