Medical Errors Kill 15,000 Medicare Patients a Month These are shocking numbers! Every patient that is kept out of a hospital by chiropractic care may

These are shocking numbers! This is from a new report from the Dept of Health and Human Services. Chiropractic care has been shown to reduce hospitalization by 30-40% compared to medical care. Every patient that is kept out of a hospital by chiropractic care may be having their life saved or avoiding serious injury.

Medical Errors Kill 15,000 Medicare Patients a Month

Patients are utilizing many unproven therapies for chronic neck pain

This is very alarming. A high number of chronic neck pain patients are taking narcotic medications, which have not been shown by research to be effective for this condition. Only one half had been prescribed exercises, which, in comparison, have been shown to be effective.

High Resource Use Found for Chronic Neck Pain

This is a meta-analysis of 41 research studies on cortisone injections. This type of study is considered higher quality because it pools the results of many studies.
This study showed poor long term results for cortisone, sometimes making the condition worse.

Steroid Shots Bad for Tennis Elbow Long Term

This is an article from Medpage that reviews a recent study from the Journal of Epidemiology and Community Health comparing Americans and English concerning diabetes, BMI (Body Mass Index), and waist size; and also discusses the differences of visceral fat and body fat.

Waist Size, Not BMI, Predicts Risk of Diabetes

Back surgery may backfire on patients in pain

This is a recent cover story by MSNBC on a new study showing that patients who had spinal fusion were less likely to return to work and needed more opiates (narcotics).

This is another study confirming what we have been seeing in the literature...that surgery can be beneficial for helping sciatica leg pain, but is much less likely to help patients whose main symptoms are in the low back.

Back surgery may backfire on patients in pain

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Medical Industry Ties Often Undisclosed in Journals

Unfortunately another article showing that a large number of the doctors who publish research in the medical journals now have financial ties to the drug companies and medical device companies. Worse yet, many of them do not disclose their ties.

Medical Industry Ties Often Undisclosed in Journals

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Science Sometimes - Stroke and Chiropractic

Dr. Stephen Perle who is professor at the Bridgeport College of Chiropractic discusses the current scientific evidence based findings on the association of chiropractic neck manipulation and stroke.

This is a rare event that has been shown in a recent study to be just as prevalent for someone with neck pain and/or headache after visiting a primary medical doctor as after visiting a chiropractic doctor. This strengthens the current thinking that the these type of rare strokes are usually already in progress at the time of the visit. Remember association does not equal causation.
Below is a link to Dr. Perle's blog in which he writes about this important issue.

Stroke Sometimes - Stroke and Chiropractic

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Dr. Stephen Perle Discusses Chiropractic and Stroke

Dr. Stephen Perle who is professor at the Bridgeport College of Chiropractic discusses the current scientific evidence based findings on the association of chiropractic neck manipulation and stroke.

This is a rare event that has been shown in a recent study to be just as prevalent for someone with neck pain and/or headache after visiting a primary medical doctor as after visiting a chiropractic doctor, which strengthens the current thinking that the the strokes are usually already in progress at the time of the visit. Remember association does not equal causation.
Below is a link to a podcast of Dr. Perle discussing this issue.

Dr. Stephen Perle Discusses Chiropractic and Stroke

Rebound Headaches

Here is a very good recent ABC News television report on rebound headaches. I was made aware of the report by a patient with whom I was recently discussing this type of headache. I treat many patients with headaches and I see patients with rebound headaches. I always educate them about this type of headache as we have known of the condition for quite some time.

Healthbeat Report: Overmedicating Headaches

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Medical General Practice Physicians Still Not Following Evidence Based Guidelines

Here is a recent study from the Archives of Internal Medicine which shows that medical physicians unfortunately are still not following evidence based guidelines for treatment of back disorders. They are still over ordering imaging, over prescribing anti-inflammatory drugs and narcotics, and not giving enough advise.

Low Back Pain and Best Practice Care A Survey of General Practice Physicians

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Spinal Fusion Surgery No Better Than Non Surgical Treatment

Here is another in a growing list of studies showing no long-term benefit with many spinal surgeries including spinal fusion surgeries for low back pain. This study is from the Annals of Rheumatic Diseases and compared spinal fusion surgery with hardware to exercise therapy and cognitive behavioral therapy in 124 patients after 4 years. The main outcome instrument the Oswestry disability index showed no significant difference in both groups and there was no difference in return to work.

