Lower Extremity Injuries: Know the Risks

That pain in your knee is often what doctors call patellofemoral pain syndrome (PFPS). Simple activities such as running, jumping, or going up and down stairs can contribute to knee pain, which means that most of us will eventually suffer from some form of PFPS.

It has been suggested that PFPS can be relieved by sufficient stretching and lengthening of tight structures around the patella (the kneecap). A study in the Journal of the Neuromusculoskeletal System investigated this potential intervention in 30 patients with PFPS.

Patients were divided into two groups: The first group received “patella mobilization” (extension of the knee with pressure and movement applied for 10 minutes, followed by patellar adjustment in the direction of restricted movement); the second group received detuned ultrasound as placebo (five minutes of ultrasound, but with the intensity set at zero).

Patients receiving mobilization had positive improvements in PFPS symptoms compared with the placebo group. The authors note that this type of conservative care may be useful when combined with other treatment options such as exercise, orthotics and activity modification. If you’re suffering from knee pain and would like to know more about nonsurgical approaches to relieving your pain, contact your doctor of chiropractic.


Rowlands BW, Brantingham JW. The efficacy of patella mobilization in patients suffering from patellofemoral pain syndrome. Journal of the Neuromusculoskeletal System 1999: Vol. 7, No. 4, pp142-49.

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Life Can Be a Pain without Chiropractic

That pain in your knee is often what doctors call patellofemoral pain syndrome (PFPS). Simple activities such as running, jumping, or going up and down stairs can contribute to knee pain, which means that most of us will eventually suffer from some form of PFPS.

It has been suggested that PFPS can be relieved by sufficient stretching and lengthening of tight structures around the patella (the kneecap). A study in the Journal of the Neuromusculoskeletal System investigated this potential intervention in 30 patients with PFPS.

Patients were divided into two groups: The first group received “patella mobilization” (extension of the knee with pressure and movement applied for 10 minutes, followed by patellar adjustment in the direction of restricted movement); the second group received detuned ultrasound as placebo (five minutes of ultrasound, but with the intensity set at zero).

Patients receiving mobilization had positive improvements in PFPS symptoms compared with the placebo group. The authors note that this type of conservative care may be useful when combined with other treatment options such as exercise, orthotics and activity modification. If you’re suffering from knee pain and would like to know more about nonsurgical approaches to relieving your pain, contact your doctor of chiropractic.

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On-the-Job Back Pain Isn’t Going Away

Lifting boxes, pushing brooms, reaching for files, carrying supplies — is it any wonder that so many people suffer from job-related low back pain? No matter what your occupation, back pain can make your life miserable at any time. But how big is the problem?

To answer that question, researchers analyzed claim data from three major sources: the Washington State Department of Labor and Industries; the Bureau of Labor Statistics; and a national workers’ compensation provider, over a period of 4-9 years. Results indicated that low-back pain claim rates decreased by 34% from 1987-1995, and claim payments declined by 58% over the same time period. But the problem isn’t going away, either. Just look at these numbers:

  • $8.8 billion was spent on low-back pain workers’ compensation claims in 1995.
  • Nearly two out of every 100 privately insured workers filed a low-back pain claim in 1995.
  • Payments for these claims accounted for almost a fourth (23%) of the total workers’ compensation payments in 1995.

So if you think you can avoid low back pain at the workplace, just look at these numbers, and think again. Better yet, help continue the decline in low back pain cases by getting regular adjustments from your doctor of chiropractic.


Murphy P, Volinn E. Is occupational low back pain on the rise? Spine, April 1, 1999: Vol. 24, No. 7, pp691-697.

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Exercise Improves More Than Just Your Physical Health

We all know about the profound physical health benefits consistent exercise brings, but let’s not overlook the mental side of things. Exercise in moderation also has mental benefits, a point emphasized by findings in a study appearing in a recent issue of The Lancet Psychiatry.

Researchers analyzed data provided by 1.2 million U.S. adults as part of the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS) surveys conducted in 2011, 2013 and 2015. The telephone surveys are used to collect information on “health-related risk behaviors, chronic health conditions, and use of preventive services.” With more than 400,000 interviews each years, the BRFSS is the world’s largest continuously conducted health survey, according to the CDC.

