Healthy Life Newsletter, January 2023
A Note from Dr. Mha Atma
January 1, 2023
Any day is a great day to contemplate our life and our world, and to reaffirm our intentions, vision, and determination to create and promote a healthier life for ourselves and a healthier and more just world for all the people and beings we share this planet with.
But today, as I write this, being the first day of the year is an especially good day to do that. And for me, today being my birthday, makes it a perfect day to do that.
And I am further motivated by the book I am reading, titled “See No Stranger” by Valarie Kaur. Her vision, based on her experience growing up in the USA as an immigrant from India, and in a Sikh, turban-wearing family, and enduring the vitriol that was poured on folks who looked like her by many scared and angry Americans after the September 11 attacks, and later becoming an activist for justice and healing for all people of color and all people everywhere, taught her that the way to overcome the limits of prejudice and division is to see every single person NOT as a “stranger” or someone from the “other side,” but to see every person as a part of ourselves. Her affirmation for dealing with everyone, no matter their ethnicity or political bias: “You are a part of me I do not yet know.” Holding the intention to be curious, to learn and grow, to have the humility to listen and the courage to stand up for justice, inspires me to want to continue learning to be a better human and to better do my part to take care of myself and my world.
I believe that holding this intention and vision can be at least as important to your health as a good diet, exercise, adequate rest, and chiropractic care!
Happy New Year!
Patient of the Month: Dolores Smith
I had terrible pain in my legs for months. At Kaiser, my doctor examined me and told me I had arthritis. He gave me various medicines but nothing worked. My daughter was a patient at Khalsa Chiropractic and she recommended that I go see Dr. Mha Atma. I had never been to a chiropractor ever before.
I had doubts that chiropractic would help me. My medical doctor told me it was NOT a good idea. I decided to see for myself.
The office felt very comfortable. Dr. Mha Atma started me on regular chiropractic treatments and gave me exercises to do. The shooting pains down my legs eased up. I could return to walking, without pain or limping. I take much less medicine now.
I started chiropractic care four years ago. I have continued with treatments because I need them. This year I did not come in for about 10 months and then my leg pains started to come back. As soon as I resumed treatment I felt much better again.
I’m convinced chiropractic works. I tell everyone I know about chiropractic. I tell them it works. No stress. Feel good. Keep coming for treatments once you start. I told my medical doctor about my treatments. All he could say was “good!”
I like coming to Khalsa Chiropractic for treatments. Dr. Mha Atma gives me good advice. The office is a great place to me.
Debunking Media “Hit Pieces” on Vitamin D
From Grassroots Health Nutrient Research Institute:
Several participants have emailed us since Forbes released their article titled “No, You Still Don’t Need Vitamin D Supplements!” Most participants were curious to know how we would respond to such a vitamin D ‘hit’ piece.
What GrassrootsHealth would like to know is, how will YOU respond to such vitamin D ‘hit’ pieces?
The Forbes article stated a number of false claims about vitamin D – below each of these statements we provide links to material that can be referred to or shared to help demonstrate that these claims are, in fact, false. Each link and resource references published, scientific research. Use these resources and links to help fight vitamin D misinformation, whether it’s on social media, via email, or in discussion with a friend or colleague.
Please go to myemail.constantcontact.com to read and share this information!
Managing Low Back Pain: Tips and Strategies for Relieving Your Pain at Home
Self-care is extremely important to our physical, social and mental well-being. There are a variety of ways to take care of your health, but many people overlook the importance of simple home remedies that can effectively manage low back pain.
Here are just a few of the things you can do at home to help manage lower back pain.
Exercise Regularly
Staying active is one of the most important things you can do to manage your pain levels. Regardless of how you exercise (as long as you’re not overworking your back), engaging in regular physical activity can help to improve your flexibility, strength and overall health, resulting in less pain. If you are worried about what activities you can safely engage in with low back pain, talk with your chiropractor.
(Not interested in staying active? You will be glad to know that most people who choose to not make any lifestyle changes to speed up the recovery process will still get better eventually.)
According to one study, Pilates, stabilization or motor control, resistance training, and aerobic exercise training are the most effective treatments for adults with low back pain. So if you have low back pain, consider starting a regular exercise routine that includes any of these – or try them all and see what works best for you!
Go for a Walk
In addition to a regular exercise routine, another way to help manage low back pain is by walking regularly. Not only can regular walking help keep your muscles flexible and strong, but it also allows you to get out of the house or office and enjoy some much-needed fresh air and natural sunlight. To get started, start with short walks at a slow pace and gradually build up your endurance.
Apply Heat or Ice Packs
Applying heat or ice to your low back can be a great way to relieve tightness and pain. If you’re dealing with chronic pain, try using an ice pack first to help reduce inflammation and swelling. Then, keep using it regularly as needed throughout the day to help soothe discomfort. Alternatively, if you’re dealing more with stiffness than pain, try using a heat pack instead to loosen up your muscles and increase circulation.
