Neck Pain: Combining Exercise and Manual Therapy for Your Neck and Upper Back Leads to Quicker Reductions in Pain

Neck Pain: Combining Exercise and Manual Therapy for Your Neck and Upper Back Leads to Quicker Reductions in Pain

Neck pain is very common, but the good news is that most neck pain is not caused by serious disease. “Mechanical neck pain” is the name healthcare professionals use when joint and muscle problems result in neck pain. Current evidence suggests that a combination of manual therapy and exercise is effective for patients with mechanical neck pain. A research report published in the March 2013 issue of JOSPT focused on finding which combination of exercise and manual therapy was more effective in quickly reducing neck pain.

NEW INSIGHTS

In this study, researchers treated 64 patients. All of the patients were prescribed mobility exercises and received mobilization of their neck. About half of these patients also received a manipulation of the upper back. After 1 week, patients who performed the exercises and received both mobilization of the neck and manipulation of the upper back noted greater relief of their neck pain. In the group that received both manual therapy techniques, 75% had significant pain reduction and 70% experienced noticeable improvement in their ability to perform daily activities. When patients only received neck mobilizations, only 19% found that their pain was reduced, and only 23% saw an improvement in their disability. The researchers concluded that the combination of exercise with neck mobilization and upper back manipulation was more effective in reducing pain in the first week of treatment.

PRACTICAL ADVICE

Patients with typical neck pain may benefit from a physical therapy program that includes exercises combined with neck mobilization and upper back manipulation. Potential benefits include less pain and improved ability to perform daily activities. Although this treatment was very successful for this group of patients with neck pain, it may not be effective or appropriate for all patients with neck pain. Your physical therapist can perform an evaluation to help determine if you are a good candidate for this treatment. The benefits in this study were only determined for the first week after treatment, so more research is needed to discover which treatments are better long term. For more information on the treatment of neck pain, contact your physical therapist specializing in musculoskeletal disorders.

This JOSPT Perspectives for Patients is based on an article by Masaracchio et al titled “Short-Term Combined Effects of Thoracic Spine Thrust Manipulation and Cervical Spine Nonthrust Manipulation in Individuals With Mechanical Neck Pain: A Randomized Clinical Trial,” J Orthop Sports Phys Ther 2013;43(3):118-127. doi:10.2519/jospt.2013.4221.

This Perspectives article was written by a team of JOSPT’s editorial board and staff, with Deydre S. Teyhen, PT, PhD, Editor, and Jeanne Robertson, Illustrator.

Current evidence suggests that a combination of manual therapy and exercise is effective for patients with mechanical neck pain. A research report published in the March 2013 issue of JOSPT focused on finding which combination of exercise and manual therapy was more effective in quickly reducing neck pain.

J Orthop Sports Phys Ther 2013;43(3):128.doi:10.2519/jospt.2013.0502

KEY WORDS: cervical spine, manipulation, manipulative therapy, mechanical neck pain, mobilization, thoracic spine

Direct LINK to source

http://www.jospt.org/issues/articleID.2858/article_detail.asp

Does Back Pain Go Away on Its Own?

Eighty percent of people suffer from back pain at some point in their lives. Back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections. Most cases of back pain are mechanical or non-organic, i.e., not caused by serious conditions, such as inflammatory arthritis, infection, fracture, or cancer.

What Causes Back Pain?
The back is a complicated structure of bones, joints, ligaments, and muscles. You can sprain ligaments, strain muscles, rupture disks, and irritate joints, all of which can lead to back pain. While sports injuries or accidents can cause back pain, sometimes the simplest of movements-for example, picking up a pencil from the floor-can have painful results. In addition, arthritis, poor posture, obesity, and psychological stress can cause or complicate back pain. Back pain can also directly result from disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss.

Back injuries are a part of everyday life, and the spine is quite good at dealing with these often “pulled” muscles. These very minor injuries usually heal within 1 or 2 days. Some pain, however, continues. What makes some pain last longer is not entirely understood, but researchers suspect that the reasons may include stress, mood changes, and the fear of further injury that may prevent patients from being active. In addition, sometimes a painful injury or disease changes the way the pain signals are sent through the body, and, even after the problem has gone away or is inactive, the pain signals still reach the brain. It is as if the pain develops a memory that keeps being replayed.

Will Back Pain Go Away on Its Own?
Until recently, researchers believed that back pain will “heal” on its own. We have learned, however, that this is not true. A recent study showed that when back pain is not treated, it may go away temporarily but will most likely return. The study demonstrated that in more than 33% of the people who experience low-back pain, the pain lasts for more than 30 days. Only 9% of the people who had low-back pain for more than 30 days were pain free 5 years later.¹

Another study looked at all of the available research on the natural history of low-back pain. The results showed that when it is ignored, back pain does not go away on its own.² Those studies demonstrate that low-back pain continues to affect people for long periods after it first begins.

