Lower back pain is the most common cause of job-related disability and the leading contributor to missed work. It is second to headaches in the realm of neurological disorders. The lower back may be painful due to a bulging disc, an injured/pulled muscle, arthritis, or even a problem from elsewhere in the body – such as the foot or knee, referring pain to the lower back. Just in the United States alone, low back pain suffers spend over 50 billion dollars a year diagnosing this pain via X-Ray, CT scans, MRIs, and other studies, and then treating this pain thru either natural methods such as chiropractic or acupuncture, or more extreme methods via painkillers, anti-inflammatory medications, and surgery. There are many reasons for low back pain, too many to discuss in just one article, but a very common and overlooked problem resulting in lower back pain is that of adrenal gland stress. Though not actually adrenal gland pain, the glands can cause lower back pain if they’re under stress.
Your adrenal glands are those little walnut-sized endocrine glands that sit on top of your kidneys. And for being so little they pack quite a punch. Most think of them when it comes to adrenalin, as this is where it is made, however they are also responsible for the production of cortisol, (to help balance blood sugar and fight inflammation), sex hormones, (DHEA, testosterone, estrogen, progesterone), and aldosterone, which is needed to balance electrolytes (sodium-potassium) in the body. Your adrenal glands are your first line of defense when it comes to stress. Under stress, cortisol levels are secreted in massive amounts, and DHEA, sometimes referred to as the longevity hormone, is suppressed. Over prolonged periods of stress your adrenals can become so fatigued that they will make very little of the hormones intended. The medical authority doesn’t recognize the adrenal glands from a functional standpoint – only from a pathological perspective. Addison’s Disease is when the production of the hormones has ceased and Cushing’s Syndrome is diagnosed when cortisol levels are extremely elevated. However, many people have a functional adrenal gland problem, meaning their hormones are not working optimally. Basically, if a person is under stress, the adrenal glands will be affected; though this is not always a bad thing as it is a natural and actually healthy response to make stress hormones when under stress. However, under heavy amounts and prolonged stress, the adrenal glands will suffer. If you’re thinking that most everybody has some sort of adrenal gland stress, you’re absolutely correct.
Since the adrenal glands are the first to react to stress, they are often the first of the endocrine glands to wear down. Prolonged stress will often result in insulin problems as the pancreas and adrenals share the workload to balance blood sugar levels. This will result in blood sugar handling problems and over time, even Type II Diabetes. A thyroid disorder will often be the secondary problem of adrenal gland stress, even though in society it is often thought of as the primary problem after discovered following some routine blood work, and there are numerous pharmaceuticals to address the thyroid readily available. Low testosterone levels in men and low progesterone levels in women often accompany further adrenal gland stress, leading to a low sex-drive, weight gain, and PMS in women.
Your adrenal glands will give you warning signs that they are under stress long before they give up on you. Here are some common signs and symptoms that your adrenal glands are stressed:
Since many of these adrenal-type muscles connect the pelvis to the knee, you can see why knee and inner thigh problems are also very often adrenal related. The two most common I see are groin pulls and medial meniscus and/or medial collateral (MCL) tears. This is because the three main muscles that attach to just below the inside of the knee all have a strong relationship with the adrenal glands. So when these muscles don’t do their job, the meniscus and MCL have a massive amount of stress put on them. Additionally, the pelvis will torque, the sacrum will misalign, and you’re an accident waiting to happen.
The muscles of the calf and feet are also related to the adrenal glands. Those tired feet, shin splints, plantar fasciitis, and burning claves are often due to adrenal gland fatigue. These muscle support the normal arch of the foot, and that allows a person to naturally pronate when they walk/run. Pronation is very important – it is the primary way your body absorbs shock upon impact. If the muscles are fatigued, the arch will weaken and pronation will be lost. Once the foot cannot pronate correctly, the stress of impact will be transferred up to the knee and ultimately the lower back.
A healthy lifestyle will keep your adrenal glands strong and working efficiently throughout your life. Resolving physical/structural problems, correcting nutritional imbalances with supplements and dietary changes, and dealing with emotional/mental problems are all equally part of the adrenal gland triad of health. However, if you sleep a few hours a night, eat a lot of refined foods, drink a lot of coffee, don’t exercise, and are under chronic emotional stress then your back is gonna let you know!
