The term "chiropractic" combines the Greek words cheir (hand) and praxis (action) to describe a treatment done by hand. Hands-on therapy—especially adjustment of the spine—is central to chiropractic care. Chiropractic, which in the United States is considered part of complementary and alternative medicineA group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Complementary medicine is used together with conventional medicine, and alternative medicine is used in place of conventional medicine. (CAM), is based on these key concepts:
While some procedures associated with chiropractic care can be traced back to ancient times, the modern profession of chiropractic was founded by Daniel David Palmer in 1895 in Davenport, Iowa. Palmer, a self-taught healer, believed that the body has a natural healing ability. Misalignments of the spine can interfere with the flow of energy needed to support health, Palmer theorized, and the key to health is to normalize the function of the nervous system, especially the spinal cord.
source: http://nccam.nih.gov
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During the initial visit, chiropractors typically take a health history and perform a physical examination, with a special emphasis on the spine. Other examinations or tests such as x-rays may also be performed. If chiropractic treatment is considered appropriate, a treatment plan will be developed.
During followup visits, practitioners may perform one or more of the many different types of adjustments used in chiropractic care. Given mainly to the spine, a chiropractic adjustment (sometimes referred to as a manipulation) involves using the hands or a device to apply a controlled, sudden force to a joint, moving it beyond its passive range of motion. The goal is to increase the range and quality of motion in the area being treated and to aid in restoring health. Other hands-on therapies such as mobilization (movement of a joint within its usual range of motion) also may be used.
Chiropractors may combine the use of spinal adjustments with several other treatments and approaches such as:
Side effects and risks depend on the specific type of chiropractic treatment used. For example, side effects from chiropractic adjustments can include temporary headaches, tiredness, or discomfort in parts of the body that were treated. The likelihood of serious complications, such as stroke, appears to be extremely low and related to the type of adjustment performed and the part of the body treated.
If dietary supplements are a part of the chiropractic treatment plan, they may interact with medicines and cause side effects. It is important that people inform their chiropractors of all medicines (whether prescription or over-the-counter) and supplements they are taking.
source: http://nccam.nih.govBy: Jean Littman
Ouch! Does it seem like every note you play on your guitar or musical instrument results in pain? Maybe it’s a nagging ache in your neck and shoulder. Perhaps you’ve had long rehearsals for that important gig or recital, and now you notice severe pain and loss of strength in your elbow and wrist. Or maybe you are trying to cope with hands that are increasingly numb and clumsy. Well it’s all part of being a serious musician, right? You’ve got to keep practicing - too much depends on it! Sound familiar?
Guitarists and instrumental musicians are a special risk group for repetitive strain injuries, with sizable percentages of them developing physical problems directly related to playing their instruments. In fact, ‘RSI’ or repetitive strain injury in musicians was around centuries before the term was recently coined for computer injuries. Incorrect posture, overuse, stress, insufficient rest, excessive force and incorrect ergonomic technique all contribute to chronic pain and injuries that spell the end to careers. For many musicians, repetitive movement injuries are more feared than stage fright or an unresponsive audience. If they are also heavy computer users (my category of experience!), their risks are further compounded.
Doctors and therapists have long known that musicians are notoriously hard to convince that playing should be reduced or stopped to allow time for injuries to heal. Many guitarists and musicians are afraid to find out they might have a severe injury, and much prefer the head-in-sand approach of ignoring the pain and pushing on. This is a disastrous policy for a musician - if it hurts, it should be checked out!
As a systems accountant consulting to small business, I spend most hours of my working day in front of a computer. Not surprisingly, this has resulted in several serious repetitive motion injuries over the years. In similar fashion to the approach of many guitarists and musicians, I spent a long time trying to ‘ignore the pain and push on’. It is only in recent years that I have discovered the optimum program for managing the injuries and avoiding future repeats, with regular chiropractic care well and truly established at number one on my list of priorities.
WHAT IS CHIROPRACTIC?
Meaning ‘done by hand’, chiropractic is a method of restoring good health through adjustments of the spine. The basic chiropractic premise is that the spine and nervous system control the body completely. Any interference to nerve function by spine misalignments can therefore result in poor organ function, resulting in any number of seemingly unrelated diseases and ailments. Chiropractors generally subscribe to the theory that technically, they don’t ‘cure’ anybody, but simply help the body to heal itself.
In the past, chiropractors traditionally had trouble gaining the respect of medical doctors. Although basic philosophical differences between medicine and chiropractic still exist, chiropractic care is now considered mainstream and is routinely recommended by members of the medical profession.
WHAT TREATMENT DO CHIROPRACTORS GIVE?
Ever wondered what happens at the chiropractor? Perhaps you’ve heard they’re just ‘bonecrackers, not doctors!’. Not so.
In the US and many other countries, the educational program for chiropractors includes training in the basic medical sciences, including anatomy with human dissection, physiology, and biochemistry. Thorough training is also obtained in differential diagnosis, radiology and therapeutic techniques. This means, a doctor of chiropractic can both diagnose and treat patients. (This separates them from non-physician status providers, like physical therapists.)
