Healthy Life Newsletter, January 2025
A Note from Dr. Mha Atma
Happy New Year! The year 2025 promises to be a challenging one. All the more reason to take very good care of yourself–physically, mentally, emotionally and spiritually–so that you can enjoy life and do your part to make our world a little better. Our job at Khalsa Chiropractic is to support and encourage you to do the things that will help you become and stay healthy and then share those things with others. Sometimes just being kind to yourself and then to the folks you encounter in your life. can make a real difference in our world. Do what you can, and never give up!
#1 for Neck Pain: Chiropractic
Research shows that most people experience neck pain at some time in their lives, with a point prevalence potentially over 10%.1-2 A new study published in the research journal Spine looks at the patterns of use for patients with new-onset neck pain by health care provider type.3
“Utilization was assessed during a 180-day follow-up period, including subsequent neck pain visits, diagnostic imaging, and therapeutic interventions.” In a cohort of 770,326 patients, “representing a mixture of ages and geographical regions across the U.S.,” chiropractors were found to be the provider of choice by 45.2% of patients, followed by primary care providers (33.4%).
In addition, 78.7% of patients who began chiropractic care for their neck pain continued with chiropractic care (rather than moving on to another provider type for their pain).
Not surprisingly, during the first 180 days of care, chiropractic patients were less likely to receive plain radiology, cervical spine CT or cervical spine MRI than patients who began their care with primary care providers, emergency medicine or orthopedists. Similarly, chiropractic patients experienced less therapeutic injections and major surgery than primary care provider and orthopedist patients.
The wholesale reliance on diagnostic imaging by primary care physicians, emergency medicine and orthopedists may expose a lack of ability to physically diagnose neck pain (or back pain, for that matter). The lack of ability to provide manual manipulation and other types of manual care appears to lead to a greater use of therapeutic injections and surgery.
As part of their paper, the authors make the following observations and recommendation with respect to the management of neck pain by health insurers and health systems:
“Our results may have implications for the design of health benefits or systems. While many payors and health systems allow patient self-referral to chiropractors and physical therapists, patients are also often able to self-refer to specialist physicians. For patients with new-onset neck pain, self-referral to specialist physicians may be comparatively inefficient as higher care intensity may not improve the prognosis of acute musculoskeletal pain conditions.4 Health systems may seek means of incentivizing initial care for musculoskeletal neck pain with chiropractors or physical/occupational therapists, while implementing protocols or criteria for referral to physician specialists. Health systems may also seek means of engendering more frequent referrals from primary care or specialist physicians to chiropractors for patients with new-onset neck pain.”
In other words, patients with new-onset neck pain need chiropractic!
References
Haldeman S, Carroll L, Cassidy JD. Findings from the bone and joint decade 2000 to 2010 task force on neck pain and its associated disorders. J Occup Environ Med, 2010;52(4):424-427.
Hoy DG, Protani M, De R, Buchbinder R. The epidemiology of neck pain. Best Pract Res Clin Rheumatol, 2010;24(6):783-792.
Fenton JJ, Fang S, Ray M, et al. Longitudinal care patterns and utilization among patients with new-onset neck pain by initial provider specialty. Spine, 2023 Aug. 1 (published online in advance of print).
Carey TS, Garrett J, Jackman A, et al. The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors, and orthopedic surgeons. The North Carolina Back Pain Project. N Engl J Med, 1995;333(14):913-917.
Curcumin: One Nutrient, Over 20 Benefits
Lexi Loch, ND
While there may be no “magic bullet” when it comes to health, this should not dissuade patients or practitioners from seeking out ingredients that offer multiple health benefits. When it comes to dietary supplements, there are thousands upon thousands of choices. So, why not choose one that can address pain and assist with mental health? A supplement that can address inflammation, while also preventing certain types of cancer.
Fortunately, herbal ingredients offer multiple mechanisms of action, resulting in multiple health benefits. There may be no greater example of this than curcumin.
Curcumin comes from the turmeric plant (Curcuma longa) and is classified as a polyphenol.1 With more than 24,000 published studies listed on the National Institutes of Health database, curcumin is one of the most well-studied botanically derived ingredients in the world. In fact, with so much information to choose from, it’s almost difficult to narrow down curcumin’s benefits to 20.
