Dr. Glenn Hyman’s Blog

An update on Miss Keri (after the bike crash) and this week’s 1-Page Health News from your Denver Active Release Providers at Denver Chiropractic Center

Miss Keri here at the office wanted to say thanks to everyone for the concern after her “meeting” with the concrete wall while on her bike last week. Her nasty injury required a little attention from a wound care nurse to make sure it doesn’t leave a scar, but she’s on the mend. Once again thanks for your concern.

That last email about her bike crash received the highest open response of any email we’ve ever sent. And here’s this week’s 1-page health news.

Mental Attitude: Meditation. Adults with memory impairment and memory loss may benefit from mantra-based meditation (12 minutes of meditation per day for 8 weeks). Mantra-based meditation has demonstrated a positive effect on patients’ emotional responses to stress, fatigue and anxiety. Findings revealed a substantial increase in cerebral blood flow in the patients’ prefrontal, superior frontal, and superior parietal cortices, and also better cognitive function. Journal of Alternative and Complementary Medicine, March 2012

Health Alert: Diabetics And Stroke. 26 million Americans have diabetes, and more than half are younger than 65. The longer you have diabetes, the higher your risk for stroke. Compared to people without diabetes (after considering other factors such as age, smoking history, physical activity, history of heart disease, blood pressure and cholesterol), the risk of stroke increased 70% in people with diabetes for less than 5 years, 80% in people with diabetes for 5-10 years and three-fold in people with diabetes for 10 years or more. American Heart Association, March 2012

Diet: Seeing Things? Hungry people see food-related words more clearly than people who’ve just eaten. This change in vision happens at the earliest perceptual stages, before higher parts of the brain have a chance to change the messages coming from the eyes. Psychological Science, March 2012 Exercise: Good Reasons. Exercise helps to alleviate low-back pain, helps to reduce the amount of insulin required to control blood sugar levels in Type I (insulin-dependent) diabetics and improves mental alertness. Surgeon General’s Report on Physical Activity and Health, 1996

Chiropractic: Hold Your Head Up! “Head in forward posture can add up to thirty pounds of abnormal leverage on the cervical spine. This can pull the entire spine out of alignment. Forward head posture (FHP) may result in the loss of 30% of vital lung capacity. These breath-related effects are primarily due to the loss of the cervical lordosis, which blocks the action of the hyoid muscles, especially the inferior hyoid responsible for helping lift the first rib during inhalation.” ~Rene Cailliet M.D., famous medical author and former Director of the Department of Physical Medicine and Rehabilitation at the University of Southern California

Wellness/Prevention: Avoid Absenteeism. The US is losing $226 billion per year due to employee absenteeism. A worker is less likely to take sick leave if their supervisor offers support (lightened work load or stress management training) when an employee is experiencing psychosomatic stress symptoms. The worker feels inclined to reciprocate the supportive treatment by keeping their work effort high. European Journal of Work and Organizational Psychology, January 2012

Quote: “Anything is possible. You can be told that you have a 90% chance or a 50% chance or a 1% chance, but you have to believe, and you have to fight.” ~ Lance Armstrong

My review of the Recent Crossfit Endurance, by Dr. Glenn Hyman, Denver Chiropractic Center

So, I’m not sure how it all happened, but I ended up enrolling in the CrossFit Endurance Class at CF CrossFit North Fort Collins a few weekends ago (April 7&8, 2012). I’m not a CrossFit Kool-Aid drinker by any means, so I think I can offer a fairly objective review. I also have a few credentials under my belt, as listed above. So I’ve been around the Strength and Conditioning block…

Anyway, I assume if you care enough to read this post you know what CrossFit is – continually varied strength and conditioning work to basically make sure you’re ready for anything.

Crossfit Endurance (CFE) is an interesting off-shoot of the main movement. In a nutshell, the CFE folks believe that most endurance athletes spend too much time going long and slow – running slowly, riding slowly etc. They advocate basing marathon, triathlon and other endurance training on shorter and more intense intervals with occasional forays into longer outings.