As with all healthcare practitioners, chiropractors follow a standard routine to secure the information needed for diagnosis and treatment. When the source of pain involves musculoskeletal structures, chiropractors manually manipulate or adjust the spinal column. This typically requires the chiropractor to bend and twist the patient into various positions, which may cause some patients (myself included!) to tense up. Other more gentle methods, such as the activator method, deliver a high-speed, gentle, thrust to the vertebrae via a small rubber tip.
Atlas orthogonal chiropractors focus on the atlas bone (the first bone that the spinal cord passes through). Using x-rays and precision measuring equipment, the atlas bone is gently realigned without using manipulation techniques. I can personally vouch for this chiropractic specialty, which worked like magic on the most recent and severe of my repetitive neck injuries.
Many chiropractors also use water, light, massage, ultrasound, electric, and heat therapy and may apply supports such as straps, taping and braces. They may also counsel patients about wellness concepts such as nutrition, exercise, lifestyle changes, and stress management, but do not prescribe drugs or perform surgery. Some chiropractors also specialise in orthopedics, sports and musician injuries, neurology, nutrition, internal disorders, and/or diagnostic imaging.
HOW CAN MUSICIANS BENEFIT FROM CHIROPRACTIC CARE?
The benefits of chiropractic care for guitarists and musicians are widespread and numerous. Chiropractors can help with relief of specific pain being experienced at the moment, or as part of an overall wellness program, which also includes exercise, proper nutrition and rest. Many musicians understand that the position they assume while playing stresses their body, and are seeking to offset this stress and prevent further problems from developing.
Chiropractors evaluate and analyse the spine with an understanding of physics and how gravity and distorted postures can stress areas of the spine, ribs, neck, shoulders and hips. Specific adjustments are used to offset these distortions.
Chiropractors who specialise in helping musicians repetitive injury problems usually examine the musician patient and the instrument together. By thoroughly analysing their patient’s posture, movement patterns and range of motion with the instrument, the chiropractor can detect areas of dysfunction in and around the spine. They also make recommendations as to what guitarists can do, both while playing and before and after playing, to keep the stress from returning. They teach their musician clients exercises to offset the repetitive stress placed on certain joints while playing a particular instrument.
Chiropractic care is reportedly simple, yet it is profound in its ability to help the body regain and maintain its health. Bob Birch, Elton John’s bass player and background vocalist said his chiropractor showed him pictures and told him ‘muscle stuff’ that no other doctors ever did. Certain things that he had wrong with him, like the extensive pain in the left shoulder blade that shot up the side of his head (which other doctors pooh-poohed) were explained and put right with chiropractic adjustments.
Make no mistake about it, regular chiropractic care for guitarists and musicians is the way to go. If you play an instrument and want to avoid repetitive strain injuries for good, go find a musician-friendly chiropractor now!. Scores of famous musicians agree with me!
Will My Health Insurance Cover Chiropractic Care?
"I’m thinking about seeing a chiropractor. Oh, but chiropractic isn’t covered by health insurance, right?" Wrong! I get this question all the time. When someone is making the decision to choose chiropractic to take care of their health issue, they have to go through several decision processes.
First, will chiropractic help my problem? Typically, they are dealing with pain and aren’t getting much help from other methods they’ve tried to resolve it. They may have tried over-the-counter pain medications, maybe even some stronger versions prescribed by their doctor. They may have bought a brace or support, changed their bed, or just tried to rest for awhile. Nothing’s working.
Next they consider the location of the chiropractor. Are they close? Can I get to the office during their office hours? If this all fits, the person will eventually start to realize their is a cost involved and will start considering whether or not their insurance will cover all or at least part of the cost of going to see a chiropractor.
Does insurance cover chiropractic? In most cases, it does. There is not going to be "unlimited treatment for an unlimited time," but there will be some coverage. Most insurance will place two types of limitations on coverage; either they will limit the total dollar amount they will pay, or they will limit the total number of times you can visit the chiropractor in a given year.
Will the amount of insurance coverage be enough for all of your treatment? It really depends on what’s wrong. Most health insurance is not set up to handle "wellness care," that is, treatment when you’re already feeling pretty good. Health insurance is usually there to help in time of crisis. You have a heart attack, you’ve been involved in a car accident, or you back is so painful you can’t get to work. That’s a crisis.
The best way to find out if your insurance covers chiropractic and to find out what limitations are present, is to contact the office you want to go see. Many offices will verify your insurance benefits before you even go into the office. This way, you’ll know what you’re in for before you set foot in the door. Choosing your chiropractor only by your out-of-pocket expense is not usually the best way to find a doctor (or any service for that matter), but it’s helpful to get as much information as possible.
source: chiroblog.com
by Philip Vincent
Headaches. Everyone gets them from time to time, but sometimes they can be so strong as to be utterly debilitating and they may not go away. Medications can address the symptoms but not the cause of these headaches, and simply dull the pain temporarily.
