Consider Acupuncture When Walking With Back Pain is too Painful

Chronic low back pain (CLBP) can be a debilitating disorder which can lead to loss of ambulation, often resulting in loss of quality of life.  When it comes to treating the loss of ambulation due to CLBP, there is no one-size-fits-all cure; in fact, managing CLBP alone can be a frustrating ordeal taking many months of trial and error therapies to find the best-fit therapy.  In the medical field, many treatments focus on relieving the pain by addressing only the anatomical problems, leaving limited options such as prescription medication or surgery but fails to address the ambulatory issues associated with the causal symptoms.  However, other means of treating CLBP can provide temporary relief from pain and aid in the restoration of ambulation over time.  One such therapy to consider is acupuncture.

Acupuncture has been around for 3000 years, originating in China.  Acupuncture uses the concept of Qi, or energy, to heal the body.  In America, this ancient art is brought to life by licensed acupuncturists adept in Traditional Chinese Medicine.  For many practitioners, incorporating this ancient healing tradition into modern day practice has many advantages, including enabling their patients to have the capacity of customizing a treatment best suited for them.    

When looking at studies which refer to acupuncture for sufferers of CLBP, it was important to segregate those studies which incorporated exercise or walking as part of the study, either as the control or in both.  Secondly, it was important to look for similarities in those studies and look for correlations.  What I found was absolutely shocking.  

 

Article	Sample	Intervention/ Treatment	Outcomes/ Relieve Pain	Correlation with Ambulation
Witt, C; et al, (2011) Randomized Control Trial Class A	Size: 9,990 Age: Adult Location: Germany Inclusions: Patients with osteoarthritis of knee or hip, low back pain, neck pain, or headache. Exclusions: All patients fulfilled predefined diagnosis-specific criteria.	Patients randomized into groups which received routine care, or 10 acupuncture treatments plus routine care for 3 months.	Positive outcome in acupuncture group.	Manipulation techniques and exercise for chronic pain positively correlates with outcome independent of the intervention.
Haake, M; et. al, (2007) Randoized Control Trial Class A	Size: 1162 Age: 18 - 86 Location: Germany Inclusions: History of chronic low back pain for ≥6 months. Exclusions: Previous spinal surgery, spinal fractures, infectious or tumorous spondylopathy or disease-influenced chronic pain.	Patients randomized into 3 groups, acupuncture, sham, and conventional therapy. Conventional therapy included 10 sessions with personal contact with a physician or physiotherapist who administered physiotherapy and exercise.	Acupuncture was not superior to sham. Both treatments were positive over conventional treatment alone.	Half the patients in both groups experienced clinically relevant improvement in pain intensity or back-specific disability.
Weidenhammer, W. et al. (2007) Cohort Observational Study Class A	Size: 2564 Age: adult Location: Germany Inclusions: Diagnosis of either lumbago with sciatica or back pain with complaints lasting ≥6 months. Exclusions: No indication of other disease conflicting and no acupuncture treatments in previous 6 months.	Patients filled out questionnaires which included intensity and frequency of pain, functionality, depression, and QOL before and after 6 months of acupuncture treatments.	45.5% of patients showed significant improvement in functionality. Mean number of days with pain decreased by half. Employed patients reported 30% decrease from baseline of work days lost.	Number of days off work for employed patients decreased over 6-month observational period and their functionality improved slightly.
MacPherson, H; et al, (2004) Randomized Control Trial Class A	Size: 148 Age: Adults Location: UK Inclusions: Low back pain lasting more than 4 weeks and less than a year. Exclusions: Patients with back pain resolved prior to treatments.	241 patients randomized in a ratio 2:1 leaving 160 to receive up to ten individualized treatments including acupuncture, cupping, herbs, exercise and lifestyle advice (12 patients were excluded).	Diagnoses among patients were individually based, however, a theme emerged with Qi and Blood Stagnation being the most prevalent.	A combination of adjunct therapies were also prescribed, including yoga and specific exercises.
Yip, Y; et al (2004) Randomized Controlled Trial Class A	Size: 51 Age: adult Location: China Inclusions: Patients who had non-specific sub-acute LBP for most days in the past 4 weeks, had not received acupuncture, physiotherapy, or manipulative therapy in the past week, and would comprehend and comply with the study guidelines. Exclusions: Patients who had LBP caused by disorders, infections, or diseases, undergone surgery, pregnant, had allergies to lavender, or had wounds at acupoint sites.	Patients randomized into control group or treatment group for a 3 week trial. Control group received normal therapy while treatment group received 8 sessions of relaxation acupoint stimulation and acupressure with lavender oil.	8 sessions of acupoint and acupressure with lavender oil was not effective in relieving short-term LBP.	By combining traditional therapies with alternative therapies, short-term reduction in LBP is possible.