So I show up for class on Saturday morning. We start with the usual 45 wasted minutes of going around the room and having everyone introduce themselves. Personally, I always think this is a huge waste of time as who gives a sh*t anyway? After that we get a basic overview of the CFE approach.

The lecture is interesting as it contrasts traditional long-slow base training with CFE’s keep in intense rationale. Since their approach is really at odds with the mainstream of the endurance world, it is interesting to see them lay out their view point. They do admit that no pros are training their way. They also admit that they have no scientific studies to back them up. (And let’s face it, NONE of the so-called research in the strength and conditioning world is actually scientific, right?) So I can roll with that.

If I understand correctly, the idea is something along these lines- don’t sacrifice your strength, power, agility, etc to go long. Don’t become skinny and weak. Maintain your other skills while also training to go long. I’m willing to try this for this racing season and see what happens. I’m far from a great triathlete, so I’ve never been in danger of winning anyway. But I do like to be strong, and I’ve never liked how my strength starts dropping as try season progresses.

After an hour of lecture, we go outside to have the instructors film us while we run. We run a few 200′s around the building and then go live for the filming. We will watch this in a few hours to see how bad our form is, and then compare it to more filming tomorrow.

We then move into the technique part of the class. The powers that be behind CrossFit Endurance are into the Pose Method. This is the movement that espouses leaning forward, mid foot striking, blah blah blah. They favor minimalist shoes (almost everyone was wearing Innov8 shoes). So we did drills. And more drills. We heard about efficiency and blah blah blah.

I personally found it a little annoying. Too much time spent on drills and too little on theory. We alternated lie that for the 2 days: an hour lecture, and an hour of drills.

The lectures were interesting. The details behind the planning based on CrossFit strength workouts and interval work was one of the most interesting hours I have ever sat through at a seminar.

All-in-all, I thought the seminar was interesting. I have no idea if they’re on to something here or are just selling something that’s rogue  to be contrarian. I guess we’ll see. Getting inside some of the CrossFit jargon is a bit of a chore, as I had to keep asking “What’s a Chippy?” Or “Can you define MetCon please?” They patiently tolerated me as an outsider and answered all of my questions.

Is it sciatica or Low Back Pain? How can Denver Chiropractic Center help you with Active Release Techniques?

Low back pain (LBP) can be localized and contained to only the low back area or, it can radiate pain down the leg. This distinction is important as LBP is often less complicated and carries a more favorable prognosis for complete recovery. In fact, a large part of our history and examination is focused on this differentiation. This month’s Health Update is going to look at the different types of leg pain that can occur with different LBP conditions.

We’ve all heard of the word “sciatica” and it (usually) is loosely used to describe everything from LBP arising from the joints in the back, the sacroiliac joint, from the muscles of the low back as well as a pinched nerve from a ruptured disk. Strictly speaking, the term “sciatica” should ONLY be used when the sciatic nerve is pinched; causing pain that radiates down the leg.

The sciatic nerve is made up of five smaller nerves (L4, 5, S1, 2, 3) that arise from the spine and join together to form one large nerve (about the size of our pinky) called the sciatic nerve – like five small rivers merging into one BIG river. Sciatica occurs when any one of the small nerves (L4-S3) or, when the sciatic nerve itself, gets compressed or irritated.

This can be, and often is caused from a lumbar disk herniation (the “ruptured disk”).  A term called “pseudosciatica” (a non-disk cause) includes a pinch from the piriformis muscle where the nerve passes through the pelvis (in the “cheek” or, the buttocks), which has been commonly referred to as “wallet sciatica” as sitting on the wallet in the back pocket is often the cause.

When this occurs, the term “peripheral neuropathy” or “ peripheral nerve entrapment” is the most accurate term to use. Direct trauma like a bruise to the buttocks from falling or hitting the nerve during an injection into the buttocks can also trigger “sciatica.”

The symptoms of sciatica include low back pain, buttocks pain, back of the thigh, calf and/or foot pain and/or numbness-tingling. If the nerve is compressed hard enough, muscle weakness can occur making it hard to stand up on the tip toes creating a limp when walking. In the clinic, we will raise the straight leg and if pinched, sharp pain can occur with as little as 20-30° due to the nerve being stretched as the leg is raised.