Many of the more severe headache symptoms are slow to respond to chemical treatment, which when made more intense to address the headache, can have long lasting and often negative effects to the body when used over time. This is why many people with chronic head pain look to the more natural (and very often the more effective alternative) solution of chiropractic care.
There Are Different Kinds of Headaches
In order to better treat any problem it is first important to understand what causes it. There are many different kinds of headaches, some which can be treated by chiropractic better than others. Headaches are most commonly caused by
-changes by vascular constriction
-tension in the muscles
-sinus congestion
These headaches can refer or radiate pain all over your head and they can feel like they’re centered in many different locations, but it is most important to realize that chiropractic seems to work best in the types of headaches that are based around muscle tension and changes to vascular flow. Sinus headaches have also had success, but they are likely to have a more complicated cause.
There are three main types of headaches typically found in a chiropractic office:
-migraine headaches
-tension headaches
-cervicogenic headaches
The last type of headache mentioned sounds a bit scary, but it just simply means a headache that is caused by referred pain that originates within the bone, muscles, or nerves of the neck.
Tension Headaches
If we become stressed, scared, or angry, your body will respond with increased muscle tension in the head, neck, and shoulders. This reaction is called the fight or flight response, and it is the normal response to stress. If we are stressed often (as most of us are) and we can neither run or fight, the muscle tension becomes a habit.
This can lead to some imbalances in the way we hold our body, which in turn leads to more muscle tension and pain. Chiropractic treatment can relax these muscles and realign the spine’s structure to put and end to the vicious cycle of pain. Those seeking chiropractic care for tension headaches can often see a marked improvement in just a few treatments as the nerves become less irritated and the muscles begin to relax.
Migraine Headaches
Migraines are brought about by changes in vascular flow, triggered by a variety of factors such as different smells, foods, weather, hormonal changes, and stress. These often very painful headaches do not always start off as pain. They can begin with nausea or the person may experience a halo effect called a visual aura.
Recent studies have shown chiropractic treatment may play a significant role in reducing the number of migraines a person has. By careful manipulation of the neck and spine, chiropractic adjustments may be able to reduce nerve irritation in the spine, thus preventing radiating or referred pain, and improve vascular flow.
Treatment Types
Chiropractic care centers around manipulation of the spine and neck to improve blood flow and posture. To reduce the headaches, the chiropractor will perform spinal adjustments using his hands, but may also include massage, trigger point therapy, or other types of complementary treatments to address the problem. The doctor of chiropractic will probably also include some home care recommendations such as stretching exercises and posture education to help keep things balanced between visits.
Low back pain is often triggered by some combination of overuse, muscle strain, or injury to the muscles and ligaments that support the spine. Less commonly, low back pain is caused by illness or spinal deformity.
A risk factor is something that increases your chances of having back pain. More risk factors means you have a higher chance of having back pain.
Risk factors that you cannot change include:
Risk factors that you can change with lifestyle changes or medical treatment include:
Even more surprising, all three acupuncture techniques tested -- including a "sham" technique with toothpicks and no skin puncturing -- worked better than the usual care given for the problem.
"Acupuncture-like treatments had a positive effect overall on people's chronic back pain," says study researcher Dan Cherkin, PhD, a senior investigator at Group Health Center for Health Studies in Seattle. "It didn't matter if you inserted the needle or superficially poked [the skin]."
That finding, Cherkin says, leads to more speculation about how the centuries-old technique actually works.
The study is published in the Archives of Internal Medicine.
Cherkin and colleagues assigned 638 men and women with chronic low back pain who had never before had acupuncture to one of four groups:
• Individualized acupuncture group. Patients received acupuncture treatment based on a customized prescription for acupuncture points.
• Standardized acupuncture group. Patients received an acupuncture treatment considered effective by experts for chronic low back pain.
• Simulated acupuncture group. Patients received a treatment that mimics needle acupuncture but used a toothpick in a needle guide tube without penetrating the skin.
• Usual care group. Patients continued whatever they were doing, such as taking pain medicine or undergoing physical therapy.
Acupuncture treatments were given two times a week for three weeks, then once a week for four weeks. The researchers measured back pain-related problems and dysfunction at eight weeks, a half year, and one year after the treatments.
Participants in the trial, funded by the National Institutes of Health, were told only that the researchers were comparing three different methods of stimulating acupuncture points.
"The individualized acupuncture did not provide any benefit over the standardized acupuncture," Cherkin tells WebMD. "The simulated acupuncture, which did stimulate the standardized points, also had the same effect. All three did better than usual care."
Those who got any of the acupuncture treatments were more likely than those getting usual care to have a "meaningful" improvement in the dysfunction scale, which reflects the ability to engage in activities of daily living. Overall, 60% of the acupuncture-treated patients, but just 39% of the usual-care group patients, had meaningful improvements in dysfunction, the researchers found.
That translated to those in the acupuncture group being able to do more daily activities, such as going to social functions or performing household tasks, Cherkin tells WebMD.