In analyzing three years of data, the researchers determined that U.S. adults who reported exercising also reported experiencing 43 percent fewer “poor mental health” days in the previous month compared to non-exercisers. A “poor mental health” day was defined as a day in which the person experienced stress, depression and/or difficulty with emotions.

Now here’s where it gets interesting. Researchers also found that the best mental health was achieved with 45-minute exercise sessions, three to five times a week; but exercising for more than three hours a day actually worsened mental health status. What’s more, the strongest association between exercise and mental health was noted for people who played team sports (22 percent lower burden), cycling (22 percent) and other aerobic and gym activities (20 percent). And the exercise didn’t need to be at a gym or on a team; even doing chores around the house reduced “poor mental health” days by 10 percent compared to non-exercisers.

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Perfect Your Posture, Improve Your Health

Ever try balancing a book on your head (for more than a second)? To do it, you need more than just patience; you need ideal posture.

One hundred and thirty thousand years ago, when residents of the planet possessed complete Neanderthalic characteristics, posture wasn’t really that high on the list of health priorities, to say the least. At the time, we assume finding food, surviving the seasons and avoiding death by all manner of creatures were considerably more important. But this is 2011 and we can stand upright, walk upright and consider our health a precious asset. And yet, like the Neanderthals, our apparent disinterest in good posture remains.

Why is good posture so important? It’s pretty simple. When the spine is properly aligned with its natural curvature and the entire body – from the ears to the shoulders to the hips, knees and down to the ankles and feet – is in balance, we maximize spine health and avoid poor posture-related pain and dysfunction. Ideal posture creates ideal balance; it also optimizes breathing and circulation. And shouldn’t we all want to achieve that?

girl with books - Copyright – Stock Photo / Register MarkMay is National Correct Posture Month, so we thought it was high time to get you out of your slumped, bent-back, round-shoulders position that is likely all too common if you work at a computer, spend considerable time texting or checking e-mail on your cell phone (who doesn’t these days?), or engage in any of the countless activities that put your back, neck and spine at risk courtesy of poor posture. It’s time to stand tall, walk tall and improve your spinal health, all at the same time!

For tips on the best ways to perfect your posture, look no further than Straighten Up America, a health promotion initiative developed in 2005 with an admirable vision: to educate the public about the importance of good posture and spinal health, to the point that “every American will take two or three minutes every day to care for their spinal health, just as they care for their dental health.” Straighten Up, which partners in promoting the nation’s health with the President’s Council on Physical Fitness and Sports, is designed to get children and adults up and moving while they improve their posture and spinal health. The Straighten Up program also includes healthy lifestyle recommendations congruent with the goals and objectives of Healthy People 2010, America on the Move, Steps to a Healthier US and the 5 A Day programs.

One of the earliest tests of this program proved quite encouraging: After five weeks of daily practice of “Straighten Up” exercises, more than 80 percent of participants reported improved posture; just under 80 percent said they had strengthened their core muscles; and 80 percent reported that after performing the exercises, they now sat and stood more upright, and their backs felt more comfortable in that position.

The butterfly - Copyright – Stock Photo / Register MarkAre you and your family ready to perfect your posture? Here are a few Straighten Up exercises; to download the complete list and for more information, visit www.straightenupamerica.org.

tilting star - Copyright – Stock Photo / Register MarkThe Butterfly: Standing and with head held high, belly button in, place your arms behind your head and gently pull your elbows backward. Slowly and gently press your head against your hands while counting to two. Relax, breathe, and repeat three times.

Tilting Star: With head high and belly button in, spread your arms and legs into a star. Breathe in and slowly stretch one arm over your head and slide your opposite arm down your leg. Slowly tilt your star to the opposite side. Relax. Repeat two times.

twirling star - Copyright – Stock Photo / Register MarkTwirling Star: In the star position (hands and legs forming a star; see Tilting Star description), turn your head to look at one hand. Slowly twist your entire spine to watch your hand as it goes behind you. Relax and repeat (each side) two times. Keep your head high, belly button in.the hummingbird - Copyright – Stock Photo / Register Mark

The Hummingbird: With head high and belly button in, put your arms out to the sides with your hands up and pull your shoulders together in the back. Now make small, backward circles with your hands and arms. Bend at your waist from side to side, keeping the circles going as you count to 10.