Mindfulness and Relaxation Techniques
Believe it or not, the power of your mind can affect the severity of your pain. By practicing mindfulness and other relaxation techniques, you can manage your discomfort more effectively.
In fact, according to one study, mindfulness is associated with the deactivation of the prefrontal and greater activation of somatosensory cortical regions. In short, mindfulness can help relieve your pain by changing the way you think about it.
If you’re feeling stressed or anxious, practicing mindfulness and relaxation techniques can be a great way to lower your stress levels and help reduce overall pain. Breathing exercises, meditation, listening to soothing music, or journaling can be helpful and reduce the pain.
Take-Home Points
Overall, managing low back pain doesn’t have to be difficult or complicated. Talk with your chiropractor today about doing some simple self-care activities at home that can keep your back healthy and ease discomfort!
The Wrong Way to Treat Migraines
The wrong way to treat migraines is by far the most common way, unfortunately: pain medication, either over the counter or prescription. When the latter version is used, opioids continue to be an option, despite the fact that the opioid epidemic has been squarely in the public and profession eye for several years.
The opioid epidemic we speak of is the rampant overprescribing of opioids that has led to overdoses, addiction and death in too many people with headaches and other pain conditions. The pharmaceutical industry can take its share of the blame, too, since it’s become known that “Big Pharma” has done its usual job of overpromoting these drugs to the doctors who prescribe them - often while knowing of their deadly potential.
In terms of migraine pain, research suggests opioid use for migraines actually increased from 2009-2018, despite their use not being recommended as a first-line treatment option in the vast majority of cases. Unfortunately, clinical guidelines from the American Headache Society encourage other medications instead, including nonsteroidal anti-inflammatories (NSAIDs – Aleve, Motrin, etc.).
So, that’s the wrong way to treat migraines. Is there a better way? Chiropractic. Among the research supporting chiropractic care, one study found that subjects who received chiropractic adjustments reported substantial improvement in various migraine parameters including frequency, duration, disability, and medication use after two months of treatment. Ask your doctor about how chiropractic adjustments can help treat migraines and other types of headache pain.
(Note from Dr. Mha Atma: While chiropractic care often helps headaches, migraines can have complex causes that sometimes make them resistant to treatment, and it’s understandable that folks who are suffering turn to pain medications in the hope of relief. Other sometimes crucial factors include diet–eliminating pro-inflammatory foods such as sugar, grain-flour products, vegetable oils (which are in most processed foods and all store-bought salad dressings) and adding anti-inflammatory supplements including vitamin D, magnesium, omega-3 (fish oil) and turmeric. Also, in women, sex hormone imbalance can sometimes be a significant factor. And stress–which can be mediated by exercise, meditation, yoga and/or other lifestyle changes.)
Vitamin K for the Bones
There are 206 bones in the human body, and as we age, our risk of breaking one or more of them increases. A bone break at any age can be a problem, but when we’re older (and depending on the location of the break), it can severely limit our ability to perform daily activities. In some cases (e.g., a hip fracture), it can even prove deadly.
When we think of bone health, vitamin D and calcium usually come to mind – and for good reason. But there’s another vitamin that can positively influence bone health, although it’s too-often overlooked: vitamin K. Here’s why vitamin K should be included in your bone-building regimen.
Vitamin K (specifically vitamin K1) reduces fracture risk, particularly the aforementioned problematic hip fractures. Among 1,400 older women (average age of 70 at the start of the study) tracked over a nearly 15-year period, women who consumed more than 100 micrograms of K1 (the equivalent of 1-2 servings of dark, leafy vegetables, the primary dietary sources of vitamin K) were 31 percent less likely to suffer a fracture compared to women who consumed less than 60 micrograms per day.
In terms of the dreaded hip fractures, results were even more encouraging: Women with the highest vitamin K1 intake reduced their risk of hip-fracture-related hospitalization by almost 50 percent compared to the women with lower K1 intake. Study findings appear in the research journal Food & Function. Of note, findings were independent of vitamin D status; that means how much vitamin D women did (or didn’t) consume via diet and/or supplements did not influence findings.
Dietary sources of vitamin K, in addition to dark, leafy vegetables such as kale, spinach, broccoli, collard greens, etc., include fermented soybeans, soybean and canola oil, with small amounts present in meat, cheese and eggs. Vitamin K supplements are also available. Always talk to your doctor before taking any dietary supplement, particularly if you are also taking medication.
(note from Dr. Mha Atma: The following article, with references at the end, basically says that careful reviews of numerous scientific studies show that, in general, surgery for conditions such as neck, back, knee, shoulder and other musculoskeletal problems does not help any more than non-surgical treatment such as chiropractic and exercise. There are definitely individual cases where surgery is somewhat or very helpful, but in the aggregate these studies show that it is not, and imply that many of these
\surgeries are not necessary.)