After a year, those in the acupuncture groups were also more likely than the usual-care group to continue to have improvement in dysfunction, with up to 65% of the acupuncture-treated patients but just 50% of the usual-care patients still reporting improvements. But the improvement waned over time.The finding that the simulated acupuncture was as good as needle acupuncture is puzzling, Cherkin admits. "What we can say is, it is not essential to achieve a benefit to insert the needle through the skin," he says.
Why this is so is not known, he says. "One possibility is there is a physiological chain of events that occurs when you insert a needle or just stimulate the skin superficially. They may or may not be the same."
Another possibility, he says, is "believing you are getting a treatment that will help your back pain" helps it.
And, he adds, not all participants benefited from the acupuncture, whatever the form. Still, he says, "acupuncture is a reasonable option" for those with low back pain. Americans spend at least $37 billion a year for medical care for back pain, Cherkin notes in his report.
"Although this study has shed some light [on back pain treatment], it is also confusing, I think," says Arya Nick Shamie, MD, associate professor of spine surgery at the University of California David Geffen School of Medicine and a spokesman for the American Academy of Orthopaedic Surgeons.
"For the most part, acupuncture is very safe," says Shamie, who has recommended it to his patients with chronic back pain. However, he adds, "this paper has confused the issue even further as to how acupuncture works." Even so, he says, "what it does show is acupuncture can help patients."
The good results with the "toothpick" acupuncture may very well be a placebo effect, Shamie says. "Even going and talking to your doctor could have a strong, positive effect on your health," he says. "When people have chronic illness, they want to feel that someone cares for them, and that basically unloads the mind of the burden of disease."
His caveat: "Chronic back pain should be evaluated by your physician or a specialist," he says, to rule out any serious underlying medical problems.
Degenerative disc disease is not really a disease but a term used to describe the normal changes in your spinal discs as you age. Spinal discs are soft, compressible discs that separate the interlocking bones (vertebrae) that make up the spine. The discs act as shock absorbers for the spine, allowing it to flex, bend, and twist. Degenerative disc disease can take place throughout the spine, but it most often occurs in the discs in the lower back (lumbar region) and the neck (cervical region).
See a picture of the spine and the discs in your spine.
The changes in the discs can result in back or neck pain as well as:
These conditions may put pressure on the spinal cord and nerves, leading to pain and possibly affecting nerve function.
As we age, our spinal discs break down, or degenerate, which may result in degenerative disc disease in some people. These age-related changes include:
These changes are more likely to occur in people who smoke cigarettes and those who do heavy physical work (such as repeated heavy lifting). People who are obese are also more likely to have symptoms of degenerative disc disease.
A sudden (acute) injury leading to a herniated disc (such as a fall) may also begin the degeneration process.
As the space between the vertebrae gets smaller, there is less padding between them, and the spine becomes less stable. The body reacts to this by constructing bony growths called bone spurs (osteophytes). Bone spurs can put pressure on the spinal nerve roots or spinal cord, resulting in pain and affecting nerve function.
Degenerative disc disease may result in back or neck pain, but this varies from person to person. Many people have no pain, while others with the same amount of disc damage have severe pain that limits their activities. Where the pain occurs depends on the location of the affected disc. An affected disc in the neck area may result in neck or arm pain, while an affected disc in the lower back may result in pain in the back, buttocks, or leg. The pain often gets worse with movements such as bending over, reaching up, or twisting.
The pain may start after a major injury (such as from a car accident), a minor injury (such as a fall from a low height), or a normal motion (such as bending over to pick something up). It may also start gradually for no known reason and get worse over time.
In some cases, you may have numbness or tingling in your leg or arm.
Degenerative disc disease is diagnosed with a medical history and physical examination. Your doctor will ask about your symptoms, injuries or illnesses, any previous treatment, and habits and activities that may be causing pain in the neck, arms, back, buttocks, or legs. During the physical examination, he or she will:
If your initial examination reveals no signs of a serious condition, imaging tests, such as an X-ray, are unlikely to help the diagnosis. Imaging tests may be considered when your symptoms develop after an injury, nerve damage is suspected, or your medical history suggests conditions that could affect your spine, such as bone disease, tumors, or infection.
To relieve pain, put ice or heat (whichever feels better) on the affected area and use acetaminophen (such as Tylenol) or nonsteroidal anti-inflammatory drugs, including aspirin (such as Bayer), ibuprofen (such as Advil), or naproxen sodium (such as Aleve).Do not give aspirin to anyone younger than 20 because of the risk of Reye syndrome. Acetaminophen (such as Tylenol) also can help relieve pain. Your doctor can prescribe stronger medicines if necessary.