________________________________________________________________________________

What was found is that although acupuncture did not appear to work on CLBP alone, however conjunctive therapies which incorporated acupuncture worked on the majority of the patients.  Part of the therapies which helped decrease pain was exercise, changing to a better diet, and physician-monitored care.  More importantly, when looking at a study focusing on acupoint therapy, the subjects were able to walk for longer and  farther after the sessions than before the study started.

Conclusion:  Considering acupuncture for CLBP may be a good idea, but it is an even better when it is used as a part of a therapeutic routine which includes exercise, healthy diet, and the normal medical treatments prescribed by physician.  It perhaps is circular logic, but in order to walk farther without CLBP, one needs to walk more.  As far as enhancing quality of life, incorporating a healthy routine with preventative maintenance and sticking with the new regimen will help to decrease the pain enough to lead a relatively normal life.       

Resources 

Haake, M; Muller, H; Schade-Brittinger. C; Basler, H; Schafer, H; Maier, C;
Endres, H; Trampisch, H; Molsberger, A, (2007) German Acupuncture Trials (GERAC)
for Chronic Low Back Pain Randomized, Multicenter, Blinded, Parallel-Group Trial With 3 Groups Arch Intern Med. 2007;167(17)   

 MacPhersona, H; Thorpe, L;  Thomasb, K; Campbellc, M. (2003) Acupuncture for low back pain: traditional diagnosis and treatment of 148 patients in a clinical trial. Complimentary Therapies in Medicine V 12: 38-44

Weidenhammer, Q; Linde, K; Streng, A;  Hoppe, A; Melchart, D. (2007) Acupuncture for Chronic Low Back Pain in Routine Care A Multicenter Observational Study Clinical Journal of Pain Volume 23: 2
  

Witt, C.;  Schutzler, L; Ludtke, R; Wegscheider, R;  Willich, S.  (2011)

Patient Characteristics and Variation in Treatment Outcomes:
Which Patients Benefit Most From Acupuncture for Chronic Pain? Clinical Journal of Pain V 27:550–555

Yip, Y; Tse, S. (2004) The effectiveness of relaxation acupoint stimulation and acupressure with aromatic lavender essential oil for non-specific low back pain in Hong Kong: a randomised controlled trial. Complimentary Therapies in Medicine V 12: 28-37

        

Selengkapnya →

Chiropractic Care for Tension Headaches

In the United States, headaches are responsible for more than 18 million office visits annually, and are the most common reason for using over-the-counter medications. It is estimated that 156 million work days are lost each year because of headaches, translating to $25 billion in lost productivity. Of the categories of chronic headaches, tension-type headaches are most common. (Erickson, 2004)

With this said, many people may want to seek out other therapies for their tension-type headaches.   There are many reasons for seeking alternative therapies.  Perhaps traditional treatments are not effective, the headaches are worsening, or maybe popping medications like M&M's have become a pain in and of itself?  Whatever the case, there are alternative therapies for treating tension-type headaches which are surprisingly as effective as medications, but without all of the side effects.  My favorite happens to be chiropractic therapy so that is what I am going to talk about today.  

 First and foremost, it is important to get a proper diagnosis.  Headaches can be triggered by a multitude of things from loud noises to neurological problems (lesions, aneurisms, tumors, and the like).  It is very important to rule out causal factors which may become severely worse (or even deadly) if not treated and that the headache is in fact a tension-type headache, (Mann & Coeytaux,2007; Erickson, 2004). 

When picking a chiropractor, like any health professional, it is important to get a professional and reputable one.  I have heard of too many horror stories of people going into a friends' of an acquaintance's basement to have a $10 adjustment done.  I do not even recommend doing this for a tattoo let alone getting a chiropractic adjustment.  So, as a rule of thumb, I always look for three major qualities: experience, certification, and most importantly, location, location, location.  Believe this or not, the location will tell you almost everything you need to know about a professional, e.g. who is the professional, what their clientele is like, where their offices are in terms of the city, when the business first opened, and how long they have been in business in the same area.   I learned my lesson about a decade ago when I went to a dentist with a hole-in-the wall, smoke filled, office next to a bar in a really slummy part of the city.  (In the waiting area, there was a half full ash tray on a broken lamp stand and a box of stale doughnuts next to a pot of coffee on a desk in the corner). I should have walked out but I didn't and I regret it to this day.  But I digress.   Just follow the three rules,  do your research, and listen to your gut instincts and you will be fine.