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Self-Care for Back Pain: Exercises to Help the Healing Process

When it comes to back pain, your first thoughts may be to take over-the-counter pain medication and rest whenever possible. Two bad options. First, medication is only going to temporarily relieve the pain, if at all, and may be accompanied by various unpleasant side effects attributable to drugs. Second, rest may actually hurt more than help. While you’re seeing your chiropractor, there are a few things you can do at home to help the healing process. Believe it or not, it’s based on the simple principle of movement.

Whenever I see a patient with back pain, I always ask, “What do you do when you are in pain? What exercises help your pain?” I am continually surprised that very few patients know what self-care to do when they have an acute episode of pain. That includes motivated patients and patients I have seen before and carefully shown the right exercises. Maybe it is because when you hurt, you stop thinking clearly; or maybe it is fear that the pain will get worse. Both are valid excuses. Most of them just rest, ice the area, and use non-steroidal anti-inflammatory drugs (without realizing that NSAIDs actually block healing). Many of them say, “I hurt too much to exercise.”

Why Movement Matters

Lady having backpain - Copyright – Stock Photo / Register MarkThe problem with this is that when you stop moving, when you are still, everything tightens up, circulation slows down, and pain chemicals accumulate in your muscles and joints. It’s like waking up after sleeping in a cold room on a lousy mattress with a draft. If you get moving, you’ll typically start to feel better.

So, here’s the number-one rule to remember: Don’t stop moving when you hurt. I know, you are in pain and afraid to move, and sudden movements may cause your back to “grab” or spasm. I am not telling you to ignore the pain. What I am saying is that you need to find movements that will ease your pain. In many cases, the most important thing to do when you hurt is to keep moving. The body often tightens up and limits your motion. If you find a motion that doesn’t hurt you, it will probably help you. When you are hurting, you may not be able to do your usual activities, but you must keep moving. Try walking slowly, especially on flat and even ground. Try walking up a hill (you can walk up a hill without walking down, on a treadmill). Try swimming or simple motions in chest-deep water. Try basic pelvic tilts, staying within a pain-free range.

Here are some basic principles. The movement should be pain free (or at least cause minimal pain while being performed). When you have finished doing the exercise, your pain should be somewhat diminished. You should feel that you can move more freely. Your back should feel straighter and less “kinked.”

Backward bending - Copyright – Stock Photo / Register MarkBackward bending is a great exercise when you’re suffering from low back pain. Start on the floor or other stable surface (top picture), then slowly raise your upper body up while keeping your lower body stationary (bottom picture). The final step involves extending your arms up (much like a push-up).Basic Exercises for Low Back Pain

Here are two basic examples of self-care exercises that have stood the test of time. Many of my patients have found variations on these and other types of movements that act as “reset” buttons for their typical pain. You are the one living in your body; you are the most likely one to know what is working for you.

Lower back diagnosis is often very difficult and confusing. For the sake of this article, let’s divide low back pain exercises into two categories: exercises that make your back feel better when you bend backward, and exercises that make your back feel better when you bring your leg toward your chest.

Backward Bending (extension of the lumbar spine). An exercise called the McKenzie extension is the first thing you should try if you have sciatica (pain running down your leg). If these exercises work, your pain will diminish and may centralize, which is a good thing. Centralize means your pain goes less far down your leg, and you may feel it closer to the spine. Bending backward may not feel good at first, but you should feel better immediately afterward. If you feel worse afterward or the pain goes farther down your leg, stop, as this is not the exercise for you.

How to Do It: Lie face-down on the floor, arms bent at your sides (sort of like a starting push-up posture). Straighten your arms up slowly, lifting your upper body off the floor as you do so. Your legs and feet should stay on the ground. Hold for 3-5 seconds, then slowly lower your upper body back down. Repeat 10 times, as often as once per hour.

If your pain or restriction is on one side, a variation on McKenzie extension (lying on a raised surface with one leg on the floor, slightly bent) may be more comfortable (keep the elevated leg straight).

Flexion Exercises (bringing the leg toward the chest). People with lower back pain can also feel better with various types of leg flexion, bringing the bent leg toward the chest, or doing contract-relax and then bringing the bent leg toward the chest. These people usually have sacroiliac joint problems. (The SI joints are located on either side of the spine in the lower back.) These are also called Tigny exercises.