Further treatment depends on whether the damaged disc has resulted in other conditions, such as osteoarthritis, a herniated disc, or spinal stenosis. Physical therapy and exercises for strengthening and stretching the back are often recommended, and in some cases surgery may be recommended. Surgery for degenerative disc disease usually involves removing the damaged disc. In some cases, the bone is then permanently joined (fused) to protect the spinal cord. Also, artifical discs are sometimes used to replace the disc that is removed.
source: webmd.com
When you are ready to discuss your pain, and start finding out exactly what options are available to you for easing that pain, contact us! www.hqclinic.com
Chiropractic is primarily used as a pain relief alternative for muscles, joints, bones, and connective tissue, such as cartilage, ligaments, and tendons. It is sometimes used in conjunction with conventional medical treatment.
The initials "DC" identify a chiropractor, whose education typically includes a pre- med undergraduate degree plus four to five years of chiropractic college.
A chiropractor first takes a medical history, performs a physical examination, and may use lab tests or diagnostic imaging to determine if treatment is appropriate for your back pain.
The treatment plan may involve one or more manual adjustments in which the doctor manipulates the joints, using a controlled, sudden force to improve range and quality of motion. Many chiropractors also incorporate nutritional counseling and exercise/rehabilitation into the treatment plan. The goals of chiropractic care include the restoration of function and prevention of injury in addition to back pain relief.
Spinal manipulation and chiropractic care is considered a safe, effective treatment for acute low back pain, the type of sudden injury that results from moving furniture or getting tackled. Acute back pain, which is more common than chronic pain, lasts no more than six weeks and typically gets better on its own.
Research has also shown chiropractic to be helpful in treating neck pain and headaches. In addition, osteoarthritis and fibromyalgia respond to the moderate pressure used both by chiropractors and practitioners of deep tissue massage.
Studies have not confirmed the effectiveness of prolotherapy or sclerotherapy for pain relief, used by some chiropractors, osteopaths, and medical doctors, to treat chronic back pain, the type of pain that may come on suddenly or gradually and lasts more than three months. The therapy involves injections to strengthen loosely connected tendons and ligaments.
People who have osteoporosis, spinal cord compression, or inflammatory arthritis, or who take blood-thinning medications should not undergo spinal manipulation.
All treatment is based on an accurate diagnosis of your back pain. The chiropractor should be well informed regarding your medical history, including ongoing medical conditions, current medications, traumatic/surgical history, and lifestyle factors. Although rare, there have been cases in which treatment worsened a herniated or slipped disc, or neck manipulation resulted in stroke or spinal cord injury. To be safe, always inform your primary health care provider whenever you use chiropractic or other pain relief alternatives.
source: webmd.com
There are times in life when things don’t go as expected. Perhaps an important project of yours ended up in failure. Or you got laid off from your job. Whatever it is, it might make you depressed. But you need to get things back under control. You need to keep moving forward. For that, you need to make yourself feel better so that you can face the situation with a positive attitude.
Here are some tips to make yourself feel better when you’re depressed:
1. Calm down
Before anything else, calm yourself down. Don’t panic. Close your eyes and take a deep breath. You can only apply the tips below if you are calm.
2. Feed your mind with positive thoughts
When you’re depressed, it’s easy to fall into a vicious cycle of negative thoughts. The negative cycle makes things look worse than they actually are. It’s important that you break this cycle so that you don’t become a victim of your own thoughts.
To do that, feed your mind with positive thoughts. You may read spiritual texts, motivational books, or inspiring quotes. You may also listen to positive tapes. Listening works well when you’re overwhelmed with negative thoughts because it doesn’t require your active participation.
3. Remember good things
Our minds tend to focus on the negative and not the positive. But you should direct your mind to the positive. Remember the good things in your life. Remember the good people around you. I’m sure there are many more things that go right in your life than those that go wrong. Looking at the good things balances your perspective so that you don’t dwell in negativity.
4. Look at the big picture
An event that seems bad might not seem that bad if you look at the big picture. Put the event in context. Think of it as one mosaic piece that’s necessary to make your life wonderful.
5. Believe that everything will be all right
What you believe has a big effect on you. If you believe that things will go wrong, that would usually be the case. On the other hand, if you believe that everything will be all right, you will have a winning attitude. And, as said in this article, a winning attitude is everything.
6. Exercise
When you’re depressed, take time to exercise. Study shows that “exercise is related to positive mental health as indicated by relief in symptoms of depression and anxiety.”
7. Forgive
Sometimes one reason you feel bad is because you don’t forgive. Perhaps you had made mistakes in the past and you blamed yourself for it. You need to forgive yourself. Or perhaps someone mistreated you. You need to forgive them. I know it’s easier said than done, but as Mahatma Gandhi said:
The weak can never forgive. Forgiveness is the attribute of the strong.
So let us all be strong.
8. Take action
The only cure for grief is action.
George Henry Lewes
Things won’t get better if you just sit and do nothing. Instead of thinking about how bad things are, think of what you can do to solve the problem and take action.
9. Say something positive
Negative words have devastating effect on your confidence and motivation. So whenever you’re about to say something negative, stop yourself and take a deep breath. Reframe what you’re going to say and make it positive. For example, instead of saying “I will never make it”, say “It won’t be easy, but I know I will make it.”