When you find a chiropractor who meets your approval, they will take a health history in addition to a physical exam. Chiropractic practitioners utilize spinal treatments among other methods to correct alignment problems and open up the central nervous system which improves mobility, decreases pain and allows the body to heal naturally (1, NCAM).  Don't be afraid to ask questions during your visit.  A chiropractor who answers your questions thoroughly shows that they not only knows what he is doing, but who also cares as well.   

When it comes to your tension headaches, your chiropractor should focus on the upper spine. The upper spine, (called the cervical) is usually the major culprit in causing tension headaches.  Damage to C1 or C2 may occur for many reasons and often without notice, but when the upper cervical becomes contorted, the muscles in the upper back and neck tries to compensate, thus results in stiff and tight muscles.  This is why pain killers and muscle relaxers do not cure the headaches.  By not correcting or improving the stress on the nervous system related to the subluxations or subluxation complex may result in continued pain and suffering, often becoming more severe over time.  Chiropractic care, however,  has been found to improve most headaches (Bryans 2011).

Not surprisingly, chiropractic care may yield results very quickly.  Some patients feel immediate improvement, while others may feel drastic improvement in less than six sessions. The philosophy behind this field of care works with the correction of subluxations and or the subluxations complex, which is the primary cause of tension headaches. Typical adjustments work toward the restoration of the central nervous system which allows improved neural function and the allowance of nutrients to enter without restrictions, (Epstein & Posa, 1999).  

A chiropractic professional will take a health history in addition to a physical exam. If chiropractic treatment is deemed appropriate, then treatment will be performed. Chiropractic practitioners utilize spinal treatments among other methods to correct alignment problems, which improve function and pain and allow the body to heal naturally, (1, NCAM).

Another benefit of the chiropractic adjustment is that it reduces stress on the nervous system, (Toftness, 1977). The reduction of stress often leads to a reduction in pain, and consequently, a reduction in pain medication as well. All too often, chiropractors see patients who were being treated by their primary physician with medication in order to mask the symptoms, causing further stress (and damage) on the vertebrae.  The result of medication in these cases often leads to a circular pattern (stress -> pain -> medication -> side effects) where more medication is prescribed as the amount of pain increases.  From a chiropractic standpoint, pain is thought of as an alarm and if the body is allowed to heal naturally, the pain is naturally reduced.  

Sources:

Bryans R, Descarreaux M, Duranleau M,  Marcouz H, Potter B, Ruegg R, Shaw L, Watkin R, White E.  Evidence-based guidelines for the chiropractic treatment of adults with headaches. 34(5):274-289. 2011.

Chiropractic: An Introduction. NCAM. http://nccam.nih.gov/health/chiropractic/introduction.htm Accessed October 1, 2011.

Epstein, D., & Posa, A. (1999, Feb-March). Breaking New Ground for Long Term Health and Wellness: Network Spinal Analysis. Retrieved 10 2, 2011, from Association for NetworkCare: http://wwwassociationfornetworkcare.com/articles/breakingnewground/networkspinalanalysis

Erickson, K. (2004). Chiropractic and Osteopathic Care. In B. Kliger, Integrative Medicine (pp. 153-176). New York: McGraw-Hill.

Ernst, E. "Chiropractic Maintenance Treatment, a Useful Preventative Approach?" Preventative Medicine 49.2-3 (2009): 99-100.

Liliedahl, Richard, David V. Axene , Christine M. Goertz, (2010). "Cost of Care for Common Back Pain Conditions Initiated with Chiropractic Doctor vs Medical Doctor/Doctor of Osteopathy as First Physician: Experience of One Tennessee-Based General Health Insurer." Journal of Manipulative and Physiological Therapeutics 33(9): 640-643

Mann, D., & Coeytaux, R. (2007). Migraine and Tension-Type Headache. In D. Rakel, Integrative Medicine (pp. 143-151). Philadelphia: Elseviere Saunders.