If pain occurs anywhere between 30 and 70° of elevation of either the same side leg and/or the opposite leg, this constitutes a positive test for sciatica (better termed, “nerve root tension”). When a disk is herniated into the nerve, bending the spine backwards can move the disk away and off the nerve resulting in relief, which is very diagnostic of a herniated disk. Having a patient walk on their toes and then heels and watching for foot drop as well as testing the reflexes, the sensation with a sharp object, and testing the reflexes at the knee and Achilles tendon can give us clues if there is nerve damage.

At our clinic we’ve gone beyond simple traditional chiropractic adjustments to “align the spine.” We use more advanced techniques, like Active Release Techniques to address the pressure that the muscles can exert on the sciatic nerve. We will also use motion-restoring spinal adjustments to restore healthy mobility to the spine. By utilizing these advanced techniques, we are usually able to get excellent results for our patients with low back pain and sciatica in a relatively short period of time.

It all starts with the initial exam. Call us to schedule yours 303.300.0424. We’re here to help you!

Miss Keri’s Bike Crash and This Week’s 1-Page Health News

Our awesome office manager Keri (my kids call her Miss Keri) was run off of the Cherry Creek bike trail and into a concrete half wall this weekend. Another cyclist was going too fast in the other direction, was too far over to his left, and basically forced Keri to choose between colliding with him or scraping the wall.

She chose the wall and this morning is sporting a nasty wound on her right arm. Of course, this guy didn’t bother to stop (maybe he was on his way to do Rocket Surgery). The message- be careful out there. A whole lot of morons are legally loose on our streets.

Of course, Miss Keri is tough as nails and never misses work, so she’s here today- bandaged up & ready to help you.

Here’s this week’s 1-Page Health News.

Mental Attitude: Get Your Sleep! Older adults with poor sleep habits have an altered immune system response to stress that may increase their risk for mental and physical health problems. Stress leads to significantly larger increases in a marker of inflammation in poor sleepers compared to good sleepers; a marker associated with poor health outcomes and death. Poor sleepers report more depressive symptoms, more loneliness and more global perceived stress relative to good sleepers. As people age, a gradual decline in the immune system occurs, along with an increase in inflammation. Heightened inflammation increases the risk for cardiovascular disease, diabetes and other illnesses, as well as psychiatric problems. American Journal of Geriatric Psychiatry, March 2012

Health Alert: Slow Down — You Move Too Fast? People who are considered ambitious, attend the best colleges and universities, have prestigious careers and earn high salaries don’t necessarily lead more successful lives. Ambition has its positive effects (in terms of career success, it certainly does) but ambitious people are only slightly happier than their less- ambitious counterparts and they actually live somewhat shorter lives. Journal of Applied Psychology, March 2012 Diet: Fish Oil. Six weeks of supplementation with fish oil significantly increased lean mass and decreased fat mass in test subjects. International Journal of Sport Nutrition and Exercise Metabolism, October 2010

Exercise: Good Reasons. Exercise helps you maintain proper muscle balance, reduces the rate and severity of medical complications associated with hypertension, helps alleviate menstrual symptoms and lowers your heart rate response to submaximal physical exertion. Surgeon General’s Report on Physical Activity and Health, 1996

Chiropractic: Adjustment or Microdiskectomy for Sciatica? 60% of patients with sciatica (symptoms of unilateral lumbar radiculopathy secondary to lumbar disk herniation at L3-4, L4-5, or L5-S1) who had failed other medical management (patients must have failed at least 3 months of nonoperative management including treatment with analgesics, lifestyle modification, physiotherapy, massage therapy, and/or acupuncture) benefited from spinal manipulation to the same degree as if they underwent surgical intervention. JMPT, October 2010

Wellness/Prevention: Dark Chocolate Good For The Heart. A flavonoid called epicatechin, found in dark chocolate, enhances mitochondria structure in people with advanced heart failure and type 2 diabetes. Mitochondria are cellular structures that provide the energy a cell requires in order to move, divide, and contract. Both heart failure and type 2 diabetes impair these cells, resulting in abnormalities in skeletal muscle. In individuals with diabetes and heart failure, these abnormalities in the heart and skeletal muscle cause decreased functional capacity, resulting in difficulty walking even short distances, shortness of breath, and a lack of energy. Clinical and Translational Science, March 2012