10. Think about other people
One of the best ways to make yourself feel better is simply by taking the focus away from yourself. The more you think about your problems, the more difficult it would feel. So start thinking about other people and how you can help them. When you do that, your problems will no longer seem so hard.
Myofascial release is a form of massage therapy that uses sustained pressure to loosen or release tightness in connective tissues (fascia). It is thought that tightness within the fascia causes restriction of muscle and other tissues, resulting in back pain and loss of motion. Injuries, stress, inflammation, trauma and poor posture supposedly contribute to this tightness.
These myofascial restrictions can't be detected with standard medical imaging studies, such as X-rays or MRIs. In addition, there have been no published trials that have evaluated myofascial release therapy as a treatment for chronic back pain. For these reasons, myofascial release therapy for back pain is not widely accepted in the medical community. However, many physical therapists and massage therapists use such techniques, and anecdotal evidence suggests that myofascial release therapy may relieve back pain in some people. Also, results of a Mayo Clinic study, published in 2008 in the Journal of Complementary and Alternative Medicine, suggest that myofascial release may be as effective as acupuncture in relieving chronic pain. However, large-scale trials are needed to confirm these findings and to evaluate the potential benefit of myofascial release therapy in treating back pain.
If you've been told that myofascial release therapy may be helpful for your back pain, consult a therapist who has training in such techniques. As with many other treatments for chronic back pain, myofascial release may benefit some people but not all.
The goal of noninvasive treatment for back pain is twofold:
After talking to you about the particular circumstances involving your back pain, your doctor may recommend one or more of the following common treatment options:
Back brace. Many back braces or corsets (lumbar supports) are available without a prescription at pharmacies and medical supply stories. Or, your doctor may prescribe a specific brace customized for your back. The rationale behind braces is that they may support your abdomen and take some of the load off your lower back, they may restrict motion, and they may improve posture. But there's also concern that use of braces may result in the wasting away (atrophy) of some muscles that support the spine through lack of use. If you use a brace, limit the use to intermittently several hours a day. If you have a labor-intensive job that places stress on your lower back, a back brace or corset can help you when you first return to work after a back injury by avoiding too much strain on your spine.
Back braces and corsets may also make transitional movements — such as from a sitting to a standing position — more comfortable during an episode of back pain. There's insufficient evidence that back braces are more effective at relieving back pain than no treatment at all. The best course of action may be strengthening your trunk muscles to be the primary support for your back.
Pain medications. You can take nonprescription medications, or your doctor may suggest prescription medications to relieve your discomfort until inflammation subsides and your body heals itself. Options include:
Antidepressants. Some antidepressant medications, taken in lower doses than would be used to treat depression, may help in the treatment of low back pain. Antidepressants may work in a variety of ways. For example, they may result in a higher level in your brain of serotonin, a neurotransmitter associated with pain control. Antidepressants may also reduce anxiety and muscle tension.
The evidence on the effectiveness of antidepressant medications in the treatment of low back pain is mixed. Among this group of medications, tricyclic antidepressants (TCAs) appear to be the most effective. They include such medications as nortriptyline (Aventyl, Pamelor), amitriptyline, desipramine (Norpramin), doxepin (Sinequan) and imipramine (Tofranil). Medications called selective serotonin reuptake inhibitors (SSRIs) don't appear to be as effective as TCAs for back pain.
Cold or heat therapy. Using cold and heat therapy may relieve pain and muscle tension in the initial days after back pain begins. Some studies show that heat is an effective approach for acute nonspecific back pain. As for chronic back pain, cold and heat likely won't cause harm and may be helpful, but there isn't scientific evidence at this time to prove that cold and heat are effective treatments for chronic low back pain. Cold or ice applied to your back can reduce inflammation and swelling by constricting blood vessels. The cold also acts to slow nerve impulses and make it less likely that your muscles will contract, in this way reducing pain.
To use cold packs, wrap an ice pack or a bag of frozen vegetables in a piece of cloth. Hold it on the sore area for about 15 minutes, several times a day. To avoid frostbite, don't place ice directly on your skin. Heat therapy increases blood circulation, which can aid healing of damaged tissues. Heat also allows tissues to stretch more easily, resulting in less stiffness, greater flexibility and less pain. To use heat therapy, take a warm bath, or use warm packs, a heating pad or a heat lamp for pain relief. Be careful not to burn your skin with extreme heat. If you find that cold provides more relief than heat, you can continue using cold packs, or try a combination of the two methods.
Electrical stimulation. Transcutaneous electrical nerve stimulation (TENS) delivers a tiny electrical current to key points on a nerve pathway. The current, delivered through electrodes taped to your skin, isn't painful or harmful. It's not known exactly how TENS works, but it may stimulate release of pain-inhibiting molecules (endorphins) or block pain fibers that carry pain impulses. However, it's unclear whether those who benefit from TENS achieve relief by some direct effect on their nervous system or from the belief that they will benefit from the therapy (the so-called placebo effect). Some people with chronic pain use TENS to help them function with less discomfort. But several studies have concluded that TENS has not been proved effective in relieving chronic low back pain.