Contribution by Dr. Stephen Gangemi
If you suffer from upper or lower back pain, you could have a restricted joint in that area of your spine. Read more about Lumbar Joint Restrictions below:
Your spine is made up of 24 bones stacked on top of each other with a soft “disc” between each segment to allow for flexibility. Normally, each joint in your spine should move freely and independently. When one or more of your spinal vertebra is slightly misaligned and restricted, we call this condition a “spinal segmental joint restriction”. A “lumbar joint restriction” means that this misalignment or restriction is located in your lower back region.
To help visualize this, imagine a normal spine functioning like a big spring moving freely in every direction. A spine with a joint restriction is like having a section of that spring welded together. The spring may still move as a whole, but a portion of it is no longer functioning.
Joint restrictions can develop in many ways. Sometimes they are brought on by an accident or an injury. Other times, they develop from repetitive strains or poor posture. Being overweight, smoking, strenuous work, and emotional stress can make you more susceptible to problems.
Restricted joints give rise to a self-perpetuating cycle of discomfort. Joint restriction causes swelling and inflammation, which triggers muscular guarding leading to more restriction. Since your spine functions as a unit, rather than as isolated pieces, a joint restriction in one area of your spine often causes “compensatory” problems in another. Think of this as a rowboat with multiple oarsmen on each side. When one rower quits, the others are placed under additional stress and can become overworked.
Joint restrictions most commonly cause local tenderness and discomfort. You may notice that your range of motion is limited. Movement may increase your discomfort. Pain from a restricted joint often trickles around your belt line or up & down your spine. Be sure to tell your chiropractor if your symptoms include any chest pain, shortness of breath, unusual cough, indigestion or flu-like complaints.
Long-standing restrictions are thought to result in arthritis - much like the way a slightly misaligned wheel on your car causes premature wearing of your tire.
You should recognize that your problem is common and generally treatable. Chiropractic care has been shown to be the safest and most effective treatment for joint restrictions. Our office offers several tools to help ease your pain. To speed your recovery, you should avoid activities that increase your pain. Be sure to take frequent breaks from sedentary activity. Yoga has been shown to help back pain sufferers so consider joining a class or picking up a DVD.
If you or someone you know suffers from back or neck pain, call our office today. Our team has knowledge and tools to help you feel better quickly!
Reprinted with permission from ChiroUp
According to research, almost 25% of people will abandon their New Year’s resolutions by the second week in January and almost 60% will quit before six months. Starting resolutions that are too vague, large, or unrealistic will only set you up for failure. If this has happened to you in the past, try setting up specific and actionable goals for yourself this New Year. For example, instead of saying “I want to get healthy in 2018”, break it down into smaller goals that you can attain by gradually changing some of your daily habits. Need some ideas? We’ve rounded up a checklist to help create realistic, actionable, and attainable goals for a healthier lifestyle in 2018.
Remember that you should not try to achieve every one of these goals all at once. Living a healthy lifestyle begins with one simple choice after another. Even choosing just a few of these to help you create better habits for yourself will put you on the right path.
Reprinted with consent by ChiroTrust
Lower back pain is an undesired consequence of the activities that our patients partake in on a daily basis. Without appropriate intervention and adequate rest, these repetitive stressors can lead to injury.
Desk jockeys are filling chiropractic offices with complaints triggered by cumulative stressors, compounded by inactivity. Prolonged seated postures and general deconditioning lead to overloaded spinal ligaments, muscles, and discs.
Altering seat and keyboard height, as well as monitor elevation & distance are all critical variables for those who spend their day sitting. But more recently, increasing numbers of workstation users are transitioning to standing desks; and standing in one spot for an extended period is not without its own set of risks.
What advice should an evidence-based chiropractor give to patients concerning their standing workstation?
Do you know why taverns have foot rails around their bars? The foot rails originated during a time when stools were not common, and patrons would stand, i.e. ‘belly up to’ the bar. The rail was intended to give patrons the ability to alternate legs, giving one a rest while providing a little flexion for those stenotic cowboy spines.