How to Do It: Lie on your back with one leg bent and then other flat on the floor. Bring the bent leg up toward the chest. Wrap your arms around the leg and then try to lower it toward the floor for 3-5 seconds, resisting with your arms. Relax, and then pull the bent leg up farther toward the chest. Repeat the entire process three times.

Flexion exercises - Copyright – Stock Photo / Register MarkFlexion exercises are another great way to relieve lower back pain. Lie on your back with one leg bent and the other leg flat on the floor. Raise the bent leg toward the chest, wrap your arms around the bent leg, and then try to lower it toward the floor as you resist with your arms.Repeat with the opposite leg.I have included a series of links at the end of this article; the first two go to videos describing the basics of McKenzie extension. The third one goes to an article I wrote describing the basic McKenzie extension exercise, and a couple of other variations. The fourth link goes to Dr. Craig Liebenson’s site, LA Sports and Spine, where you can download his article and pictures on McKenzie self-treatment for sciatica. The fifth and sixth links relate to the Tigny flexion exercises, including a one-minute video demonstration.

So, here is the bottom line: When your lower back starts to hurt, find one or more simple movements or exercise that helps. Do the exercise over and over until you are back to normal. If you are not getting better quickly, call your chiropractor.

With that said, please use common sense. Stop immediately is you hurt more during or after doing any exercise. Exercise is not without risks. These or any other exercises may cause pain or injury. As with any exercise program, if at any point during your routine you begin to feel faint, dizzy, or have physical discomfort, you should stop immediately. To reduce your risk of injury, consult with your doctor before doing these exercises for the first time, particularly if your pain is new and/or you would like further explanation of how to perform the exercises correctly.

By Marc Heller, DC

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Take the Isometric Challenge

Has your workout program been in a downward spiral lately? Have you been doing less and less physical activity? Are the once pain-free activities now causing increased pain? If so, you might want to resume your workouts with isometric exercise.

You are probably more familiar with isometric exercises than you think. If you play sports or do any movement that involves changing directions, that in-between change-of-direction time, no matter how brief, requires an isometric contraction. If you are familiar with doing biceps curls with a dumbbell, each time you hold the weight at the top or the bottom of the movement, you are performing an isometric contraction. You change from one muscle contraction type to the other, but the “hold” portion of the exercise is an isometric contraction. The fun thing about isometrics is that you can hold the contraction for only 5-6 seconds or you may hold it for 30 seconds, a minute, 2 minutes, etc. The length of the “hold” plays a very important role in strengthening.

Isometric contractions help improve body awareness, posture, movement and strength. Isometrics produce muscle contractions, but you are not moving an arm or a leg or the trunk while performing isometrics. It’s a static “hold it” position. You can make the sensation of the contraction effort really hard, hard, or a little hard. Holding a yoga pose is a good example of a static “hold it” position. Your own body-weight acts as the resistance.

isometrics exercise - Copyright – Stock Photo / Register MarkJust lean against a wall with both hands, push against the wall and you will cause an isometric contraction in the arms and torso. When you press the palms of your hands together in front of your body, you will feel the muscle tension in the chest. Lifting a heavy object or free weight (dumbbell), or holding the weight stack in a machine at a certain level or height, will cause an isometric contraction.

In my chiropractic practice, I like using isometric exercises for improving posture and developing initial strength. If you are just beginning a workout program, coming off an injury, or can’t make it to the gym where weights or weight machines are available, doing isometrics will provide some progress in your training. If you feel muscle weakness or have had the experience of getting injured when you start to work out, and/or you get easily injured when working out, isometrics can help prevent injury.

Gaining Strength in All The Right Places

Have you ever watched someone have a hard time standing up and getting out of certain chairs or couches? This suggests a need to strengthen the legs (quadriceps) and stabilize balance. If I see a person having difficulty getting out of a chair, using the arms to climb up, then gaining strength back in the legs is a priority. To perform a “get up out of a chair,” your legs produce most of the force. The momentum must be transferred through a stable trunk to the upper body.