Quote: “Common sense is the collection of prejudices acquired by age eighteen.” ~ Albert Einstein

How to keep your brain healthy- some natural secrets from Denver Chiropractic Center and featured guest Mike Roizen MD…

Repeat the mono mantra. Choosing monounsaturated fats instead of saturated fats for protection against brain damage from silent strokes. So, spread peanut butter (or the more sophisticated walnut, avocado, almond or cashew butter—note, yes we know walnuts have 6 times more omega-3’s than any other nut) instead of cream cheese on some celery or apple slices; olive oil and vinegar instead of Ranch or bleu cheese dressing on your salad; and a small handful (6 to 12 halves) of walnuts and a crunchy apple instead of snacking on chips or ice cream.

Catch some omega-3s, even if you don’t love fish. Three 3-ounce servings a week of non-fried fish rich in omega-3 fatty acids – like salmon, trout, haddock or sardines – can make your brain younger. Not into fin food? Take omega-3 capsules. We like the DHA form of omega-3s (and prefer algae-based supplements to fish oil) and recommend 600 to 900 milligrams a day.  I (Glenn) take 900 mg of DHA omega-3s a day (I actually take a purified fish oil available by prescription). Why so much emphasis on DHA? DHA is the healthy fat your brain needs — it is not a storage fat but a structural fat.   Only 2% of ALA (a healthy omega-3 in avocados and walnuts) makes it to EPA, the omega-3s thought to be healthiest for your heart. Only 2% of EPA goes to DHA.  But, DHA readily goes to EPA, so for the healthiest brain and heart, you want 900 mg of DHA a day. We eat avocados and walnuts too.

Focus on produce for brain-pampering vitamins. Drive-through dining with a multivitamin chaser won’t cut it. Aim to eat a rainbow of brightly-colored produce for your vitamin C. Get your B’s here: B6 from baked potatoes, roasted skinless chicken breast and chickpeas; seafood, yogurt or nutritional yeast for vitamin B12; and folate (yep, it’s in the B family) from spinach, lentils, papayas and asparagus. Add almonds, sunflower seeds, spinach or hazelnuts for your dose of mixed tocopherols (known as the active component of vitamin E). Top it off with a vitamin D supplement (1,000 IU of vitamin D before age 60, 1,200 after).

Enjoy lean, free-ranged (not fatty, feedlot or corn-fed) meats, and watch your sweets white carbs. Limiting these also helps protect your thinking ability.  Treat foods with saturated and trans fats and added simple sugars and syrups like criminals (they are). They steal your memories (and increase your risk of other bad things). Choose grass fed beef (way less artery-clogging saturated fat than corn fed); fruit veggies. Try to minimize grains (you don’t have to completely avoid them, I shoot for no more than 50 grams of carbs a day from grains. Sometimes, a guy just wants a sandwich).

Use Curcumin (or tumaric) as a seasoning spice for food.   Cheap mustard?  Yes, the yellow cheap stuff apparently is made with tumaric to give it taste rather than the more expensive mustard seed.   The amount in an average teaspoon is 17 mg. But, enjoy two to be sure, every day.

Do exercise with (as a bare minimum) 2 minutes of very intense exercise at the end of 30 minutes of walking or whatever a day, if your doc says you can. Impressive new research reinforced exercise’s importance as a secret sauce against Alzheimer’s. The study didn’t just do the usual memory tests. Most of my readers do more than this. It tracked the results against scans of brain sizes. In this case, a bigger brain means a better memory. Try kettlebells or CrossFit, or train for a triathlon.

Neck Pain: Manipulation vs. Mobilization – What’s Better?

Does mobilization (MOB) get less, the same, or better results when compared to spinal manipulative therapy (SMT)? To answer this question, let’s first discuss the difference between the two treatment approaches.