Toftness, I. (1977). Chiropractic Spinal Correction :Philosophy of Chiropractic Correction. Cumberland, Wisconsin: Toftness Publishing

Bronfort, G., Haas,M, Evans, R., Bouter,L (2004) Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. The Spine Journal. (4); 335-356

Rubinstein, S., Leboeuf-Yde,C.,Knol, D., deKoekkoef,T.Pfeifle,C.,vanTudder,M.  ^{The Benefits Outweigh the Risks for Patients Undergoing Chiropractic Care for Neck Pain: A Prospective, Multicenter, Cohort Study. Journal of Manipulative and Physiological Therapeutics Volume 30, Issue 6, July 2007, Pages 408-418}

Wolsko, Peter M. MD, MPH, Eisenberg, David M. MD; Davis, Roger B. ScD; Kessler, Ronald PhD and; Phillips, Russell S. MD. Patterns and Perceptions of Care for Treatment of Back and Neck Pain: Results of a National Survey. Spine: 1 February 2003 - Volume 28 - Issue 3 - pp 292-297

Selengkapnya →

Insight into herbs

Herbs have been used for centuries in healing and therapy.  In fact, Ancient Chinese Medicine is still utilized today.  In Chinese, it is believed that Qi (Chi) is our life force or vital force energy.  It represents a flow of energy which circulates through everything on Earth.  Chinese have used Qi for thousands of years to heal and perfect the body.  The three vital treasures are believed by the Chinese to be the combination of the life force elements as they represent the different functions of the body, the mind, and the spirit as one.  Each function is clearly different but as the Taoists believe, they  all make up the same individual. 
What does this have to do with herbs?  The herbs we collect are filled with energy and life force.  Each herb has a different effect depending upon what elemental energy it possesses. This is only one theory  and only one way of utilizing herbs.

Yin and Yang is a Taoist philosophy which incorporates all opposites which intertwine to form balance.  Yin represents water, cold, heavy, fluidity, rest, passiveness, and earthy. Yang represents fire, activity, hot, light, energetic, aggressive, and quickness.  Those with too much of either show symptoms corresponding to the representation and therefore need more balance.
The five elements, Fire, Earth, Metal, Water, and Wood, are symbolic of the energies which manifest through the natural cycles found on Earth.  These elements are quite useful in healing but can be also applied to astrology, Feng Shui, and art, among other such practices.  This cycle represents the creation cycle where one element transitions and manifests from the previous element in a continuous loop.    Teas are a great way to receive and benefit from the photochemicals within various plants.  Start by researching different teas and trying out a variety of flavors.  The longer the tea steeps, the more phytochemicals are released.  The more tea an individual drinks, the more the oximation (dying) process is reversed.

An herbal medicine, also known as botanical medicine or phytotherapy, is medicine in the form of natural herbs, plants and natural substances for medicinal purposes.  Since the dawn of hominids, herbs have aided in the cure and recovery of most illness and cause of pain.  It wasn’t until later when the invent of the pill took over and herbal treatments phased out.  Only until recently, we have seen a rise in herbal treatments once more. 
--------------------------

Synergism: are the active chemicals in herbs which work in sync with its other substances that enhance the overall effect of the herb.
Phytonutrients: are chemicals in herbs which make them biologically active.  These chemicals also give the plants their color, their flavor and natural disease resistance. 
Antioxidants: are agents such as plants, vitamins, minerals, and enzymes which naturally fight against damaging free radicals.
Free radicals: are essentially oxygen molecules which lose their electrons and then take other electrons from stable molecules.  Over time, the body undergoes considerable amount of changes and becomes unhealthy.
---------------------------
The properties of alkaloids are nitrogen based compounds including analgesic, local anesthetic, sedating antispasmodic, hallucinogens, and varying poisons.  The uses of these alkaloids affect the nervous system and the circulatory system.  Some everyday alkaloids are nicotine and caffeine, which both have been known to cause serious health risks; as well as doctors prescribe drugs such as morphine and quinine to their patients for pain relief.

The properties of fatty oils are triglycerides, glycerol and fatty acids most commonly used as omega-3 fatty acids known to fight cardiovascular disease and depression.  
The properties of isoflavones are certain compounds closely related to the human hormone estrogen.  Isoflavons are found in soy milk and other soy products.  These compounds may prevent cancers related to hormones.  Isoflavons also may lower cholesterol and relieve symptoms of menopause while even preventing osteoporosis. 
-------------------------
Almost 30% of prescription drugs are originally derived from plants.  Some well known drugs include aspirin, quinine, and morphine.  These all are derivatives from everyday natural sources like flowers and tree bark.
--------------------------
The American Herbal Pharmacopoeia was organized in 1995 as a foundation to educate America on the pharmacology, dosages, side effects, and other health related topics concerning the use of herbs.

Selengkapnya →

What To do With a Tension Headach

Selengkapnya →