Safely Relieves Pain
In a 2021 study, people with osteoarthritis were given 500 mg, twice per day, of curcumin with turmeric essential oil or 650 mg of paracetamol (also known as acetaminophen) for six weeks. The change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores (pain subscale) were similar between the two groups and curcumin was shown to be non-inferior to paracetamol.
Additionally, 18% of the patients receiving curcumin had a 50% improvement in their symptoms, while no one in the paracetamol group reached that threshold.2 Not to mention that paracetamol is the most common cause of drug-induced liver injury (DILI) in the United States.3
Curcumin is non-inferior to paracetamol for pain relating to OA.
Curcumin is generally well-tolerated: less than 6% of the curcumin group experienced mild side effects, while almost 13% of the paracetamol group had adverse effects.
Curcumin can reduce C-reactive protein (CRP) and tumor necrosis factor alpha (TNF-ɑ) levels.4 Higher CRP levels have been correlated with increased severity of lower back pain,5 fibromyalgia pain, and overall higher pain sensitivity ratings.6
Other research has found that curcumin can reduce paracetamol-related liver injury by preserving mitochondrial function, liver histopathology, and glutathione levels.7
Improves Symptoms of Rheumatoid Arthritis
People with active rheumatoid arthritis were divided into three groups: 500 mg twice per day of curcumin, 50 mg twice per day of diclofenac sodium (one brand name is Voltaren), or a combination of the two for eight weeks. All groups experienced significant reductions in their Disease Activity Score (DAS) 28 and American College of Rheumatology (ACR) criteria.
The curcumin monotherapy group experienced the highest overall improvement in DAS (45% improvement) and ACR scores, proving to be significantly better than the diclofenac monotherapy scores. Plus, 14% of the participants in the diclofenac sodium group dropped out because of adverse effects.
Curcumin can be safely combined with certain non-steroidal anti-inflammatory drugs, like diclofenac sodium.
Curcumin safely reduces painful and swollen joints associated with active rheumatoid arthritis.
Curcumin can work quickly for pain, with a 60% reduction in visual analog scale (VAS) scores in just eight weeks.8
Other research has shown that curcumin can attenuate RA progression, partially through its downregulation of the phosphatidylinositol 3-kiase (PI3K) / protein kinase B (Akt) pathway.9
Alleviates Anxiety and Depression
In a clinical trial involving 60 patients with major depressive disorder (MDD), participants were given 1,000 mg of curcumin, 20 mg of fluoxetine, or a combination for six weeks. Overall, the combination group experienced the highest response rate, albeit not statistically significant. The mean change in Hamilton Depression Rating Scale, 17-item version (HAM-D17), was similar for all three groups.
Curcumin can have similar efficacy to fluoxetine for MDD.
Curcumin has clinical research in combination with selective serotonin reuptake inhibitors (SSRIs), the first-line pharmaceutical treatment for MDD.
Other research has also found that curcumin can increase brain-derived neurotrophic factor (BDNF), which is important for mood disorders and neurodegenerative conditions like dementia, Alzheimer’s disease, and Parkinson’s disease.10
In a multi-arm clinical trial involving curcumin and saffron, 123 participants with MDD were included. Participants received either 250 mg twice per day of curcumin, 500 mg twice a day of curcumin, 250 mg of curcumin plus 15 mg of saffron twice per day, or placebo. All the active treatment groups experienced significant reductions in depression symptomology and anxiety scores, plus those with atypical depression had a 65% response rate.
Curcumin significantly improves anxiety scores alone and in combination with saffron.
Curcumin is beneficial for people with atypical depression.11
Other research has found that curcumin may play a therapeutic role in other neuropsychiatric disorders like post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), bipolar disorder, and schizophrenia.12
Enhances Cancer Remission
Cancer remains the second leading cause of death in the United States according to the Centers for Disease Control and Prevention. A 2022 clinical trial involving people with multiple myeloma who were ineligible for a bone marrow transplant demonstrated curcumin’s ability to increase remission rates.
All patients received melphalan (a chemotherapeutic) and prednisone, while half of the group also received eight grams of curcumin and the other half received placebo. After just 28 days, 75% of the curcumin group entered remission versus 33% of the placebo group.
Curcumin improves remission rates in people with multiple myeloma.
