Archive for the 'Low back pain' Category


Spotlight on Massage and Lower Back Pain

According to the National Institutes of Health, lower back pain is the second most common form of chronic pain after headaches. Expertssirene tropicale estimate that approximately 80% of Americans will seek help for low back pain at some point during their lives. Public health officials and insurers estimate that Americans spend $50 billion each year on treatments that are often ineffective. The standard treatment for lower back pain is to take muscle relaxants, painkillers or anti-inflammatory medications, along with physical therapy and back exercises. However, few medical interventions relieve pain reliably, and continuing to take painkillers on a long-term basis is not advised. Massage, on the other hand, has been found to be an effective way of dealing with back pain on a regular basis.

Treatment for lower back pain accounts for approximately a third of all visits to a massage therapist. A study published in the Annals of Internal Medicine found that patients suffering from lower back pain of unknown origin were helped more by massage than by conventional medical treatment. Of 401 total study participants, 133 received traditional medical care with no massage, 132 received structural massage (which addresses particular muscular and skeletal structures that cause pain) and 36 received relaxation massage (a general form of massage, such as Swedish, intended for overall relaxation).

Participants in the massage groups received one hour-long massage once a week for 10 weeks. All participants completed a questionnaire at the beginning of the study, then again at 10 weeks, 24 weeks and a year after the beginning of the study to report on their perceived pain. Both kinds of massage groups reported greater pain relief and ease of motion after 10 weeks of treatment than the medical group.

An average of 37% of the patients in the massage groups reported that their pain was almost or completely gone, while only 4% of the usual care group reported similar results. This was also the case at 26 weeks. However, at the one-year mark, the benefits to all groups were about equal. The type of massage used did not seem to matter, with both massage groups experiencing comparable levels of pain relief. The massage groups were less likely to report having used medication for their back pain after the 10 weeks of intervention, and they also reported having spent fewer days in bed and had lost fewer days of work or school than those in the usual care group.

Dr. Richard A. Deyo, professor of family medicine at Oregon Health and Science University in Portland says of the study, “I think this trial is good news in the sense that it suggests that massage is a useful option that helps some substantial fraction of these patients. Like in most other treatments, this is not a slam dunk, and it’s not like a cure, but it’s something that seems to offer a significant benefit for a substantial number of patients.” Deyo sees massage as a way of people being able to break out of the pain-inactivity cycle. He notes, “I don’t see massage as the final solution, I see it as maybe a helpful step toward getting people more active.”


Dr Dubois, DC, CCSP

Pierre DuboisDr. Dubois, a Swiss physician, and a Triangle Certified Sport Chiropractor has over 20 years of experience in the treatment and prevention of disorders of the musculoskeletal system. Amongst his patients, two world champions in martial arts (gold medalists in 2005 WMJA), one carrier of the Olympic flame in 2004, and numerous soccer players, swimmers and athletes of all levels who benefited from his chiropractic care.


Is Chiropractic Safe During or After Pregnancy?

Low back pain is a common complaint among pregnant and post-partum women due to the extra weight they carry during the nine months of gestation.   For this reason, it is not at all surprising that many pregnant women and new mothers seek chiropractic treatment to relieve their discomfort.  However, we believe that women who are expecting or who have recently given birth should seek the advice of their physician anytime they are considering any sort of medical treatment at this point in their lives.  Chiropractic care is no different.

What does science have to say about the safety of chiropractic adjustments for women before and after having a child?  Three North American chiropractors reviewed the literature to look for evidence of adverse reactions to spinal manipulation therapy (SMT) in both pregnant and post-partum women (post-partum here being defined as up to six weeks following childbirth).  In their research, they identified two appropriate review articles and five study papers.  Four of these papers were case reports and the fifth was a cohort inquiry.

The four case reports all detailed some adverse effects in pregnant and post-partum women following SMT.  Reported complications following treatment included memory loss and cerebellar problems, serious circulation difficulties (blood clots and blocked arteries), swelling, neck pain and numbness.  Two of the reports also listed hematomas among the observed side-effects.

The cohort study reported that only three of 78 pregnant and post-partum patients described any form of adverse reaction to SMT.  In all three cases, the adverse reaction was an increased level of pain, which resolved in less than one week with no additional complications.  Both of the review articles noted the general absence of reported adverse effects following spinal manipulation carried out on pregnant and post-partum women.

Given the number of pregnant and post-partum patients treated by chiropractors, it is reasonable to conclude that the low number of reports of adverse reactions indicates that SMT is likely safe to perform on women in this condition.  Although there may be a number of unreported post-treatment complications, this seems unlikely.  It is also worth adding that spinal manipulation in patients outside of this treatment group may also infrequently cause increased levels of pain and other issues.  The relatively low number and severity of post-treatment problems observed in the cohort study also add weight to the overall argument in favor of the safety of SMT during and immediately following pregnancy.

Provided that SMT is performed within the usual therapeutic guidelines, the existing evidence suggests that the benefits of reduced pain and a potentially easier delivery are likely to outweigh the risk of complications for pregnant and post-partum women.  While additional studies (and improved reporting of problems following treatment) would be beneficial, there is no reason to believe that future findings will contradict the overall conclusion that SMT is safe to carry out on pregnant and post-partum patients.

Dr. P. Dubois, DC, CCSP

  Dr. Dubois,a Swiss physician, and a Triangle Certified Sport Chiropractor has over 20 years of experience in the treatment and prevention of disorders of the musculoskeletal system.Amongst hispatients, two world champions in martial arts (gold medalists in 2005 WMJA), one carrier of the Olympic flame in 2004, and numerous soccer players, swimmers and athletes of all levelswho benefited from his chiropractic care.

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