Mobilization (MOB) of the spine can be “technically” defined as a “low velocity, low amplitude” force applied to the tissues of the cervical spine (or any joint of the body, but we’ll focus on the cervical region). This means a slow, rhythmic movement is applied to a joint or muscle using various methods such as stretching.

Spinal Manipulative Therapy (SMT) can be defined as a “high velocity, low amplitude” type of force applied to joint which is often accompanied by a audible release or “crack,” which is the release of gas (nitrogen, oxygen, and carbon dioxide).

Some joints “cavitate” or “crack” while others are less likely to release the gas. Studies that date back to the 1940s report an immediate improvement in a joint’s range of motion occurs when the joint cavitates. Many people instinctively stretch their own neck to the point of release, which typically, “…feels good.” This can become a habit and usually is not a big problem. However, in some cases, it can lead to joint hypermobility and ligament laxity.

As a rule, if only a gentle stretch is required to produce the cavitation/crack, it’s typically “safe” verses the person who uses higher levels of force by grabbing their own head and twisting it beyond the normal tissue stretch boundaries. The later is more likely to result in damage to the ligaments (tissue that strongly holds bone to bone) and therefore, should be avoided.

Since SMT is usually applied in a very specific location (where the joint is fixated or “stuck”, or, partially displaced), it’s obviously BEST to utilize chiropractic, as we chiropractors do this many times a day (for years or even decades) and we know where to apply it and can judge the amount of force to utilize, especially the neck where there are many delicate structures.

Back to the question: Which is better, MOB or SMT? Or, are they equals in the quest of rid of neck pain? A recent study of over 100 patients with “mechanical neck pain” (strain/sprain)  showed that those who received SMT had a significantly better response than the MOB group as measured by a pain scale, a disability scale and 2 tests that measure function!

In our clinic (Denver Chiropractic Center) we’ve found that the best approach uses BOTH. Mobilization in the form of Active Release Technique combined with safe and gentle (never forced) adjustments get better results in a shorter time frame. It all starts with the initial exam, so call us to schedule yours – 303.300.0424.

A weekend immersed in CrossFit Endurance & The 1-Page Health News For You

I (Glenn) am back in the office after a week stay-cation in Denver. We spent a day at the zoo, a day at the Rockies game, and I got a lot of riding and running in.

Two weekends ago, I (Glenn) completed the CrossFit Endurance certification class in Fort Collins. It was a very interesting introduction to a different methodology for training for endurance sports, like triathlons and marathons. Think: less volume and more intensity.

Anyway, I’m completing the Level 1 CrossFit certification in May, and then soon after will be holding classes at Colorado Kettlebell Club. Stay tuned for more info.

Mental Attitude: Music and Emotions. Music can evoke positive emotions, which in turn can lower stress levels. In a survey study, positive emotions were experienced more often and more intensively in connection with music listening. The more the participants liked the music, the less stress they experienced. To get the positive effects of music, you have to listen to music you like. University of Gothenburg, March 2012

Health Alert: Slow Brain Growth In Babies Linked To Depression During Pregnancy! Many women experience a roller coaster of emotions during pregnancy: stress, confusion, fear, sadness and depression. Babies whose mothers are depressed during pregnancy have a greater chance of growing slower, resulting in the head and body showing retarded growth. Also, antidepressants increase the risk of slow growth in the development of babies’ brains. Archives of General Psychiatry, March 2012 Diet: High-Fat Diets Increase Colon Cancer Risk. Eating too much fat and sugar puts a person at greater risk for colon cancer and obesity. In normal tissue from patients with colon cancer, they found that epigenetic marks on genes involved in breaking down carbohydrates, lipids and amino acids (abundant in the fatty Western diet) appeared to have been retrained. Epigenetic marks are chemical modifications that serve as on/off switches for many genes. These foods are changing the methylation patterns on a person’s insulin genes so that they express differently, pumping out more insulin than the body requires. Cancer Prevention Research, March 2012

Exercise: Exercise Linked To Change In DNA. Exercise almost immediately alters DNA in healthy but inactive men and women. Although the genetic makeup is not altered, DNA molecules change structurally and chemically when a person exercises. One researcher noted, “Our muscles are really plastic. We often say ‘You are what you eat.’ Well, muscle adapts to what you do. If you don’t use it, you lost it and this is one of the mechanisms that allow that to happen.” Cell Metabolism, March 2012

