Dr. Oz on death of Katie May

Dr. Oz recently had a very good show on the circumstances surrounding the death of model Katie May including an interview with her family. Also interviewed was chiropractic physician Dr. Steven Shoshany as part of his ninth appearance on the show and a neurosurgeon. 
The pain started shortly after a photo shoot in which she was holding some extreme neck positions. She received three chiropractic treatments and later suffered a stroke secondary to tearing of the inside wall of the vertebral artery.
The largest study on this issue showed that this type of stroke occurs with the same frequency after seeing a family doctor and after seeing a chiropractic physician giving more evidence to the thinking that these events have already occurred before the person visits the doctor.
Here is a video of the show and an article on this subject
http://www.f4cp.com/files/media-responses/11.16.16-dr.oz.php
Any questions or comments on this information?

Did a Visit to the Chiropractor Cause One Woman’s Death?

Report finds traffic deaths jumped in first half of 2016

I treat many patients for injuries sustained in motor vehicle crashes and was aware that traffic deaths had decreased significantly over several decades from 50,000/year to 30,000/year. 
Unfortunately there has been a very significant increase of deaths and injuries over the last two years probably partially due to distracted driving.
Driving a motor vehicle is the most dangerous activity done by most people. I commonly see the effects of these injures on patient's lives and encourage you to lessen your distractions while driving.
Report finds traffic deaths jumped in first half of 2016

Elderly Hospital Patients Arrive Sick, Often Leave Disabled

This is an article from a very popular website for medical doctors called Medscape. About one-third of patients over 70 years old and more than half of patients over 85 leave the hospital more disabled than when they arrived, research shows.
Studies also show that people that get chiropractic are less likely to end up in a hospital. I feel chiropractors do a great service by keeping some of our patients out of these dangerous places. 
Do you agree?

Elderly Hospital Patients Arrive Sick, Often Leave Disabled

Mild exercise, chiropractic care and alternative therapies can relieve back pain

I thought this was a good reply from a medical physician and professor at Harvard Medical School. He first points out that acetaminophen(Tylenol) has not been shown to be effective for acute back pain. He then goes on to write "Chiropractic manipulation, acupuncture, massage or yoga provides relief for some people with acute back pain. Several studies support using these alternative/complementary therapies."

Do you think he is correct?

Mild exercise, alternative therapies can relieve back pain

New Gallup-Palmer College of Chiropractic survey: Three in four patients describe chiropractic care as ‘very effective.’

New Gallup survey shows that of patients that received chiropractic care within the last year 95% say that it is effective.
Has anyone who has been helped with chiropractic care like to share their experience?
New Gallup-Palmer College of Chiropractic survey: Three in four patients describe chiropractic care as ‘very effective.’

Opiate prescriptions down at the VA, alternatives on the rise

Great news! The Veterans Administration has significantly reduced its over-prescribing of opioid (narcotic) drugs by 25% in the last 3 years even with one half million more veterans in their system. They have greatly increased alternatives with 50% of the VA hospitals now employing doctors of chiropractic.
Why do you think this took so long?

Opiate prescriptions down at the VA, alternatives on the rise

Many Back Pain Patients Get Limited Relief From Opioids And Worry About Taking Them, Survey Shows

The American Society of Anesthesiologists recently presented research showing that many patients only get limited relief from opioid (narcotic) drugs while experiencing side effects that effect the quality of their lives. There is also no evidence that they are effective for back pain of more than 3 months duration, although they are commonly prescribed for these chronic conditions.
The Society states that while some patients may benefit from opioids for severe pain for a few days after an injury, physicians need to wean their patients off them and use multi-modal therapies instead.”
Does this sound like a good recommendation to you?

Many Back Pain Patients Get Limited Relief From Opioids And Worry About Taking Them, Survey Shows

Medical licensing laws restrict access to more affordable options like chiropractors.

Americans spend $300 billion annually on pain treatment. Much of this is on treatment for back and neck pain, which two-thirds of us have sought at some point.
The American College of Physicians ( the national organization for internal medicine physicians) recommends chiropractic and physical therapy as effective for mechanical back disorders.
US News and World Report argues that a substantial amount of this money could be saved if more Americans were given easier access to chiropractic and physical therapy services.


Medical licensing laws restrict access to more affordable options like chiropractors.

Chiropractic Care results in less time off for injured workers

Injured workers receiving chiropractic care had the lowest costs for time off work as compared to workers who had treatment by medical physicians or physical therapists. That is the finding from a new study published in the Journal of Occupational Rehabilitation.
Does this surprise anyone?
Association Between the Type of First Healthcare Provider and the Duration of Financial Compensation for Occupational Back Pain

Should You See a Chiropractor?