What Can I Do to Prevent Long-Term Back Pain?
If your back pain is not resolving quickly, visit your doctor of chiropractic. Your pain will often result from mechanical problems that your doctor of chiropractic can address. Many chiropractic patients with relatively long-lasting or recurring back pain feel improvement shortly after starting chiropractic treatment.³ The relief they feel after a month of treatment is often greater than after seeing a family physician.⁴

Chiropractic spinal manipulation is a safe and effective spine pain treatment. It reduces pain, decreases medication, rapidly advances physical therapy, and requires very few passive forms of treatment, such as bed rest.⁵

How Can I Prevent Back Pain?

• Don’t lift by bending over. Instead, bend your hips and knees and then squat to pick up the object. Keep your back straight, and hold the object close to your body.
• Don’t twist your body while lifting.
• Push, rather than pull, when you must move heavy objects.
• If you must sit for long periods, take frequent breaks and stretch.
• Wear flat shoes or shoes with low heels.
• Exercise regularly. An inactive lifestyle contributes to lower-back pain.

What Should I Tell My Doctor of Chiropractic?
Before any treatment session, tell your doctor of chiropractic if you experience any of the following:

• Pain goes down your leg below your knee.
• Your leg, foot, groin, or rectal area feels numb.
• You have fever, nausea, vomiting, stomach ache, weakness, or sweating.
• You lose bowel control.
• Your pain is caused by an injury.
• Your pain is so intense you can’t move around.
• Your pain doesn’t seem to be getting better quickly.

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References

1. Hestbaek L, Leboeuf-Yde C, Engberg M, Lauritzen T, Bruun NH, Manniche C. The course of low-back pain in a general population. Results from a 5-year prospective study. J Manipulative Physiol Ther 2003 May;26(4):213-9.
2. Hestbaek L, Leboeuf-Yde C, Manniche C. Low-back pain: what is the long-term course? A review of studies of general patient populations. Eur Spine J 2003 Apr;12(2):149-65.
3. Stig LC, Nilsson O, Leboeuf-Yde C. Recovery pattern of patients treated with chiropractic spinal manipulative therapy for long-lasting or recurrent low back pain. J Manipulative Physiol Ther 2001 May;24(4):288-91.
4. Nyiendo J, Haas M, Goodwin P. Patient characteristics, practice activities, and one-month outcomes for chronic, recurrent low-back pain treated by chiropractors and family medicine physicians: a practice-based feasibility study. J Manipulative Physiol Ther 2000 May;23(4):239-45.
5. Time to recognize value of chiropractic care? Science and patient satisfaction surveys cite usefulness of spinal manipulation. Orthopedics Today February 2003;23(2):14-15.

SOURCE:  http://www.acatoday.org/content_css.cfm?CID=66

Chiropractic Care may have a positive impact on some Asthma sufferers

When people think about chiropractors, they don’t generally associate them with treating asthma. However, in some cases, chiropractic care may help with asthma sufferers. This can be especially true for children or asthma sufferers that had an onset in childhood.

Below are some research studies proving evidence that Chiropractic may have a positive impact on patients with asthma.

Dr. Ray Hayek conducted a trial at 16 treatment centers in Australia, involving 420 patients with an average age of 46, in an effort to find out what effects spinal manipulation has on symptoms such as depression and anxiety, general health status, and the levels of immunity. He tested the concentrations of both an immunoglobulin (IgA) and an immunosuppressant (cortisol) to gauge his results. Dr. Hayek was trying to prove that different forms of manual therapy (including massage) improve symptoms and lower cortisol levels in asthma patients.

Dr. Hayek reported that only the patient group that underwent spinal manipulation displayed significant improvement in asthma symptoms. Conducting only interviews at the treatment centers or being monitored at home did not yield these improvements. In addition, patients actually undergoing spinal manipulation displayed dramatic increases of IgA and decreases of cortisol even after asthma treatment had ceased, suggesting that the treatments affected the patients’ health long term. These patients were expected to ward off subsequent asthmatic attacks.

These changes not only suggest that the effects of spinal manipulation are more far-reaching than commonly believed, but that they may be more long-term as well. The gain in health achieved after spinal manipulations were performed is expected to reduce the incidence and severity of pathogenic invasion of the airways. There would be less of a risk under these circumstances of experiencing the symptoms of asthma.

CASE STUDY 1

Chiropractic Care of a Pediatric Patient with Asthma:  A Case Report

 Heather Whittle-Davis D.C. Bio & Krystal Czegus D.C. Bio  

Journal of Pediatric, Maternal & Family Health – Chiropractic ~ Volume 2011 ~ Issue 3 ~ Pages 77-81  Abstract
Objective:  To review the outcomes of a toddler suffering from asthma, gastrointestinal complaints and frequent colds undergoing subluxation based chiropractic care.