Curcumin can be safely combined with certain chemotherapeutics, like melphalan.13
Other research has found that curcumin can target cancer stem cells, act as a chemo- and radiosensitizer, and reduce side effects from conventional cancer treatments.14-15
Improves Glycemic Control
A meta-analysis of curcumin’s medicinal activities for type 2 diabetes found it can significantly reduce fasting blood glucose, glycated hemoglobin (HbA1c), and body mass index; plus, improvements in lipid profiles were inflammatory markers.16
Curcumin can reduce blood sugar and HbA1c in people with type 2 diabetes.
Other research has found that curcumin can reduce symptoms of peripheral neuropathy and promote the activity of nerve growth factor (NGF).17
A Multitargeted Approach
Practitioners of many holistic modalities (chiropractic, acupuncture, naturopathy) are seeking treatments that can offer simultaneous resolution of multiple health conditions and have been verified in clinical research. Patients and clients are looking to maximize their dollar and perhaps reduce their pill count. When it comes to meeting (and exceeding) these goals, it seems like curcumin may truly be the all-in-one solution.
Curcumin offers a multitargeted approach (transcription factors, growth factors, protein kinases, inflammatory cytokines, etc.) that has shown to be useful as a monotherapy, combination therapy, or adjunctive treatment for many – if not all – of the common health conditions seen today.18
To see references go to dynamicchiropractic.com
Time Your Eating
Are you morning heavy or evening heavy when it comes to eating? If the bulk of your caloric intake is at night, you could be putting your health at risk. Here’s why, and it relates to your glucose (blood sugar) levels.
Adults ages 50-70 with prediabetes or diabetes (and overweight or obese) were divided into two groups based on their eating preference: early eaters, meaning they consumed at least 45% of their daily calories during the day (before 5 p.m.); and late eaters, who did just the opposite, consuming 45% or more of their calories after 5 p.m.
It’s important to note that both groups ate the same foods equally the same caloric total; they just did so at different times during the day / night.
Findings revealed that late eaters have poorer glucose tolerance (higher levels of blood sugar) compared to early eaters. In other words, late eaters – who already had prediabetes or diabetes, remember – certainly aren’t helping their efforts to get their blood sugar in line. The fact that late eaters also tend to eat more carbohydrates and fat during that time only makes things worse.
The bottom line: Whether you’re overweight / obese, prediabetic / diabetic, or none of the above, when you eat matters! As the study authors suggest, the majority of your calories should be consumed at breakfast and lunch, not dinner (or even later than dinner, as is too often the case). A light, early dinner can make all the difference when it comes to your blood sugar – and your overall health.
Steps for the Brain
Let’s talk about step count for a minute – after all, everyone else seems to be talking about it lately. More steps equal better health, pure and simple, reducing your risk of developing any number of diseases … or just dying “before your time.” The latest study has found an association between step count / intensity and dementia risk among adults ages 40-79. Let’s see what the research concluded.
In the study, researchers monitored nearly 80,000 adults who wore accelerometers to track activity (steps). A higher number of daily steps was associated with a lower risk of dementia by any cause; and a step count of just under 10,000 per day proved most effective in reducing the risk. In terms of step intensity and dementia risk reduction, the optimal pace (steps per minute) was 112 steps, on average, and was associated with greater risk reductions than walking for the same number of steps, but at a slower pace. Findings appear in JAMA Network Open.
You might not be a fan of the gym, but walking – all that takes is a comfortable pair of shoes and the willingness to open your front door and pick a direction. With all the research linking walking to better health, if you’re not walking every day, the question is: What are you waiting for?
Exercise and Lifespan
Ever heard the phrase, “Movement is life”? We’ve used it several times before, but we certainly didn’t invent it. It’s well-known that physical activity – movement – is one of the most important variables contributing to a long, healthy life. Recent research makes the latest case for this connection.
Researchers applied a predictive model to determine how physical activity levels could impact lifespan. Participants were age 40 and older with physical activity levels based on data from a National Health and Nutritional Examination Survey (NHANES). The primary outcome measure: “how much life expectancy could be improved by increasing physical activity levels for both populations and individuals.”
OK, are you ready for the results? Drum roll, please: “If all individuals were as active as the top 25% of the population, Americans over the age of 40 could live an extra 5.3 years … on average. The greatest gain in lifetime per hour of walking was seen for individuals in the lowest activity quartile, where an additional hour’s walk could add 376.3 min (~6.3 hours) of life expectancy.”