Exercise and physical therapy. Physical activity plays a strong role in recovering from back pain and particularly in helping to prevent future pain and loss of function. Physical activity can include one or many among a wide range of exercises that you do in the presence of a physical therapist, or exercises that you do on your own at home. An exercise program can include any or all of the following components: flexing, stretching, endurance training, strength building and aerobic.
Supervised programs that include stretching and strengthening exercises, which don't specifically target the back, are more beneficial in relieving chronic low back pain and improving function. Your doctor or physical therapist can tailor an exercise program to meet your individual needs. There is no one-size-fits-all approach. Exercise programs are individualized because people have different levels of pain and differing injuries that caused the pain initially.
Exercise doesn't appear to increase your risk of future back injuries and may help prevent back pain at work. Benefits of a physical activity program may include:
Some studies suggest that exercise therapy is more effective than are conservative or inactive treatments in people with chronic low back pain. Short-term, modest improvements were seen in such areas as pain, disability, strength and flexibility. Exercise and physical therapy are an important part of your treatment program and should become part of your permanent routine at home. Improving the strength, endurance and function of your back helps minimize the chance of recurrence of back pain. One study showed that people who didn't exercise after an initial episode of acute low back pain were more likely to experience a recurrence of low back pain than were people in the study's exercise group. Mild discomfort that you may feel as you begin an exercise program should gradually ease as your muscles become stronger. The key is to start an exercise program at a low level to ensure your comfort and proper technique, and then progress slowly as your symptoms allow.
Cognitive behavior therapy. This type of talk therapy combines attempts to identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones. It's based on the idea that your own thoughts determine how you behave. Even if an unwanted situation hasn't changed, you can change the way you think and behave in a positive way. The therapy may have a role in the case of chronic low back pain for which no specific physical cause is evident.
Your doctor may talk to you about the psychological and social issues surrounding your chronic pain, such as whether you have stress, anxiety or depression, how your family has responded, how the pain has affected your work and other activities, and what you believe causes the pain to continue. You and your doctor may also talk about your readiness to accept that the condition will improve over time without any major medical intervention. Cognitive behavior therapy has been shown to be effective in relieving pain and improving function as one component of back care.
Multidisciplinary treatment programs. A multidisciplinary approach to treating chronic low back pain involves, as the phrase suggests, a variety of therapies. These may include a combination of exercise, physical therapy, education, cognitive behavior therapy, vocational counseling and other strategies. Reviews of studies show long-term effectiveness of multidisciplinary treatment programs in lowering pain, improving function and reducing return to work time.
source: www.mayoclinic.com
CORVALLIS, Ore. – Millions of Americans with significant or chronic pain associated with their medical problems are being under-treated as physicians increasingly fail to provide comprehensive pain treatment – either due to inadequate training, personal biases or fear of prescription drug abuse.
A pharmaceutical expert in pain management in the College of Pharmacy at Oregon State University says the issue is reaching crisis proportions, and in two new professional publications argues that health consumers must be aware of the problem and in many cases become more informed, persistent advocates for the care they need and deserve.
"We have more sophisticated pain management techniques available now than ever before," said Kathryn Hahn, a pharmacist, affiliate faculty member at OSU and chair of the Oregon Pain Management Commission. "But many doctors are not fully informed about all the options available, and also often turn patients away because they're very concerned about the problems with prescription drug abuse.
"Because of this, many people suffer needlessly with pain that could be treated, and almost 80 percent of visits to community pharmacies involve pain issues," Hahn said. "We're in the middle of a storm here, and have to figure out some way to navigate through it."
Adequate pain treatment has always been a concern, Hahn said, in part because it's not a major part of most physician's medical training. Even though they will often see a stream of patients with pain problems throughout their careers, they may only get a few hours of education on the use of opioids in medical school.
In recent years, the problems have dramatically increased due to concerns about prescription drug abuse, in which drugs such as oxycodone are often stolen from homes or otherwise misused. In a 2006 survey of teenagers, 62 percent said prescription pain relievers were easy to get from their parents' medicine cabinet. One analysis concluded that admissions to federally supported treatment programs for prescription opioid abuse increased 342 percent from 1996 to 2006 – a comprehensive problem that is also estimated to cost insurance companies tens of billions of dollars a year.
Concerns about this within the medical profession are sufficiently high, Hahn said, that many doctors prefer not to even work with patients who have ongoing pain issues. They also fear criticism from other doctors if they have high numbers of pain-related cases or prescribe significant amounts of pain medications, she said.
"I see patients every week who have lost their doctors, don't know what to do and these people are scared," Hahn said. "It's particularly bad with elderly and Medicare patients. Prescription drug abuse is a very real problem, we do have to take necessary steps to address it, but right now the pendulum has swung too far, and legitimate pain problems are not being managed."