There has been much criticism in the medical literature of both the lumbar and cervical spinal fusion surgeries because of an increasing amount of studies showing no benefit our only minimal benefit, and the high cost and complication rate of these types of surgery. In spite of the studies in their criticisms, the fusion rates continue to increase every year and the insurance companies and insurance plans continue to cover the majority of the costs.

Recently Medicare considered whether it would continue to pay for spinal fusion surgery for certain conditions and surprisingly to me they decided to continue to pay billions of dollars every year for these surgeries.

Four-year follow-up of surgical versus non-surgical therapy for chronic low back pain

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Six Rules For Eating Wisely

Michael Pollan has a new book entitled "Food Rules".
I would also highly recommend his last book "Omnivore's Dilemma".

Six Rules For Eating Wisely

Prescription drug overdose cases skyrocket at emergency departments

This is an article from the American Medical Association news website concerning the dramatic increase of ER visits due to prescription drugs including opioids such as Vicoden and Tylenol 3. There has been increasing criticism in the medical literature concerning the increasing prescribing of opioid painkillers for back pain and joint pain because the research shows they are not nearly as beneficial for non cancer pain and they have such serious side effects.

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Do Certain Types of Sneakers Prevent Injuries?

Another commonly held medical presumption that different types of shoes are beneficial for preventing running injuries has been shown to be another medical urban legend. Two recent studies show no decrease of injuries by using motion control or cushioned running shoes.

Do Certain Types of Sneakers Prevent Injuries?

FDA recommends new limits on livestock drugs

The use of antibiotics to promote growth in livestock is a long term practice that has been criticized for a long time. It is good to see the FDA finally come out with recommendations against this practice. Unfortunately these are not regulations so many wonder if they will be followed.

FDA recommends new limits on livestock drugs

Best fix for rotator cuff tear remains uncertain.Best fix for rotator cuff tear remains uncertain.

Evidence on the pros and cons of various surgical and non-surgical treatments for rotator cuff tears is limited and inconclusive, a new review of published studies concludes.

This literature review is part of a growing type of research called comparative research. Comparitive research will help determine which treatments and interventions are superior. This includes comparing surgical versus non-surgical and and comparing different treatments within the surgical realm and the non-surgical realm. This will help greatly to improve patient care by allowing doctors and other practitioners to practice in a more evidence based manner, decrease cost, and decrease side effects and adverse events.

Best fix for rotator cuff tear remains uncertain.

Family Practice Study Shows Chiropractic Care to be Most Effective of 6 Complementary Care Methods

Many authorities no longer classify chiropractic treatment as a complementary healthcare method, but this new study published by the Journal of the American Board of Family Practice included chiropractic treatment as one of 6 complementary therapies and found that it is not only more utilized than the other 5 therapies combined, but it also has the highest perceived value of effectiveness.

Perceived Benefit of Complementary and Alternative Medicine (CAM) for Back Pain: A National Survey

Chiropractic Manipulation Again Shown to Be More Effective Than Physiotherapy and Back School

It was long believed that chiropractic spinal manipulation was only effective for acute low back pain and only in the short-term. Several studies have now shown that spinal manipulation is also effective for chronic low back pain in both the short-term and long-term. This is a recent study from the January, 2010 issue of Clinical Rehabilitation Journal. It had 210 subjects with chronic low back pain and median age of 59 years old. The physiotherapy group received mobilization, exercise, and soft tissue techniques and the back school group received instruction in how to lift.
The manipulation group had the most improvement in both the short-term and the one-year follow-up.

Spinal Manipulation Compared with Back School and with Individually Delivered Physiotherapy for the Treatment of Chronic Low Back Pain: A Randomized Trial with One-year Follow-up

Woman Awarded $8M for Jaw Damage Related to Osteoporosis Drug

The FDA says this side effect is rare and the benefits outweigh the risks.
The majority of people take bone density drugs for the lesser bone density
loss called osteopenia and even though the drugs increase bone mass, they do
not decrease the fracture rate. This is thought to occur because the bone
they help build is a lower quality weaker type of bone.

Woman Awarded $8M for Jaw Damage Related to Osteoporosis Drug

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Diet Soft Drinks Deplete Urinary Calcium

A new study funded by the Walter Reed Department of Clinical Investigation has found that consumption of diet soft drinks causes significantly more excretion of calcium and phosphorus than drinking water over the two-day study period. This was a small study but it sheds some light on the causative factors for previous cross-sectional studies that have shown a relationship between decreased bone mass and consumption of cola beverages. This effect is probably more significant in people who drink diet colas as they have been shown to consume more of the beverage than people who drink sugar colas.