Chiropractic: Is Chiropractic Safe? YES. Chiropractic’s non-surgical, drug-free approach to health places it among the safest of all health care practices. Remember, chiropractic takes nothing out of the body and puts nothing in. As a result, chiropractors enjoy one of the lowest malpractice rates of all health care professionals. Massachusetts Chiropractic Association

Wellness/Prevention: How Much Selenium? While too much selenium may result in the development of type 2 diabetes, high selenium intake has been shown to protect against certain cancers, such as lung, colorectal, bladder, and prostate cancer. It also increases male fertility and has positive effects on antiviral function. Low selenium intake has been linked to memory and brain decline, low immune system quality, and a greater risk of death. The Lancet, March 2012 Quote:

“The main goal of the future is to stop violence. The world is addicted to it.” ~ Bill Cosby

Carpal Tunnel Syndrome treatment at Denver Chiropractic Center – How can our Active Release Techniques (ART) treatment help you?

Carpal Tunnel Syndrome (CTS) is a very common problem. The American Association of Orthopedic Surgeons (AAOS) reported that in 2007, there were 330,000 carpal tunnel release surgeries performed. (WHOA!) The main reason to have the surgery is to “open up” the tunnel. That is, the transverse carpal ligament or “floor” of the tunnel is released so the contents inside the tunnel are able to move more freely, reducing the pressure inside the tunnel.

Essentially, this is the goal of any treatment (surgical or not): improving the depth of the tunnel, thus reducing the pressure from inside the tunnel allowing the tendons to slide better as the muscles on the palm-side forearm contract to move the nine tendons that pass through the tunnel and attach to the fingers and thumb.

However, there are non-surgical methods for reducing the pressure within the tunnel that should be first attempted as surgery is always reported to be the “…last resort” for good reason. There can be surgical complications, the effects may be only partial, and there is an average of 30% grip strength loss following the transverse ligament surgical release. So, the question is, how can chiropractic approaches reduce the pressure inside the carpal tunnel without somehow changing the length of the transverse carpal ligament?

By going beyond traditional chiropractic care and using Active Release Techniques (ART), we can often release the transverse carpal ligament by hand, taking pressure off of the nerve and relieving symptoms. We can also address possible muscular entrapment sites for the median nerve, like the pronator teres muscle. These muscular entrapments mimic Carpal Tunnel Syndrome, but can be easily released with ART treatment. In the last 15 years, we’ve helped literally hundreds of patients avoid carpal tunnel surgery by using Active Release Techniques. We don’t claim to have a 100% success rate, as some cases do require surgery. But we believe it’s best to try us first and see what we can do.

The use of a night splint to keep the wrist in a straight or slightly “cocked-up” position is also highly beneficial as the pressure inside the tunnel goes up as much as 6-8x when CTS is present when the wrist bends.

If you, a friend or family member require care for CTS, we would be happy to help. Just call 303.300.0424 to set up your first appointment.

This week’s 1-page newsletter from the Chiropractors @ Denver Chiropractic Center

I don’t know about you, but I love spring weather here. On Sunday I was slaving away in the heat hauling dirt out of the garden, and today I needed boots to get through the parking lot. Ah, spring. Love it.

As outdoor sports season is ramping up, just remember we’re here for you if something starts hurting. If you happen to ride the Cherry Creek Trail you may see the Denver Chiropractic Center bike jersey, so make sure you say hi!

I (Glenn) will be on vacation next week, so if you’ve been thinking about coming in, give us a call. Dr. Stripling will be here covering for me next week (and seeing his patients as well). My kids are in a year-round school, so they get a 3-week spring break. Can you imagine?

And here’s this week’s health news for you. 