Clinical Features:  A 23-month-old female suffering from asthma, gastrointestinal complaints and frequent colds was presented for a chiropractic evaluation and possible care.  At this time, the patient was taking a series of different asthma medications and was also under constant monitoring by her pediatric pulmonologist.

Intervention and Outcomes:  The patient was cared for using a combination of both high velocity, low amplitude Diversified adjustments and low-force adjustments with the Activator adjusting instrument to address areas of vertebral subluxation in the cervical, thoracic, and lumbosacral spine.  Within approximately 11 months, the patient’s parents reported a 90% improvement of their child’s condition.  The patient was able to reduce her care plan frequency and discontinued use of all medications.  The parents also reported a decrease in their child’s asthma, sinus problems and frequency of colds.

Conclusion:  This case report provides supporting evidence that chiropractic care can have a positive impact on children suffering with asthma and help balance immune system functioning.  It is recommended that further research be conducted on this subject to support the findings of this case study.

Key Words:  Chiropractic, asthma, children, spinal manipulation

Case Study 2

Improvement in a Pediatric Patient with Neurofibromatosis Type 1 and Asthma:  A Case Report
  

Brian Kachinsky, D.C. Bio  & Jill Kachinsky, D.C. Bio   

Journal of Pediatric, Maternal & Family Health – Chiropractic ~ Volume 2011 ~ Issue 1 ~ Pages 1-4  Abstract

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Objective: To evaluate the chiropractic care on a 3 year-old boy with asthma as an alternative option to traditional medical care.

Clinical Features: A 3 year-old male with a history of Neurofibromatosis Type I, asthma and ear infections. He was having frequent asthmatic episodes requiring emergency department visits two times per month. His mother sought chiropractic care to attempt to control his exacerbations of asthma. He had a previous RSV (Respiratory Syncytial Virus) infection

Intervention and Outcomes: The patient was adjusted utilizing the Diversified chiropractic technique at a frequency of two to three times per week. Within one month after beginning care the patient no longer had violent exacerbations of his asthma and was able to sleep through the night and decrease his rescue inhaler usage.

Conclusions:  This specific case shows a positive response to chiropractic care in the treatment of uncontrolled asthma in a three year old male with a history of Neurofibromatosis type 1, ear infections and a previous RSV infection. However, more research is needed to explore chiropractic as a viable alternative to medical care in these types of cases.

Key Words: Neurofibromatosis Type 1, asthma, chiropractic, antibiotics, vertebral subluxation

Please Note: The information provided here is merely referential and informative. It is in no way a representation of professional medical advice and you should consult with your medical doctor in conjunction with your chiropractor to determine any possible diagnosis and asthma treatment methods that you may require.

(Source: chiropracticpediatricresearch.web.officelive.com)

Research at a Glance – Treating Chronic Neck and Back Pain

Spinal manipulation may provide broader and more significant long-term benefit for chronic spinal pain patients than acupuncture and medication.
Muller R, Giles LGF. Long-Term Follow-Up of a Randomized Clinical Trial Assessing the Efficacy of Medication, Acupuncture, and Spinal Manipulation for Chronic Mechanical Spinal Pain Syndromes. J Manipulative Physiol Ther 2005;28(1):3-11.
BACKGROUND
Chronic mechanical back pain and neck pain, which are often caused by an injury or disease, present a diagnostic and treatment challenge and pose a significant financial strain on the health care system. Some evidence shows that a multidisciplinary team approach to treating spinal pain results in high patient satisfaction. The evidence about the superiority of a particular treatment for non-specific chronic spinal pain is inconclusive.
THE OBJECTIVE of this study was to assess the long-term effect of medication, needle acupuncture and spinal manipulation on treating patients with chronic (> 13 weeks) spinal pain.
THIS STUDY conducted a one-year follow-up of a randomized clinical trial investigating the effectiveness of medication (Celebrex, Vioxx and/or acetaminophen), acupuncture or high-velocity low-amplitude spinal manipulation on treating chronic spinal pain. Sixty-nine patients were randomized into three treatment groups, receiving one type of treatment for nine weeks. The one-year follow-up was conducted through Oswestry Back Pain Index, Neck Disability Index, Short-Form-36 and Visual Analog Scales. The study analyzed the results of treatment of 40 patients who had received only one randomly allocated type of treatment.
RESULTS
Comparison of the initial and long-term follow-up questionnaires produced the following results:
• Only the group receiving spinal manipulation showed long-term treatment benefit, with five of the original seven improvements remaining statistically significant after one year.
• Only one of seven improvements remained statistically significant in each of the acupuncture and the medication treatment groups at follow-up.
CONCLUSION
For treating chronic spinal pain, spinal manipulation, if not contraindicated, may provide broader and more significant long-term benefits than acupuncture or pain-relief medication.