A new study examined the impact of standing workstations on LBP. (1) The authors concluded that one variable, footrest height, had a significant contribution to muscle fatigue and lower back pain. Their recommendation:
“The results suggest that a footrest height of 10% of the body height can be recommended as a normalized height for prolonged standing work in subjects with a history of non-specific lower back pain during prolonged standing.”
The take away from this is to incorporate a foot rest with your standing workstation. You can't argue with the evidence!
1. Son JI, et al. Effects of footrest heights on muscle fatigue, kinematics, and kinetics during prolonged standing work. J Back Musculoskelet Rehabil. 2017.
Reprinted with permission from ChiroUp
1.A systematic review of 11 pertinent articles determined that cervical HVLA manipulation increased pain-free handgrip strength in patients with lateral epicondylagia. Galindez-Ibarbengoetxea Xabier, Setuain Igor, Andersen Lars L., Ramírez-Velez Robinson, González-Izal Miriam, Jauregi Andoni, and Izquierdo Mikel. The Journal of Alternative and Complementary Medicine. September 2017, 23(9): 667-675.
2.A cross sectional study confirmed that in patients with adolescent idiopathic scoliosis, the Cobb angle has a direct correlation to pain and disability. Bracing was associated with lower disability and pain. Théroux J et al. Back Pain Prevalence Is Associated With Curve-type and Severity in Adolescents With Idiopathic Scoliosis: A Cross-sectional Study. SPINE. 42(15):E914–E919, AUG 2017
3.The Journal of Rheumatology published an articulate narrative on the genesis of arthritis: “Following skeletal maturation, chondrocyte numbers decline while increasing senescence occurs. Lower cartilage turnover causes diminished maintenance capacity, which produces accumulation of fibrillar crosslinks, resulting in increased stiffness and thereby destruction susceptibility. Mechanical loading changes proteoglycan content. Moderate mechanical loading causes hypertrophy and reduced mechanical loading causes atrophy. Overloading produces collagen network damage and proteoglycan loss, leading to irreversible cartilage destruction because of lack of regenerative capacity. Thus, age seems to be a predisposing factor for OA, with mechanical overload being the likely triggering cause.” Jorgensen AE et al. The Effect of Aging and Mechanical Loading on the Metabolism of Articular Cartilage The Journal of Rheumatology April 2017, 44 (4) 410-417
4.“The knee is the most common site of OA. Numerous studies have shown an inconsistency between patients’ reports of pain and their radiographic findings. This inconsistency may be partially explained by the fact that a portion of the pain originates from the myofascial trigger points (MTrPs) located in the surrounding muscles. Treatment focusing on MTrPs seems to be effective in reducing pain and improving function in OA patients.” Dor, Adi et al. A myofascial component of pain in knee osteoarthritis. Journal of Bodywork and Movement Therapies , Volume 21 , Issue 3 , 642 – 647
5.In patients undergoing MRI for degenerative spinal disease, expanding the regional study to include a T2 whole spine screen identified incidental findings in 15.8% of patients, 4.3% of which required further medical or surgical intervention. The authors concluded: “Considering the potential advantages in identifying significant incidental findings and the minimal extra time spent to perform whole spine screening, its application can be considered to be incorporated in routine imaging of spinal degenerative diseases.” Kanna, R.M., Kamal, Y., Mahesh, A. et al. The impact of routine whole spine MRI screening in the evaluation of spinal degenerative diseases. Eur Spine J (2017) 26: 1993.
6.A small randomized clinical trial demonstrated that periodic chiropractic maintenance care can prevent and/or minimize episodes of LBP. Patients who underwent an average of 7 visits per year suffered on average 19.3 fewer days with LBP. Eklund A, et al. Prevention of low back pain: effect, cost-effectiveness, and cost-utility of maintenance care – study protocol for a randomized clinical trial. Trials. 2014;15:102 Eklund A et al., Prevention of Low Back Pain: Effect of Chiropractic Maintenance Care as Compared to Symptomatic Treatment – A Pragmatic Randomized Clinical Trial. First prize 2017 European Chiropractors Convention, Cyprus.
7.In athletes who sustained an acute musculoskeletal sports injury, three minutes of acupressure was effective in decreasing VAS pain intensity. Macznik AK. Does Acupressure Hit the Mark? A Three-Arm Randomized Placebo-Controlled Trial of Acupressure for Pain and Anxiety Relief in Athletes With Acute Musculoskeletal Sports Injuries. Clin J Sport Med. 2017 Jul;27(4):338-343.