If you can add an extra five-plus years to your life purely through physical activity – and add six-plus hours to your life by adding an hour walk to your routine, the only question is: What are you waiting for? If you can’t find the time, energy or motivation to get off the couch and adopt a consistent exercise routine, ask your doctor for help. It’s never too late.
Drinking Water, Losing Weight
Written by Michael Greger M.D. FACLM
A few times a day, drink two cups of cold water on an empty stomach for weight loss.
After drinking two cups (half a liter) of water, you can get a surge of the adrenal hormone noradrenaline in your bloodstream, as if you had just smoked a few cigarettes or had a few cups of coffee, boosting your metabolic rate up to 30 percent within an hour, When put to the test in randomized controlled trials, that appeared to accelerate weight loss by 44 percent, making drinking water the safest, simplest, and cheapest way to boost your metabolism.
This strategy may fail if you’re on a beta-blocker drug. (Beta blockers are typically prescribed for heart conditions or high blood pressure and tend to end with the letters lol, such as atenolol, nadolol, or propranolol, sold as Tenormin, Corgard, or Inderal, respectively.)
Just a single cup (240 mL) of water may be sufficient to rev up the noradrenaline nerves, but additional benefit is seen with drinking two or more cups (480 mL). A note of caution: One should never drink more than about three cups (710 mL) in an hour, since that starts to exceed the amount of fluid your kidneys can handle.
What kind of water are we talking about? Does it have to be plain, regular water? It shouldn’t matter, right? Isn’t water just water whether it’s flavored or sweetened in a diet drink? Actually, it does matter. When trying to prevent fainting before blood donation, drinking something like juice doesn’t work as well as plain water. When trying to keep people from getting dizzy when they stand up, water works, but the same amount of water with salt added doesn’t. That may explain the studies that found that overweight and obese individuals randomized to replace diet beverages with water lost significantly more weight.
Cold water (fridge temperature) can boost metabolism more than warm or room-temperature water, as the body expends energy to warm it up, though this effect is relatively small.
To read this entire article and see related links, go to nutritionfacts.org
Statins Weaken Your Bones
Statin medication (brand names: Lipitor, Crestor, Altoprev, Livalo, etc.) is designed to reduce cholesterol by blocking the key enzyme the body uses to make cholesterol, particularly low-density lipoprotein (LDL or “bad”) cholesterol; while also removing (reabsorbing) existing LDL from the bloodstream. Doing so can reduce the risk of heart disease and its often-fatal consequences: a heart attack or stroke.
Unfortunately, as is too often the case with medication, statins help one thing, but harm another – they improve your cholesterol profile at the expense of bone health. Using a mouse model, researchers compared high-dose statins vs. no statins with regard to osteoporosis risk. High-dose, long-term (one year) statin use increased osteoporosis risk significantly compared to non-use of statins.
Osteoporosis, a bone disease characterized by low bone density / strength, increases the risk of bone fractures, particularly of the hip or spine, which can compromise mobility and function. In other words, it’s bad news at any age.
This study, published in Biomedicine & Pharmacotherapy, should make you ask your doctor three questions at your next visit if you have high cholesterol or are at risk for it:
What’s my cholesterol profile? Your total cholesterol score is far less significant from a health perspective than your LDL:HDL (high-density lipoprotein or “good”) cholesterol ratio. You don’t need statins just because you have high total cholesterol.)
What can I do to lower my LDL cholesterol and/or reduce my risk of high cholesterol without medication? (Exercise and dietary changes are the big ones.)
If I absolutely need to take a statin, what’s the smallest dose and shortest amount of time I need to take it? The quicker you can get off statins (or any medication), the quicker you reduce your risk of suffering an adverse effect associated with all medications – in the case of statins, increased risk of osteoporosis, among other potential problems.
The bottom line: High cholesterol, particularly high LDL, is a health risk – but so is taking statin medication, something an estimated 200 million do worldwide according to Johns Hopkins. Talk to your doctor about how to stay healthy and safe naturally and avoid the need for statins. Your bones will thank you for it.