Runner's World Magazine writes "You'll likely hear some cracks--changing pressure in the joints releases gas bubbles that pop. This can be disconcerting for the first -timers. But chiro regulars often report instant relief."
Any chiro experience from any of you runners?

Should You See a Chiropractor?

Gallup Survey Finds High Satisfaction With Chiropractic Care

Eighty-eight percent of recent chiropractic patients agree the quality of care they received from chiropractic
was a good value for the money. This is from a recent Gallup Survey. It also showed that U.S. adults are more likely to describe chiropractic care as “very safe” and “very effective” than to say this about pain medications or back surgery. 
Nearly 62 million U.S. adults (25 percent) went to a chiropractor in the last five years, with more than half (35.5 million) saying they went in the last 12 months.
Are you surprised that respondents described chiropractic care as safer than pain medications?

One in Four Adults Sought Care for Neck/Back Pain Last Year

Knuckle-cracking is actually good for you

New study shows knuckle-cracking is actually good for you. The study by hand surgeon Dr. Robert was presented in December at a meeting of the Radiological Society of North America.
The study confirmed the results of a study from last year showing the the sound is produced by the creation of a gas bubble just as happens when we flip the tab on a soda can.
The study showed no adverse effects, and in fact showed benefit of increased range of motion. This is not surprising to doctors of chiropractic as we commonly see or feel increased range of motion after manipulations/adjustments and that is the main reason we adjust joints.
We are not "putting bones back in place". Joints are the hinges of the body and increasing the joints' range of motion always the body to move more correctly with less stress.


Knuckle-cracking is actually good for you

The most common injury at the Olympics

Many new patients are perplexed telling me that they have pain but they did not do anything. Many conditions I treat are not from a trauma or a single incident, and the same thing is true for Olympic athletes. Even though we commonly hear about traumatic injuries to Olympians, a majority of their injuries are what are commonly called repetitive or cumulative trauma injuries. These are small repetitive over stressing of tissues that eventually cause enough damage to begin to cause pain or other symptoms.
Repetitive trauma injuries are easier to treat and have a better prognosis when they are treated early before they become chronic and more severe.
The most common injury at the Olympics

Should You Visit a Chiropractor for Back Pain?

Another article by Consumer Reports recommends chiropractic spinal manipulation as a reasonable option for back and neck disorders.

By the way, that is a very flexible person being adjusted in the picture! Most patients are not rotated to that degree :-)

Any questions about the efficacy or safety of spinal manipulation?

Should You Visit a Chiropractor for Back Pain?

Las year the Academy of Medical Royal Colleges called exercise a "miracle cure". It is hard to think of it in that way when we are bombarded by marketing for the latest drugs and procedures, but none of these compares to the overall benefit of exercise. There are now a multitude of randomized controlled trials showing that exercise can help many medical conditions as well or better than drug therapy.
Unfortunately many people get caught up in the hype of the current trendy exercise fads that promote suffering during exercise. The amount needed to produce large benefits would surprise many people...just getting the heart rate up to 100-140 bpm ( brisk walk or riding a bike at less than 10 mph for most people) 30 minutes a day 5 days a week..
What is keeping you from getting started or continuing with an exercise program?

Closest Thing to a Wonder Drug? Try Exercise

A SAFER STRATEGY THAN OPIOIDS

A Safer Strategy Than Opiods (Narcotics) is the name of a new white paper from the Foundation for Chiropractic Progress. 
The Unites States has awakened on every level to the crushing impact of the opioid use/abuse epidemic. 
Since 2009 more than 165,000 Americans (3 times the number that died in the 20 years of the Vietman war) have died from prescription narcotic drugs. Calls have come from the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the Institute of Medicine (IOM) for a shift away from opioid use toward non-pharmacologic
approaches to address chronic pain.
An important non-pharmacologic approach in helping to solve this crisis is chiropractic care.

A SAFER STRATEGY THAN OPIOIDS

Prescripton medications now kill more Americans than all the illegal drugs combined! Most of these medications are the opioid (narcotic) class such as Vicodin, Tylenol 3, Narco, Oxycontin, and Oxycodone. Many people take these for back pain. These drugs can be very effective for acute pain such as post-surgical pain and pain from cancer, but studies show that they are not very effective for most chronic conditions including chronic low back pain.
JAMA Internal Medicine recently published a pooled study of 20 high quality randomized trials and found that the drugs relieved pain slightly, but the effects were not clinically significant, and the medicines did little to improve disability. The effectiveness was similar to that achieved by NSAID's such as aspirin.
Why do you think so many medical providers continue to prescribe these dangerous ineffective drugs instead of referring patients to much safer treatments done by chiropractors and PT's?