You can perform an isometric exercise to strengthen the legs by duplicating the position of getting out of a chair. To do this, stand against a wall with your feet facing straight ahead. Your hips, upper back and head should be up against the wall. Walk your feet away from the wall approximately 2 to 2 ¼ feet. Bend your knees and start sliding down the wall. Hold this position and keep the weight in your heels. Your lower back should be flush up against the wall. Build up to holding this position for 2 minutes. Holding positions at the angles / stages at which you have the greatest difficulty getting up can help you overcome those sticking points and improve your ability to transition from sitting in a chair to standing up.

No matter your age or level of fitness, certain muscles should constantly be worked. For example, no one wants flabby butt muscles. A simple isometric contraction for flabby butt muscles (gluteals) is the gluteal squeeze. Stand with your feet pointed straight ahead and begin squeezing your buttocks together. Hold for 6 seconds and then release your buttock muscles. Repeat this for 20 repetitions and build up to three sets. Try to relax your upper body, your stomach and your thighs while performing the gluteal squeeze. Placing your hands on your buttock muscles will allow you to feel the contraction. It does not have to be a maximal contraction.

Develop Good Posture Through Isometrics

An isometric exercise for posture is the sitting knee pillow squeeze. Sit in a chair with a pillow between your knees and your pelvis rolled forward to place an arch in your lower back. Keep your feet pointed straight ahead and your body relaxed. Squeeze the pillow for 6 seconds and then release the pillow between your knees. Remember to keep the arch in your low back. Do this 15-30 times.

Additional isometric contractions for posture enhancement involve lying on your stomach on the floor with your forehead and nose flat to the floor. Place your hands straight ahead above your head and elevate (lift) the arms and forearms 4-6 inches off the floor. Squeeze the muscles between the shoulder blades. Make sure you lock your arms out and point your thumbs up to the ceiling, with the movement coming from the shoulders. Move your arms out to 45 degrees (like a “Y” position) and repeat the arm lift and hold. Then move your arms out to 90 degrees and repeat. Keep your hips relaxed so that your heels remain dropped outward.

Isometrics are used on muscles that provide stabilization to the body during other movements. In other words, you must fix your body in a specific position to effectively perform the exercise. For example, in the above exercise, you must stabilize the trunk and lower body so that the shoulder joint and shoulder girdle muscles have a strong base against which to contract.

This usually occurs automatically with contraction of the trunk (rib cage) muscles and holding your breath. In addition, the spinal (midsection) muscles undergo contraction to stabilize the trunk. This is one reason why you see the trunk arching during execution of the exercise. Difficult isometric contractions should be held only for 5-6 seconds at a time.

Other Beginning Isometric Exercises to Try

Sustain Plank (isolates chest and core)

Lie on floor and then get into a “plank position: hold a straight body position, supported on elbows and toes.
Brace the abdominals and set the low back in the neutral position.
Keep back flat and cervical spine in neutral; keep body / torso in alignment.
Build up to holding the plank for 1 minute. Perform two reps.

Supine Gut Contractions

Lie on the floor on your back, feet flat on the floor with the knees bent.
Contract the glutes to create a bridge, elevating off the floor.
Maintain the cervical spine in a neutral position. No low back discomfort and no hamstring cramps.
Build up to holding each squeeze from 10 seconds to 60 seconds. Perform five repetitions.

dumb bells - Copyright – Stock Photo / Register MarkUpper-Body Arm Hangs

Pull yourself up on a chin-up bar while keeping the eyes horizontal to the bar.
Keep hands / wrists in neutral position, elbows at 90 degrees, and avoid body movement (swinging, etc.).
Maintain the position to failure without violating the above rules.

Stability Ball Bridge

ball bridge - Copyright – Stock Photo / Register MarkPlace your head and upper back on a stability ball, torso in a “table top” pose.
Contract the glutes to create a bridge. The muscles recruited should be primarily from the glutes (some abdominals and quadriceps.
There should be no low back discomfort and no hamstring cramps.
As you progress you can lift your head off the ball.
Build up to holding each squeeze from 10 seconds to 30 seconds. Perform five reps.

Take the Isometric Challenge

Whatever the isometric exercise, test yourself for the amount of time you can hold a specific position /pose. You can use free weights, kettlebells, weight machines or elastic tubing. For example, hold a kettlebell weight in your hand with the weight at your side. Your objective is to prevent it from going down or shifting your posture. Your intent is not to move the load (i.e., raise or lower it), but to prevent its movement.