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Dr. Dao Tran and Dr. Quan Tran graduated from Cleveland Chiropractic College of Los Angeles. Together, they have over 18 years of combined experience providing Chiropractic treatment for the injured and Lifestyle Chiropractic care to help their patients achieve optimum health and maintain peak performance. They have two Chiropractic offices in Southern California – Orange County-Fountain Valley and South Bay-Lawndale.
bbCall to make an appointment with Dr. Tran today!

California Pain Center

9475 Heil Ave., Suite D

Fountain Valley, CA 92708

(714) 775-7700

South Bay Pain and Rehab Center

14921 Prairie Ave., Ste. 2,

Lawndale, CA 90260

(310) 263-7246

If you have any questions or concerns feel free to contact us through our website:  Contact us and you can Follow us on Twitter and also Become a FAN on Facebook.

(Source: ncbi.nlm.nih.gov)

Maintenance Chiropractic = Better long term results for Low Back Pain!

Does maintained Spinal manipulation therapy for chronic non-specific low back pain result in better long term outcome?

Senna, Mohammed K.; Machaly, Shereen A.

Source

Rheumatology and Rehabilitation Department, Mansoura Faculty of Medicine, Mansoura University.

Spine: POST ACCEPTANCE, 17 January 2011

Abstract

ABSTRACT:: Study Design.

A prospective single blinded placebo controlled study was conducted.Objective. to assess the effectiveness of spinal manipulation therapy (SMT) for the management of chronic non-specific low back pain (LBP) and to determine the effectiveness of maintenance SMT in long-term reduction of pain and disability levels associated with chronic low-back conditions after an initial phase of treatments.

Summary of background. SMT is a common treatment option for low back pain. Numerous clinical trials have attempted to evaluate its effectiveness for different subgroups of acute and chronic LBP but the efficacy of maintenance SMT in chronic non-specific LBP has not been studied.

Subjects and Methods. 60 patients with chronic, nonspecific LBP lasting at least 6 months were randomized to receive either

(1) 12 treatments of sham SMT over a one-month period,

(2) 12 treatments, consisting of SMT over a one-month period, but no treatments for the subsequent nine months, or

(3) 12 treatments over a one-month period, along with “maintenance spinal manipulation” every two weeks for the following nine months.

To determine any difference among therapies, we measured pain and disability scores, generic health status, and back-specific patient satisfaction at baseline and at 1-month, 4-month, 7-month and 10-month intervals.

Results: Patients in second and third groups experienced significantly lower pain and disability scores than first group at the end of 1-month period (P = 0.0027 and 0.0029 respectively).

However, only the third group that was given spinal manipulations during the follow-up period showed more improvement in pain and disability scores at the 10-month evaluation.

In the no maintained SMT group, however, the mean pain and disability scores returned back near to their pretreatment level.

Conclusion. SMT is effective for the treatment of chronic non specific LBP. To obtain long-term benefit, this study suggests maintenance spinal manipulations after the initial intensive manipulative therapy.

Back pain often ranks as one of the top reasons for employee absenteeism and “presenteeism” (being at work but not really doing any work!) costing companies millions of dollars.  Back pain afflicts approximately eight of every ten Americans during their lifetime.

Another recent study published in the Journal of Occupational & Environmental Medicine – March 2011, showed Chiropractic to be more effective than traditional medical care as well as physical therapy for patients with low back pain. 

Do you or do you know of someone that has Low Back Pain? Why continue to suffer?

We’re here to help!  Call our office to today to get your spine checked and get relief today!

ALSO SIGN UP FOR OUR NEWSLETTER SUBSCRIPTION TO RECEIVE THE LATEST HEALTH NEWS/TIPS.
CLICK HERE NOW

Dr. Dao Tran and Dr. Quan Tran graduated from Cleveland Chiropractic College of Los Angeles. Together, they have over 18 years of combined experience providing Chiropractic treatment for the injured and Lifestyle Chiropractic care to help their patients achieve optimum health and maintain peak performance. They have two Chiropractic offices in Southern California – Orange County-Fountain Valley and South Bay-Lawndale.
Call to make an appointment with Dr. Tran today!

California Pain Center

9475 Heil Ave., Suite D

Fountain Valley, CA 92708

(714) 775-7700

South Bay Pain and Rehab Center

14921 Prairie Ave., Ste. 2,

Lawndale, CA 90260

(310) 263-7246

If you have any questions or concerns feel free to contact us through our website:  Contact us and you can Follow us on Twitter and also Become a FAN on Facebook.

(Source: ncbi.nlm.nih.gov)