8.A new study in Spine confirms that adults who participate in muscle strengthening exercise suffer lower incidence of LBP. Alnojeidi AH et al. Associations Between Low Back Pain and Muscle-strengthening Activity in U.S. Adults. Spine (Phila Pa 1976). 2017 Aug 15;42(16):1220-1225.
9.For patients with Failed Back Surgery Syndrome, evidence supports exercise or spinal cord stimulation as opposed to medication and re-operation. Amirdelfan K et al. Treatment Options for Failed Back Surgery Syndrome Patients With Refractory Chronic Pain: An Evidence Based Approach. Spine (Phila Pa 1976). 2017 Jul 15;42 Suppl 14:S41-S52.
10.A systematic review and meta-analysis found that workplace exercise programs and workstation modifications reduce the prevalence and intensity of shoulder pain. Lowry V et al. Efficacy of workplace interventions for shoulder pain: A systematic review and meta-analysis. J Rehabil Med 2017 Jul 7;49(7):529-542.
Reprinted via Permission from ChiroUp
Between 80% and 90% of the general population will experience an episode of lower back pain (LBP) at least once during their lives. When it affects the young to middle-aged, we often use the term “non-specific LBP” to describe the condition. The geriatric population suffers from the “aging effects” of the spine—things like degenerative joint disease, degenerative disk disease, and spinal stenosis. Fractures caused by osteoporosis can also result in back pain.
The “good news” is that there are rare times when your doctor must consider a serious cause of LBP. That’s why he or she will ask about or check the following during your initial consultation: 1) Have you had bowel or bladder control problems? (This is to make sure a patient doesn’t have “cauda equina syndrome”—a very severely pinched nerve.) 2) Take a patient’s temperature and ask about any recent urinary or respiratory tract infections to rule out spinal infections. 3) To rule out cancer, a doctor may ask about a family or personal history of cancer, recent unexplained weight loss, LBP that won’t go away with time, or sleep interruptions that are out of the ordinary. 4) To rule out fractures, a doctor may also take x-rays if a patient is over age 70 regardless of trauma due to osteoporosis, over age 50 with minor trauma, and at any age with major trauma.
Once a doctor of chiropractic can rule out the “dangerous” causes of LBP, the “KEY” form of treatment is giving reassurance that LBP is manageable and advise LBP sufferers of ALL ages (especially the elderly) to KEEP MOVING! Of course, the speed at which we move depends on many things—first is safety, but perhaps more importantly is to NOT BECOME AFRAID to do things! As we age, we gradually fall out of shape and end up blaming our age for the inability to do simple normal activities. Regardless of age, we must GRADUALLY increase our activities to avoid the trap of sedentary habits resulting in deconditioning followed “fear avoidant behavior!”
Here are a few “surprising” reasons your back may be “killing you”: 1) You’re feeling down – That’s right, having “the blues” and more serious mood disorders, like depression, can make it more difficult to cope with pain. Also, depression often reduces the drive to exercise, may disturb sleep, and can affect dietary decisions—all of which are LBP contributors. 2) Your phone – Poor posture caused by holding a phone between your bent head and shoulder (get a headset!) or prolonged mobile phone use can increase your risk for spinal pain. 3) Your feet hurt, which makes you walk with an altered gait pattern, forcing compensatory movements up the “kinetic chain” leading to LBP. 4) Core muscle weakness, especially if you add to that a “pendulous abdomen” from being overweight—this is a recipe for disaster for LBP. 5) Tight short muscles such as hamstrings, hip rotator muscles, and/or tight hip joint capsules are common problems that contribute to LBP. Stretching exercises can REALLY help!
Reprinted with Permission from Chiro-Trust
Opioid Use Disorder (OUD) has quietly but quickly become the hottest topic in healthcare public policy. More than 1/3 of Americans use opioids and 11.5 million misuse or abuse the drug. (1) Tragically, more than 20,000 people died in 2015 due to an opioid overdose. (2) Over a ten-year period, the opioid death rate quadrupled in direct proportion to the number of prescriptions. (3)
Currently, almost every governmental and healthcare group on the planet is working to combat this problem. Solutions range from prescription limits to equipping all first responders with Narcan™. However, the underappreciated issue is that opioids are most frequently prescribed for chronic non-cancer pain, primarily spinal pain. The vast majority of spinal pain is mechanical in origin. Prescribing a chemical does not adequately address that problem. Fortunately, there is abundant research that shows chiropractic spinal manipulation is very effective at resolving mechanical problems.