Mental Attitude: Memory and Stress. Anyone who has ever experienced chronic stress knows it can take a toll on both your emotions and your ability to think clearly.Researchers have discovered a neural mechanism that directly links repeated stress with impaired memory. This study also provides critical insight into why stressresponses can act as a trigger for mental illnesses. Neuron, March 2012

Diet: Rosemary Essential Oil On My Mind? Blood levels of a rosemary oilcomponent correlate with improved cognitive performance. Results indicate, for thefirst time in human subjects, that concentration of 1,8-cineole in the blood is relatedto an individual’s cognitive performance, with higher concentrations resulting inimproved performance. Both speed and accuracy were improved, suggesting thatthe relationship is not describing a speed-accuracy trade off. Therapeutic Advancesin Psychopharmacology, March 2012


Exercise: Yoga And Stress. Yoga may be effective for stress-related psychologicaland medical conditions such as depression, anxiety, high blood pressure andcardiac disease. The theory could be used to develop specific mind-body practicesfor the prevention and treatment of these conditions in conjunction with standardtreatments. Medical Hypotheses, March 2012


Wellness/Prevention: Irregular Heartbeat? An irregular heartbeat, atrial fibrillation, is a strong predictor of cognitive decline and the loss of independence in daily activities in older people at risk of cardiovascular disease. This is just another good reason to maintain your heart health and get checked to prevent heart problems. (note – Glenn will have more to say about heart health soon, having just found out his cholesterol was 259 and some early plaquing has developed in his left carotid artery.) Canadian Medical Association Journal, March 2012


Quote: “The more serious the illness, the more important it is for you to fight back,mobilizing all your resources – spiritual, emotional, intellectual, and physical.” ~Norman Cousins

Maintenance Care for Chronic Low Back Pain

When people think of chiropractic, they immediately think of low back pain and are often surprised to find out that chiropractic can benefit many conditions such as carpal tunnel syndrome, tennis elbow, rotator cuff tears, as well as hip, knee, and ankle conditions.  There is also research support for manipulation (a key component of chiropractic) and its role in managing “somatovisceral” related conditions such as pneumonia, dizziness, stage 1 hypertension, PMS, asthma, colic, and bed wetting.

Research clearly shows that chiropractic manipulation out performs other forms of treatment for acute, subacute and chronic low back pain. But, the question remains, can “maintenance chiropractic” PREVENT problems down the road? Ironically, two medical doctors in August of 2011 published an article in a leading medical journal (SPINE) entitled, “Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcome?” The study’s objective was to determine if treating chronic low back pain patients (pain >6 months) after a course of 12 treatments in the first month would do better, the same or worse if treatments were continued at 2-week intervals for an additional 9 months. They compared 3 groups of patients: 1.) 12 treatments of “sham” (placebo) manipulation over a 1-month period. 2.) 12 treatment of “real” spinal manipulative therapy (SMT) for 1 month but no treatments for the subsequent 9 months. 3.) The same as #2 but with treatments every 2 weeks over the next 9 months. To determine the differences between these 3 groups, the authors measured pain and disability scores (using questionnaires), generic health status (questionnaire), and back-specific patient satisfaction (questionnaire) at 1, 4, 7 and 10-month intervals.

The results showed that groups 2 (SMT for 1 month only) and 3 (SMT for 1 month + every 2 weeks for 9 months) had significantly lower pain and disability scores than the 1st group (sham/placebo group) at the end of the 1st month or, 12 visits. However, only group 3 (treatments were continued for 9 months at 2 week intervals) showed more improvement in pain and disability scores at 10 months. Equally important, the scores for the non-maintained group 2 patients returned to near their pre-treatment levels by month 10!

The authors concluded that not only is spinal manipulative therapy effective for chronic low back pain, but more importantly, REGULAR ADJUSTMENTS EVERY 2 WEEKS after the initial course of concentrated care (3x/week for 4 weeks) was needed, “…to obtain long-term benefit,” suggesting that, “…maintenance SM after the initial intensive manipulative therapy,” is appropriate care to obtain long-term results.

This study FINALLY supports the recommendations made by chiropractors for many years –regular adjustments are beneficial to obtain a higher quality of life, less pain and less disability! While this study didn’t include Active Release Technique, we have observed that combining ART with adjustments is much more effective than adjustments alone. If you’re dealing with back pain, call us. We can help 303.300.0424.