Surgery for Musculoskeletal Conditions: No Added Benefit
A 2022 published review and meta-analysis of randomized, controlled trials of various interventions with and without surgery for non-fracture musculoskeletal (MSK) conditions in adults evaluated the potential benefits and harms. (1)
One hundred studies involving a total of 12,645 patients were selected, representing 28 different conditions at nine body sites including neck, low back, shoulder, pelvis, hip and knee. The review authors sought to estimate the benefits and harms of various interventions with and without surgery by looking at outcomes for patient-reported pain, physical function, quality of life, and serious adverse events (SAEs) for some of the more common MSK conditions.
Except for some spinal conditions, pain data on nine of 13 conditions, function data on 11 of 11 conditions and quality-of-life data on nine of nine conditions found no clinically relevant differences between interventions with and without surgery. For SAEs, 13 of 16 conditions with data; and for death, 16 of 16 conditions, found no differences in harms between surgery vs. no surgery.
Of the remaining four of 13 conditions with pain data, surgery appeared to lead to a greater improvement of at least moderate effect size for cervical disc herniation (three studies), lumbar spinal stenosis (five studies), sacroiliac joint pain (two studies), and chronic low back pain (five studies), but did not demonstrate greater improvement in either function or quality of life.
In addition, only 14 percent of MSK RCTs comparing surgery to placebo surgery, nonsurgical intervention or no intervention demonstrated statistically significant and clinically relevant benefits for surgery.
This isn’t the first time research has suggested most musculoskeletal conditions should be treated nonsurgically, rather than surgically. Per a 2021 study, “The low certainty of evidence does not support recommending surgery over nonsurgical alternatives for most MSK conditions with available RCTs. The lack of supporting evidence for surgery was recently confirmed by an umbrella review of meta-analyses.” (2)
The study notes that MSK conditions are the second most common indication for surgery worldwide, exceeded only by unintentional injuries. A previous systematic review suggested MSK surgeries have fewer supporting RCTs compared to other surgical procedures, and that less than 1 percent compared surgery to not performing the surgical procedure. (3)
And the authors of a 2017 study stated, “By quantifying benefits and harms and assessing risk of bias, our study adds weight to previous research and suggests that, for many conditions, best practice nonsurgical interventions are viable alternatives to surgery. Even for patients where nonsurgical treatment is not sufficiently effective, evidence supporting the effects of surgery is missing. For some conditions, surgery is even recommended against by clinical guidelines and does not provide additional benefit to nonsurgical treatment.” (4)
Interestingly, some studies have demonstrated that even after surgery, the costs (5) and need for further nonsurgical care (6-7) can be high, suggesting that undergoing successful surgery in terms of improved pain and function is not necessarily associated with reduced societal burden of MSK conditions; or does not necessarily result in the surgical intervention being more cost-effective as an alternative or in addition to nonsurgical intervention. (6,8)
These results, when combined with previous research, further support nonsurgical interventions as first-line care for MSK conditions for pain reduction, increased physical function, improved quality of life and fewer serious adverse events.
References
\1. Skou ST, Poulsen E, Bricca A, et al. Benefits and harms of interventions with surgery compared to interventions without surgery for musculoskeletal conditions: a systematic review with meta-analysis. JOSPT, 2022;52(6):312-344.
2. Blom AW, Donovan RL, Beswick AD, et al. Common elective orthopaedic procedures and their clinical effectiveness: umbrella review of level 1 evidence. BMJ, 2021;374:n1511.
3. Harris IA, Sidhu V, Mittal R, Adie S. Surgery for chronic musculoskeletal pain: the question of evidence. Pain, 2020;161:S95-S103.
4.Siemieniuk RAC, Harris IA, Agoritsas T, et al. Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline. BMJ, 2017; 57:j1982.
5. Kroslak M, Murrell GAC. Surgical treatment of lateral epicondylitis: a prospective, randomized, double-blinded, placebo-controlled clinical trial. Am J Sports Med, 2018;46:1106-1113.
6. Kiadaliri AA, Englund M, Lohmander LS, et al. No economic benefit of early knee reconstruction over optional delayed reconstruction for ACL tears: registry enriched randomised controlled trial data. Br J Sports Med, 2016;50:558-563.
7. Multanen J, Uimonen MM, Repo JP, et al. Use of conservative therapy before and after surgery for carpal tunnel syndrome. BMC Musculoskelet Disord, 2021;22:484.
8. Skou ST, Roos EM, Laursen MB, et al. Cost-effectiveness of total knee replacement in addition to non-surgical treatment: a 2-year outcome from a randomised trial in secondary care in Denmark. BMJ Open, 2020;10:e033495.