Diet Soft Drinks Deplete Urinary Calcium

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Surgery for Back Pain Often Fails

Here is an article from AOL Health talking about the low success rate of many types
of back surgery. I and recent studies in the medical literature would take issue with the
statement that 90% of cases heal of their own within weeks, but the rest
of the article is fairly accurate.

Surgery for Back Pain Often Fails

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Biggest radiation threat is due to medical scans

Luckily the media has recently been publishing many articles explaining the huge increase in medical radiation that Americans have been experiencing over the last two decades. Unfortunately much of this radiation is from unnecessary tests and procedures being performed for various non-evidence based reasons. Here is a recent article.

Biggest radiation threat is due to medical scans

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Health Myths That May Surprise You

I have been interested in myths in general and medical myths for quite some time. It may surprise many that medical myths are still quite prevalent among the medial profession. I read about them and hear about them from my patients all the time. This book “Don’t Swallow Your Gum! Myths, Half-Truths and Outright Lies About Your Body and Health,” by Dr. Aaron E. Carroll and Dr. Rachel C. Vreeman examines many of these medical myths. One that strikes home for me and one they discuss in this block is the myth that knuckle cracking causes arthritis. The reality is that knuckle-crackers are no more likely to have arthritis than those who don’t make annoying popping sounds with their fingers.

11 Health Myths That May Surprise You

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FDA: FDA Some heartburn meds pose long-term fracture risk

It has been known for some time that by decreasing the acidity of the stomach, antacids can decrease the absorption of calcium and other minerals. This warning stems from a recent review of studies by the FDA.

FDA Some heartburn meds pose long-term fracture risk

Overtreated: More medical care isn't always better

This is a very unfortunate problem in our country and many other developed nations that leads to much dangerous tests, treatments, and surguries. I agree with the article that the worse area of this is probably with back conditions.

Overtreated: More medical care isn't always better

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Does Massage Help After Exercise?

It had previously been thought that massage aided muscle recovery by increasing blood flow and decreasing lactic acid in the muscles. There have more recently been several studies that have shown that massage does not increase blood flow, but actually decreases blood flow to muscles.
A new study in Medicine & Science in Sports & Exercise measured both blood flow and lactic acid levels after exercise of the forearm muscles and found massage massage decreased the blood flow and increased the lactic acid levels as compared to rest and active recovery.

As noted in the study this does not prove that massage is harmful, just that two proposed mechanisms to recovery do not occur. There very well may be physical and/or psychological mechanism that are beneficial. This will hopefully lead to more studies that can find
if there are physical mechanisms that occur during massage that aid in exercise recovery.

Massage impairs postexercise muscle blood flow and "lactic acid" removal.

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This recent study from the British Medical Journal shows the common procedure of multiple injections of hyaluronan into the knee joint from osteoarthritis is no better than placebo and is not effective.
We unfortunately commonly see medical procedures used extensively for long periods of time before being subjected to more rigorous studies and being shown to be ineffective or much less effective than previously thought.

Intra-articular hyaluronan is without clinical effect in knee osteoarthritis: a multicentre, randomised, placebo-controlled, double-blind study of 337 patients followed for 1 year

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Cost and use of conservative management of lumbar disc herniation before surgical discectomy

A recent study published in the Spine Journal examined the costs of treating back disorders for the 90 days before disc surgery. They looked at approximately 30,000 patients that met the inclusion criteria. There was over $100 million of charges with 32% for injections and 31% for diagnostic imaging giving these 2 categories 63% or almost 2/3 of the presurgery charges. Physical therapy services were 11% of the charges and chiropractic treatment was only 2% of the charges.
Although these percentages do not reflect amounts of treatment, they are similar to many cost-effectiveness studies that show better cost effectiveness for chiropractic care compared to medical care.

http://www.ncbi.nlm.nih.gov/pubmed/20359960

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Strokes Among Young

Strokes are the second leading cause of death. Woman have a much higher chance of dying from stroke than from breast cancer or all cancers combined. Now we unfortunately are seeing increasing rates in the young according to a findings reported at the 2010 International Stroke Conference. The best way to prevent strokes is still eating healthy, getting adequate exercise, and stopping smoking.

A new study in the Pain Journal of the American Pain Society has found that comsumption of ginger results in moderate to large reductions in muscle pain following exercise induced muscle injury. These findings are similar to those showing effectiveness of ginger on the pain of osteoarthrosis/osteoarthritis.
These findings are also important because many athletes subject themselves to the side effects of NSAID drugs on a regular basis thinking that they will help with post exercise muscle pain, when in fact no study has shown that NSAID's are effective for this condition.