That Pain in Your Back? It’s Really a Pain in Your Brain
By Nathaniel Frank
As a chronic pain sufferer, I sometimes surprise people by telling them that my pain doesn’t have a physical cause. It’s a mind-body thing, I say, related to stress and emotions. To many, this sounds like admitting to being a little bit crazy. And when I up the ante by suggesting they’ve probably had this kind of pain too, some become outright angry, interpreting my words to mean their pain is “all in their head.”
All of which makes a new study published in the Journal of Pain a big deal. It offers robust evidence that the overwhelming majority of chronic back and neck pain cases — among the most common chronic pain complaints — come from the mind, despite the fact that most diagnoses cite a physical cause, such as bulging disks or bone spurs.
In the new study, doctors assessed 222 consecutive pain patients at an orthopedic care clinic in Louisiana — everyone who showed up, as long as they could complete a questionnaire. Just 12% showed evidence of a structural problem as the root of their pain. Eighty-eight percent, on the other hand, had what the researchers call “primary pain,” which refers to symptoms generated by neural circuits in the brain rather than by “structural” damage to the body.
Based on this and prior research, the authors believe that a process in the brain initiates the non-structural pain. The sensations could be the residual pain from a bodily wound that healed but didn’t notify the brain. Or the brain may have generated pain in the absence of any injury, perhaps in an effort to protect the patients from emotional wounds by occupying their attention with physical sensations instead.
The role of the brain and emotions in producing pain has long been known, and it has been validated by neuroimaging that shows that the brain processes physical pain and emotional distress in the same regions. Observational studies indicate that people feel more pain when primed with negative emotional stimuli. And additional research has shown that therapeutic interventions that help patients understand and reinterpret their pain can significantly reduce the symptoms. The theory is that pain is a danger signal, so as we come to feel safer and less threatened, our nervous systems shift out of fight-or-flight mode, and stop firing the pain signals.
As a result, scientists now believe that all pain is essentially brain pain. The idea is that just as the brain generates sensory experiences such as vision and hearing, it also generates pain by consulting our memories, expectations and emotions, as well as whatever physical inputs our nerves may sense, and creating pain when it determines we are under threat. While our nerves detect sensations, it’s the brain that decides if we’ll experience them as pain.
The implications for healthcare are profound. Chronic pain is among the top reasons people seek medical care. More than 1.5 billion people worldwide suffer from chronic pain, including 50 million to 100 million Americans. For the most part, these patients are spending billions of dollars pursuing physical treatments. If the cause is non-physical, the money is wasted and the suffering only mounts.
And not only are we failing to alleviate the pain, we are creating dangerous side effects that include the opioid crisis as well as surgeries that may be unnecessary and can leave patients worse off.
Of course, sometimes chronic pain does have a physical cause, and distinguishing between when it does and doesn’t is crucial. To address this key challenge, the researchers at the Louisiana clinic devised a rule-out/rule-in diagnosis method that should be adopted far and wide.
The process starts with a thorough patient exam and review of scans to rule out physical causes of the pain. There is a nuance: Just because an anomaly — a squished disk in your back, for example — shows up on a scan, it is not necessarily the cause of pain. As the study explains, research repeatedly shows that the majority of people without pain show similar anomalies. In other words, doctors diagnosing the source of chronic pain need to be aware of the poor correlation between scary scans and pain.
The rule-in process further clarifies whether a patient has structural or mind-body pain. It consists of taking a detailed history of the patient’s pain and life. Doctors need to know if prior treatments that should have resolved structural causes have failed; if treatments associated with a placebo response brought relief; if a patient’s history contains significant stress or adversity; if they have other ailments associated with mind-body causes (headaches, gut and bladder conditions, fibromyalgia, chronic fatigue, tendonitis and more can have such associations). And they need to know if the pain is inconsistent — does it move around in the body or come and go; is it triggered by biologically irrelevant stimuli like the weather, smells or sounds? These variables don’t track well with structural causes.
The process may sound a bit subjective, and it is. But no more than any other diagnostic approach. Medicine is not an exact science, and doctors must act on imperfect information. “We deal in probabilities,” said Dr. Howard Schubiner, lead investigator of the Louisiana study and a clinical professor at Michigan State University College of Human Medicine. Using the careful criteria developed for the study offers as well-grounded a basis for action as anything: “When there is strong evidence using these criteria, a physician can be confident that what they’re seeing is a mind-body problem.”
To read the rest of this article go to latimes.com