Opioids Narcotics Often Ineffective for Low Back Pain

JIM MCMAHON TALKS ABOUT CHIROPRACTIC TREATMENT FOR CONCUSSION RELIEF

Former Bears quarterback Jim McMahon talks about the relief he has obtained from chiropractic treatment for severe headaches.
Did you know that many headeaches have a cervical neck component and can be helped with non drug treatments such as chiropractic care?
JIM MCMAHON TALKS ABOUT CHIROPRACTIC TREATMENT FOR CONCUSSION RELIEF

Do you really need that MRI of your back?

I once heard a chiropractor say that he could get an MRI of your phone that would show every part inside, but would not tell him if the phone was ringing or not. MRI' and CT's have very high false positive rates showing many abnormalities that have nothing to do with a patient's pain. Relying on these so heavily as has become the norm in medical practice many times leads the clinician astray from the actual cause of the problem and leads to unnecessary/incorrect and dangerous treatments and increases disability.
I have had many patients tell me they were not even examined or touched by the doctor. Now that is very sad care.
Has anyone ever gone to a doc for a back or joint problem and not been examined?

Do you really need that MRI of your back?

other of many studies showing chiropractic care is less expensive for back disorders. This new study was on 72,000 Medicare patients with chronic back disorders. It looked at six years of treatment and patients that had multiple comorbidities (other medical disorders). Chiropractic patients also had the shortest duration of their pain episodes.
Should Medicare provide better coverage for chiropractic care?

Tech Neck

This has also been called text neck.
The World Health Organization has recently classified neck disorders as the 4th leading cause of disability in the world and they are the 2nd most common condition I treat in my clinic. Most patients I treat have not had a single traumatic incident, but have conditions due to what is called repetitive trauma such as tech neck.
Tech Neck

Popular painkiller doesn't help low back pain, arthritis, study finds

The most popular pain drug in the US, acetaminophen (Tylenol) does not help with back disorders. This was the finding of a recent study in the British Medical Journal which looked at 13 previous randomized studies on this drug for treating back, knee, and hip disorders. Acetaminophen accounts for 100,000 hospital visits a year and is the number one cause of acute liver failure.
So does it make scientific sense that a medical provider would prescribe acetaminophen instead of referring for chiropractic care?

You Asked: Are Chiropractors Legitimate?

Very good article from the April Time Magazine. It quotes Dr. Michael Schneider who was a co-author of mine on a paper concerning using CT myelogram ( with dye) on patients with suspected spinal disc herniation and negative MRI. He has obtained a PhD in rehabilitation science and is now an associate professor of health sciences at the University of Pittsburgh.
There are dangers to all medical interventions but spinal manipulation is one of the safest. 

You Asked: Are Chiropractors Legitimate?

F4CP Lauds CDC Opioid Prescribing Guidelines, Chiropractic is Safer, Non-Drug Approach for Pain Relief

Americans consume 80 percent of the world’s opioid (narcotic drugs) supply, despite comprising less than five percent of the global population! That is an amazing statistic.
In 2014, the increased utilization of opioids led to 28,647 deaths – or 61 percent of total drug overdose fatalities in the U.S. 
In response to the new federal guidelines issued by Centers for Disease Control and Prevention (CDC) regarding opioid prescribing, the Foundation for Chiropractic Progress (F4CP) notes that many individuals are prescribed opioids for pain associated with musculoskeletal conditions, including low back and neck pain are unaware of the effectiveness of alternative care, which includes chiropractic.

F4CP Lauds CDC Opioid Prescribing Guidelines, Chiropractic is Safer, Non-Drug Approach for Pain Relief

Epidural Steroid Injections Segment from Dr. Oz

Although some of this Dr. Oz segment is overdramatized as is common with TV and news articles, it still informs on some important points. Epidural steroid injections are performed about 9 million times a year and providers may earn up to $2000 for this 10 minute procedure. These steroids have never been approved by the FDA for injection into the spine and even carry labels stating that fact, and have recently been banned in Australia and New Zealand.
Studies have shown that they may provide marginal short term relief for a small segment of patients whose main symptom in sciatica (radiating leg pain), yet 3/4 are performed in patients without sciatica. There are also infrequent but potentially severe adverse effects.
There is also a part two to this video segment. 
Epidural Steroid Injections, The Truth... Finally!