Isometric exercises are an important component of a quality workout, particularly when they are combined with plyometricexercises, which, unlike isometrics, rely on short, quick bursts of speed, power and movement (think jumping, hopping, leaping, skipping, etc.). Your doctor can give you more information on isometrics and plyometrics while outlining a safe, effective workout that’s tailored to your current fitness level and health needs.

muscle - Copyright – Stock Photo / Register MarkThe Advantages of Isometrics

  • An injured or immobilized extremity can be tensed while in a cast or in a splint after the immediate pain has subsided.
  • Ideal for people with little or no exercise experience.
  • Can be used early in a rehabilitation program.
  • Great way to teach proper biomechanics.
  • Can help prevent muscle and strength losses.
  • Achieves maximum muscular contraction and increases strength faster than any other form of training.
  • Gain strength in isolated areas or muscle groups without moving the joints.
  • May increase muscle size and develop more efficient muscle contractions.
  • Works muscle with more intensity in a shorter period of time.
  • Prepares the musculoskeletal system for more advanced activities.
  • Increases neurological strength, recruits more muscle fibers for each movement.
  • Good for enforcing movement patterns (especially in youth).
  • Isometric workouts can be fast and done anywhere.
  • Safer than conventional training (doesn’t involve movement).
  • Dramatically improves conventional training; can increase lifts by as much as 14 – 40 percent!

By Dr. Jeffrey Tucker

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Three Reasons to Choose Chiropractic

When you’re suffering low back pain, shoulder pain or any number of similar musculoskeletal conditions, who gets the call: your medical doctor or your doctor of chiropractic? Your choice of health care provider in those situations could make a big difference, and research is continuing to prove it. According to the latest study, chiropractic care is at least as effective as medical care for certain musculoskeletal conditions, while reducing health care costs and leaving patients more satisfied with the results.

The authors of the study, published in the Journal of Manipulative and Physiological Therapeutics (JMPT), went so far as to state that for certain musculoskeletal conditions, visiting an MD first instead of a DC may actually be a mistake:

“The findings of this study support first-contact care provided by DCs as an alternative to first-contact care provided by MDs for a select number of musculoskeletal conditions. Restrictive models of care in which patients are required to contact a medical provider before consulting a chiropractic provider may be counterproductive for patients experiencing the musculoskeletal conditions investigated and possibly others.”

easy - Copyright – Stock Photo / Register MarkThe study sample included 403 patients who saw medical doctors and 316 patients who saw doctors of chiropractic as the initial health care providers for their spinal, hip or shoulder pain complaint. Four months following care, all patients completed a questionnaire that evaluated pain on that day and four months earlier (11-point scale); satisfaction with care received and the results of that care (5-point scale from “very satisfied” to “very unsatisfied”); and other variables. The researchers evaluated related costs of care by reviewing an insurance claims database.

“Patients initially consulting MDs had significantly less reduction in their numerical pain rating score and were significantly less likely to be satisfied with the care received and the outcome of care.” What’s more average per-patient costs over the four-month period were significantly lower in patients who initially consulted DCs ($368 difference compared to MD care).

JMPT Editor-in-Chief Claire Johnson, DC, MEd, emphasized the importance of the latest findings: “Comparative studies – in other words, research that compares the outcomes between two different providers or modalities – are rare for chiropractic care,” she said. “Thus, this study … is especially important if payers and policy-makers are to better understand the ‘triple aim’ as it relates to chiropractic. Specifically, this study helps us better understand what type of care provides better patient satisfaction, is more cost effective, and improves population health.”

The answer, suggests an increasing body of research, is chiropractic care.

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Are You Suffering From the #1 Cause of Worldwide Disability?

Are you suffering from back or neck pain? You’re definitely not alone, and we mean on a global scale. A series of studies emerging from the Global Burden of Disease 2010 Project, a massive collaboration between the World Health Organization, the Institute for Health Metrics and Evaluation, the University of Queensland School of Population Health, Harvard School of Public Health, Johns Hopkins Bloomberg School of Public Health, and the University of Tokyo, Imperial College London, clarifies the worldwide health burden of musculoskeletal conditions, particularly back and neck pain, in crystal-clear fashion, with low back pain identified as the number-one cause of disability worldwide and neck pain the number-four cause. Overall, musculoskeletal conditions represent the second leading cause of global disability.