Long-term solutions, Hahn said, will take education and responsibility by all parties involved, including consumers, physicians, nurses and pharmacists.
Among the steps that may help:
Hahn outlined some of these issues in two new publications, one in the Journal of Pain and Palliative Care Pharmacotherapy, and the other in The Rx Consultant.
"Surveys show that at least 30 percent of patients with moderate chronic pain and more than 50 percent of those with severe chronic pain fail to achieve adequate pain relief," she wrote in one article. "The economic impact of acute and chronic pain exceeds $100 billion per year in the U.S. alone."
Community pharmacists, she said, are often on the front lines of this issue and constantly see individuals with pain concerns and inadequate pain management by their health care providers. They can often help serve as advocates, improve lines of communication between patients and their doctors, and help patients manage their prescribed drug therapies.
Health insurers also have an important role to play in reducing prescription drug abuse, Hahn said. They can help educate physicians on appropriate use, advocate for universal precautions in use of pain medicines, restrict off-label uses of readily diverted opioids, pay for multidisciplinary pain management programs, and take other steps.
source: www.sciencecodex.com
MADISON -- Your facial expression may tell the world what you are thinking or feeling. But it also affects your ability to understand written language related to emotions, according to research that was presented today to the Society for Personal and Social Psychology in Las Vegas, and will be published in the journal Psychological Science.
The new study reported on 40 people who were treated with botulinum toxin, or Botox. Tiny applications of this powerful nerve poison were used to deactivate muscles in the forehead that cause frowning.
The interactions of facial expression, thoughts and emotions has intrigued scientists for more than a century, says the study's first author, University of Wisconsin-Madison psychology Ph.D. candidate David Havas.
Scientists have found that blocking the ability to move the body causes changes in cognition and emotion, but there were always questions. (One of the test treatments caused widespread, if temporary, paralysis.) In contrast, Havas was studying people after a pinpoint treatment to paralyze a single pair of "corrugator" muscles, which cause brow-wrinkling frowns.
To test how blocking a frown might affect comprehension of language related to emotions, Havas asked the patients to read written statements, before and then two weeks after the Botox treatment. The statements were angry ("The pushy telemarketer won't let you return to your dinner"); sad ("You open your email in-box on your birthday to find no new emails"); or happy ("The water park is refreshing on the hot summer day.")
Havas gauged the ability to understand these sentences according to how quickly the subject pressed a button to indicate they had finished reading it. "We periodically checked that the readers were understanding the sentences, not just pressing the button," says Havas.
The results showed no change in the time needed to understand the happy sentences. But after Botox treatment, the subjects took more time to read the angry and sad sentences. Although the time difference was small, it was significant, he adds. Moreover, the changes in reading time couldn't be attributed to changes in participants' mood.
The use of Botox to test how making facial expressions affect emotional centers in the brain was pioneered by, Andreas Hennenlotter of the Max Planck Institute in Leipzig, Germany.
"There is a long-standing idea in psychology, called the facial feedback hypothesis," says Havas. "Essentially, it says, when you're smiling, the whole world smiles with you. It's an old song, but it's right. Actually, this study suggests the opposite: When you're not frowning, the world seems less angry and less sad."
The Havas study broke new ground by linking the expression of emotion to the ability to understand language, says Havas's advisor, UW-Madison professor emeritus of psychology Arthur Glenberg. "Normally, the brain would be sending signals to the periphery to frown, and the extent of the frown would be sent back to the brain. But here, that loop is disrupted, and the intensity of the emotion, and of our ability to understand it when embodied in language, is disrupted."
Practically, the study "may have profound implications for the cosmetic-surgery," says Glenberg. "Even though it's a small effect, in conversation, people respond to fast, subtle cues about each other's understanding, intention and empathy. If you are slightly slower reacting as I tell you about something made me really angry, that could signal to me that you did not pick up my message."
Such an effect could snowball, Havas says, but the outcome could also be positive: "Maybe if I am not picking up sad, angry cues in the environment, that will make me happier."
In theoretical terms, the finding supports a psychological hypothesis called "embodied cognition," says Glenberg, now a professor of psychology at Arizona State University. "The idea of embodied cognition is that all our cognitive processes, even those that have been thought of as very abstract, are actually rooted in basic bodily processes of perception, action and emotion."
With some roots in evolutionary theory, the embodied cognition hypothesis suggests that our thought processes, like our emotions, are refined through evolution to support survival and reproduction.
Embodied cognition links two seemingly separate mental functions, Glenberg says. "It's been speculated at least since Darwin that the peripheral expression of emotion is a part of the emotion. An important role of emotion is social: it communicates, 'I love' or 'I hate you,' and it makes sense that there would be this very tight connection between peripheral expression and brain mechanism."
"Language has traditionally been seen as a very high level, abstract process that is divorced from more primitive processes like action, perception and emotion," Havas says. "This study shows that far from being divorced from emotion, language understanding can be hindered when those peripheral bodily mechanism are interrupted."
source: www.sciencecodex.com