Patients who utilize chiropractic co-management have significantly lower rates of opioid use (19% vs 35%) and are 30 times less likely to undergo surgery. (4,5) Health plans realize significant savings by incorporating chiropractic care, with some carriers reporting a 2:1 ROI. (6,7)
Not surprisingly, in the past year chiropractic or spinal manipulation has been endorsed as an alternative to opioids by the FDA, CDC, Joint Commission, American College of Physicians, and 37 State Attorney Generals. (8-12) Earlier this week, a Presidential Commission Report on Opioids echoed those recommendations. (13)
1. Substance Abuse and Mental Health Services Administration. 2017. Results from the 2016 National Survey on Drug Use and Health: Detailed Tables. Table 1.28A and 1.28B. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf, accessed on October 26, 2017.
2. Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey
3. Paulozzi MD, Jones PharmD, et al. Vital Signs: Overdoses of Prescription Opioid Pain Relievers – United State, 1999-2008. Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Center for Disease Control and Prevention. 2011:60:5.
4. Whedon J. Association between Utilization of Chiropractic Services and Use of Prescription Opioids among Patients with Low Back Pain. Presented ahead of print at the National Press Club in Washington DC on March 14, 2017. Accessed online at http://c.ymcdn.com/sites/www.cocsa.org/resource/resmgr/docs/NH_Opioids_Whedon.pdf on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51). Retrieved from http://www.samhsa.gov/data/
5. Benjamin J. Keeney , Ph.D., et al. Early Predictors of Lumbar Spine Surgery After Occupational Back Injury. SPINE Volume 38, Number 11, pp 953–964
6. Feldman V, Return on investment analysis of Optum offerings — assumes Network/UM/Claims services; Optum Book of Business Analytics 2013. Analysis as of 12/8/2014.
7. Liliedahl RL, Finch MD, Axene DV, Goertz CM. Cost of care for common back pain conditions initiated with a chiropractic doctor vs medical doctor/ doctor of osteopathy as first line physician: experience of one Tennessee-based general health insurer. J Manipulative Physiol Ther. 2010;33:640–643.
8. FDA Education Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain. May 2017. Accessed on May 12, 2017
9. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain- United States, 2016. MMWR Recom Rep 2016;65(No. RR-1):1–49.
10. The Official Newsletter of The Joint Commission. Joint Commission Enhances Pain Assessment and Management Requirements for Accredited Hospitals. July 2017 Volume 37 Number 7. Ahead of print in 2018 Comprehensive Accreditation Manual for Hospitals.
11. Joint Commission Online. Revision to Pain Management Standards. http://www.jointcommission.org/assets/1/23/jconline_november_12_14.pdf
12. Attorney General Janet Mills Joins 37 States, Territories in Fight against Opioid Incentives. Accessed 9/19/17 from http://www. maine.gov/ag/news/article. shtml?id=766715
13. The Presidents Commission on Combating Drug Addiction and the Opioid Crisis. https://www.whitehouse.gov/sites/whitehouse.gov/files/images/Final_Report_Draft_11-3-2017.pdf
Reprinted with Permission from Chiro Up.
As exciting as the holidays can be, the added stress that comes along can really affect how your body functions. Whether you’ll be doing a lot of shopping, cooking, wrapping presents, or attending holiday parties, chances are you’ll be putting your body through a lot more than it’s normally accustomed to and all of this can trigger back and neck pain. Here are 11 tips to help you prepare for a happy and healthy holiday season.
• Dress appropriately before heading out for a day of shopping. Wear comfortable low-heeled shoes with arch supports and leave your heavy purse at home. Opt for a light backpack or a fanny pack to carry your personal belongings.
• Drink plenty of water to stay hydrated.
• A long day of shopping, i.e. walking, should be treated like an athletic event. Make sure you stretch before and after.