Findings emphasize the shift in global health that has resulted from disability making an increasingly larger footprint on the burden of disease compared to a mere 20-30 years ago. In addition, while more people are living longer, the flip side is that they do so with an increasing risk of living with the burden of pain, disability and disease compared to generations past.

Dr. Scott Haldeman, a neurologist and doctor of chiropractic, provides a summary of the project’s findings that should make it abundantly clear that conditions many people may consider relatively harmless actually have tremendous potential for long-term health consequences:

  • Musculoskeletal conditions such as low back pain, neck pain and arthritis affect more than 1.7 billion people worldwide and have a greater impact on the health of the world population (death and disability) than HIV/AIDS, tropical diseases including malaria, the forces of war and nature, and all neurological conditions combined.
  • world epidemic - Copyright – Stock Photo / Register MarkWhen considering death and disability in the health equation, musculoskeletal disorders cause 21.3 percent of all years lived with disability (YLDs), second only to mental and behavioral disorders, which account for 22.7 percent of YLDs.
  • Musculoskeletal conditions represent the sixth leading cause of death and disability, with only cardiovascular and circulatory diseases, neonatal diseases, neoplasms, and mental and behavorial disorders accounting for more death and disability worldwide.
  • Low back pain is the most dominant musculoskeletal condition, accounting for nearly one-half of all musculoskeletal YLDs. Neck pain accounts for one-fifth of musculoskeletal YLDs.
  • Low back pain is the sixth most important contributor to the global disease burden (death and disability), and has a greater impact on global health than malaria, preterm birth complications, COPD, tuberculosis, diabetes or lung cancer.
  • When combined with neck pain (21st most important contributor to the global disease burden – death and disability), painful spinal disorders are second only to ischemic heart disease in terms of their impact on the global burden of disease. Spinal disorders have a greater impact than HIV/AIDS, malaria, lower respiratory infections, stroke, breast and lung cancer combined, Alzheimer’s disease, diabetes, depression or traffic injuries.
  • Current estimates suggest that 632.045 million people worldwide suffer from low back pain and 332.049 million people worldwide suffer from neck pain.

“The Global Burden of Disease Study provides indisputable evidence that musculoskeletal conditions are an enormous and emerging problem in all parts of the world and need to be given the same priority for policy and resources as other major conditions like cancer, mental health and cardiovascular disease,” said Dr. Haldeman.

The seven studies from Global Burden of Disease 2010, as well as accompanying commentaries, appear in The Lancet. To review the studies and all relevant material, click here. And by the way, when it comes to preventing and treating musculoskeletal issues, particularly back and neck pain, chiropractic care has been shown in numerous research studies to be an effective conservative option.

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Caffeine Increases Risk for Chronic Daily Headache

Before your reach for your next “cup-o’-jo,” consider the consequences of excessive caffeine consumption. Caffeine has been shown to cause withdrawal headache, which may contribute to the development of chronic daily headache (CDH), or headache occurring at least 15 days per month.

To confirm such a hypothesis, researchers recruited population-cases and control subjects from three U.S. metropolitan areas as part of a study designed to address caffeine’s potential involvement in CDH. Control subjects reported two to 104 headache days annually (average: 30 days), while population-cases reported 180 or more headache days per year (average: 260 days). Current and past caffeine consumption was assessed by way of self-report.

Results: High caffeine exposure, defined as being in the upper quartile of dietary consumption or using a caffeine-containing over-the-counter medication as a headache treatment, was associated with onset of CDH. Approximately one-fourth of case subjects reported taking pain medication of any type daily for headache in the previous three months.

According to the authors, “High medicinal or dietary caffeine consumption at the time of CDH onset (e.g., pre-CDH consumption) was a modest risk factor for CDH onset. Secondary analyses revealed that pre-CDH caffeine consumption might be an initiating factor in a subset of CDH sufferers, with the high-risk groups being women and those younger than age 40.”

Still need a “pick-me-up” in the morning, but want to wean off caffeine? Try drinking green tea instead, which contains substantially less caffeine than coffee and has been shown to have a host of health benefits, including antioxidant and anti-cancer properties.


To learn more about headaches, visit www.chiroweb.com/find/archives/musculoskeletal.

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