Release suggests peanuts reduced kids’ risk for obesity, but maybe it was the exercise Health News Review

Wouldn't you expect a news release from a academic medical center to be of high quality? Unfortunately that is often not the case.
My last post was about the website Health News Review which grades news articles and news releases on 10 quality criteria and assigns a 5 star rating. This recent news release from the University of Houston suggesting peanuts reduced kids’ risk for obesity only passed 3 of their 8 quality criteria (2 did not apply) and only received a 2 star rating.
This poor quality reporting is one of the reasons we get more confused about medical and health study results. Please review this free site and it will help you make better medical and healthcare decisions in the future.
Please let me know if you have any questions on their quality criteria.
Release suggests peanuts reduced kids’ risk for obesity, but maybe it was the exercise

Five Principles to Red Flag News Articles on Medical and Health Issues

Unfortunately many news articles on medical treatment and health issues are of poor quality. Gary Schwitzer is an adjunct associate professor at the University of Minnesota School of Public Health and runs a website called Health News Reviews which reviews and rates medical and health news articles and press releases on a five star criteria. 
Below is an article in which he discusses five basic principles that everyone can use to red flag articles for quality. The last two principles concerning observational studies and relative vs absolute risk may be somewhat harder to grasp, so let me know if you have any questions on these concepts.

5 tips for fact-checking claims about health

Back pain? Try some placebo surgery

Back Pain? Try Some Placebo Surgery.
That is the name of a recent article by a retired spinal surgeon about the dramatic increase of spinal fusion surgeries.
It may surprise you to learn that most spinal and joint surgeries including spinal fusion surgery have not been subjected to placebo controlled research trials, so we do not know if they are better than sham surgery (placebo). 
There have been a few good studies comparing spinal fusion to non surgical treatment and two of the studies showed no better results for the spinal fusion surgery.
We have the FDA trying to minimize harm for drugs, but no FDA like agency for surgeries. 
Back pain? Try some placebo surgery

Chiropractic care for pain relief

Information about chiropractic care from Harvard Medical School.
Notice the great posture of the DC in this pic bending from the hips and not from the back.
Chiropractic care for pain relief

Your chair, phone could be damaging your spine

Tips to help with and prevent back and neck disorders from Dr. Karen Erickson of the American Chiropractic Association.
Please remember that the low back disorders are the number cause of disability in the world and neck disorders are number 4.

Your chair, phone could be damaging your spine

To Prevent Back Pain, Exercise Is In

Does exercise help prevent back disorders? A new systematic review in JAMA Internal Medicine looked at 21 randomized controlled trials of over 30,000 people and found that exercise alone or in combo with education prevents future back disorders.
I am board certified in rehabilitation and spend a considerable amount of time every day educating patients in exercise and lifting techniques. 

To Prevent Back Pain, Orthotics Are Out, Exercise Is In

Why Are Medical Mistakes Our Third Leading Cause of Death?

One of the overlooked benefits of chiropractic care is that it keeps many patients from dangerous medical and hospital care. I have posted in the past concerning the three large studies estimating 100,000 to 400,000 deaths per year from hospital mistakes. This article by Dr. Allen Frances, professor emeritus at Duke University, explains why these mistakes are so prevalent and seem to be getting worse over the last 17 years. Very insightful.
Why Are Medical Mistakes Our Third Leading Cause of Death?

Disturbing New Study Finds Medication Errors In Half Of All Surgeries

Medication errors occur in half of all surgeries. This was the conclusion from a new study published in the October issue of the journal Anesthesiology. 
The author of this Forbes article states "The level of waste and harm that is generally accepted in the healthcare sector would never be tolerated in other mature industries. We need to stop holding the healthcare industry to a different standard than every other industry we interact with. It really is a matter of life and death."
Disturbing New Study Finds Medication Errors In Half Of All Surgeries

Prevention and Intervention Strategies to Decrease Misuse of Prescription Pain Medication

Every 19 minutes in the US someone dies of a prescription drug overdose, many of them from narcotic drugs. I have been a long time member of the American Public Health Association and they recently released a policy statement that includes urging of prescription providers to be educated on identifying and treating pain with alternative modalities, and to coordinate pain management with complementary and integrative care providers.
Prevention and Intervention Strategies to Decrease Misuse of Prescription Pain Medication

World report on disability

A recent series of joint studies by the World Health Organization, Harvard School of Public Health, and John Hopkins School of Public Health show that low back disorders are the #1 cause of disability in the entire world, and neck disorders are #4.
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.
So, although these disorders are not going to directly kill anyone, they can severely mess up or destroy people's lives. This will become even more significant in the future as people continue to live longer.
World report on disability

What to Expect On Your First Visit To A Doctor Of Chiropractic

We commonly have people unfamiliar with chiropractic care call and ask what is done on the first visit.
Well, here is the answer from the American Chiropractic Association!
What to Expect On Your First Visit To A Doctor Of Chiropractic