• Make extra trips to the car to drop off your goods so you don’t have to carry those heavy bags around all day.
• Take advantage of online shopping. Skip the long lines and crowded malls completely and shop from the comfort of your own home.
• Simplify your to-do list by picking up gift cards at the grocery store. You’ll get two errands done in one stop.
• Use a table or a counter to wrap gifts. The floor is a less than ideal spot to do your wrapping. Standing or sitting in a chair will promote better posture and help you avoid back and neck pain.
• Don’t wait until the last minute to wrap all of your gifts. Wrapping a few at a time is best.
• Don’t neglect your fitness routine. Although you’ll be busier than normal, it’s important to keep those workouts on your daily to-do list. Even a quick 20-minute workout is better than skipping it all together and you’ll be helping to manage your stress.
• Get enough sleep. The holidays won’t be as enjoyable if you aren’t catching enough z’s. Make sure you’re getting the recommended 7-9 hours of sleep every night.
• Try to stay on track with your healthy eating. Gaining extra weight will only contribute to back pain and health problems. Before attending a party, make sure you eat something healthy and drink plenty of water to avoid overeating while you’re there. It’s ok to indulge a little with holiday treats, just be sure to be sensible about it.
With some simple preparation, you can manage holiday stressors and ward off debilitating back and neck pain. If you do experience pain this season, please give our office a call. We’re experts at finding the root cause of your pain and can help you get back to a better quality of life.
The muscle responsible for flexing your hip toward your trunk, is called the Psoas. This muscle begins on your lower spine and passes through your pelvis to attach onto the top of your femur (thigh bone). Along this course, the muscle travels across the front of your hip socket and over several bony prominences. If the muscle is too tight, its tendon may rub over these “bumps”. This occasionally produces an audible snapping sound, hence the moniker, “snapping hip”, aka “psoas tendinopathy”. The tendon can be irritated by an acute injury, but more commonly from overuse- particularly repeatedly flexing your hip toward your trunk. The condition is also known as “dancer’s hip” or “jumper’s hip”, as movements associated with these activities are known culprits. Likewise, the condition is frequently seen in athletes who participate in rowing, track and field, hurdling, running (especially uphill), soccer, and gymnastics. Your symptoms may include a “snapping” sound or sensation when you flex and extend your hipalthough many cases are silent. Repeated rubbing causes inflammation and subsequent deep groin pain that can radiate to the front of your hip or thigh. Long-standing problems can trigger weakness or even limping. The diagnosis of snapping hip is frequently overlooked. In fact, some studies show that identification is often delayed more than two years, while other potential causes are pursued. Fortunately, your problem has been recognized, and our office has several treatments to help you recover. Psoas problems often start when one group of muscles is too tight, while another is too loose. Your home exercises will help to correct this problem. Depending upon the severity of your condition, you may need to avoid certain activities for a while. You should especially avoid repetitive hip flexion. Prolonged seated positions can encourage shortening of your hip flexors so be sure to take frequent breaks. Patients with fallen arches may benefit from arch supports. If you or someone you know suffers from this condition, call our office today. Our doctors are experts at relieving many types of pain including hip injuries.
Reprinted with permission from ChiroUp
Medline contains more than 24 million articles, with almost one million new citations added each year. Evidence-based chiropractors know that they must employ and continually refine “best practices” to obtain great outcomes. The following up-to-date chiropractic research review offers 11 new studies that impact our patients and practices.
1.A new paper provides additional confirmation that patellofemoral pain syndrome (PFPS) and dynamic knee valgus do not arise from within the knee, rather from hip abductor/ external rotator weakness and/or foot hyperpronation: “The most effective intervention programs included exercises targeting the hip external rotator and abductor muscles and knee extensor muscles.” and “PFPS patients with foot abnormalities, such as those with increased rearfoot eversion or pes pronatus, may benefit the most from foot orthotics.”Petersen W, Rembitzki I, Liebau C. Patellofemoral pain in athletes. Open Access Journal of Sports Medicine. 2017;8:143-154.
2.A systematic review and meta-analysis of more than 1700 cases determined that patients with a decreased lumbar lordosis have significantly higher levels of lumbar disc herniation and LBP. Chun, Se-Woong et al. The relationships between low back pain and lumbar lordosis: a systematic review and meta-analysis. The Spine Journal , Volume 17 , Issue 8 , 1180 – 1191
3.A study of more than 300 adult patients found that both hypo- and hyper-lordosis correlate with DJD in the lumbar spine. Murray KJ, Le Grande MR, Ortega de Mues A, Azari MF. Characterisation of the correlation between standing lordosis and degenerative joint disease in the lower lumbar spine in women and men: a radiographic study. BMC Musculoskeletal Disorders. 2017;18:330.
4.Weakness of the deep neck flexors is a known contributor to chronic neck pain, particularly cervicogenic headaches and cervicogenic vertigo. A systematic review confirmed that low-load craniocervical flexion exercise is highly effective for improving deep cervical flexor muscle impairments in these patients. Amiri AS, et al. The Effect of Different Exercise Programs on Size and Function of Deep Cervical Flexor Muscles in Patients With Chronic Nonspecific Neck Pain: A Systematic Review of Randomized Controlled Trials. Am J Phys Med Rehabil. 2017 Aug;96(8):582-588.
5.In a small study of patients with cervicogenic headache, chiropractic spinal manipulation resulted in decreased headache frequency and intensity with only mild and transient adverse events. Chaibi A, Knackstedt H, Tuchin PJ, Russell MB. Chiropractic spinal manipulative therapy for cervicogenic headache: a single-blinded, placebo, randomized controlled trial. BMC Research Notes. 2017;10:310. doi:10.1186/s13104-017-2651-4.
6.In patients exhibiting a loss of the cervical lordosis, a 12-week home exercise program consisting of isometric cervical extension improves cervical lordosis and reduces pain levels. Alpayci M et. al. Isometric Exercise for the Cervical Extensors Can Help Restore Physiological Lordosis and Reduce Neck Pain: A Randomized Controlled Trial. Am J Phys Med Rehabil. 2017 Sep;96(9):621-626.
7.Regarding cervical spine pain, the definition “acute” should be reserved for the period of 0-4 weeks. Nyirö L, Peterson CK, Humphreys BK. Exploring the definition of «acute» neck pain: a prospective cohort observational study comparing the outcomes of chiropractic patients with 0–2 weeks, 2–4 weeks and 4–12 weeks of symptoms. Chiropractic & Manual Therapies. 2017;25:24. doi:10.1186/s12998-017-0154-y.
8.In patients with neck pain, intermittent cervical traction provides significant immediate relief but little functional improvement or long-term benefit. Yang JD et al. Intermittent Cervical Traction for Treating Neck Pain: A Meta-analysis of Randomized Controlled Trials. Spine (Phila Pa 1976). 2017 Jul 1;42(13):959-965.
9.A randomized clinical trial of patients with shoulder impingement syndrome determined that thoracic manipulation decreased pain and improved scapular upward rotation i.e. lessened the impingement effect of scapular dyskinesis. Haik, Melina N. et al. Short-Term Effects of Thoracic Spine Manipulation on Shoulder Impingement Syndrome. Archives of Physical Medicine and Rehabilitation , Volume 98 , Issue 8 , 1594 – 1605
10.Belief about the relative risk of acute lumbar disc herniation (LDH) resulting from chiropractic spinal manipulation varies by profession. Chiropractors generally fell into a group with the most optimistic views, believing that chiropractic SMT reduces the incidence of acute LDH by about 60%. Family physicians expressed a neutral belief, while orthopedic surgeons comprised the majority of a group with the most pessimistic views believing that chiropractic SMT increases the incidence of acute LDH by about 30%. Hincapié, C.A., Cassidy, J.D., Côté, P. et al. Chiropractic spinal manipulation and the risk for acute lumbar disc herniation: a belief elicitation study Eur Spine J (2017).
11.An electromyographic study confirms that athletes with rotator cuff tendinopathy demonstrate an aberrant patter of scapular movement, i.e. delayed activation of the serratus anterior and lower trapezius. This muscular dysfunction impairs upward rotation of the scapula resulting in further rotator cuff impingement. Leong HT. et al. Rotator cuff tendinopathy alters the muscle activity onset and kinematics of scapula. J Electromyogr Kinesiol 2017 Aug;35:40-46.
Reprinted with permission from Chiro Up