Back Pain in Pottsville: New Research Shows Manipulation Trumps Medication

April 4, 2013 by
chiropractor pottsville Back Pain in Pottsville: New Research Shows Manipulation Trumps Medication

Back pain treatment failures

Schuylkill County: Back Pain Research Update

In my attempt to share with you some of the most up-to-date information that crosses my desk, there are two articles that really caught my attention:

 The first, from the journal Pain, found that even after adjusting for a substantial number of potential confounders, (things that can confuse the issue) prescription opioids (addictive medications used to relieve pain) were associated with slightly worse functioning in back pain patients at 6-month follow-up. 1

The second article has incredibly important implications for the profession, and in my opinion what should be considered among the best practices for care of acute low-back pain. It was printed in the April 2013 edition of the Spine. 2

It found that in a subgroup of patients with acute nonspecific low-back pain, spinal manipulation was significantly better than the non-steroidal anti-inflammatory drug diclofenac (trade name Voltaren), and clinically superior to placebo.

For those of us that manipulate, these are not surprising research findings.  But, I bet they are surprising for you.  We can now start to put opioids in a worse category than epidural injections for back pain.  (Web MD states flat out that epidurals don’t work.)  The new category for opioids is; drugs that make your back problem worse.

Voltaren did help back pain, but not nearly as much as manipulation.  If you are having back pain ask your doc to send you to a doctor of chiropractic for manipulation.  In fact, you don’t even need to ask for the referral just call, no referral is needed.  Why would you settle for a second best treatment for back pain when you can easily get the first best treatment?

As always, watching your back;

Dr. Dave

  1. http://www.painjournalonline.com/article/S0304-3959(13)00101-2/abstract
  2. http://journals.lww.com/spinejournal/Abstract/2013/04010/Spinal_High_Velocity_Low_Amplitude_Manipulation_in.3.aspx
Filed Under: Arthritis, Back Pain, Car Accidents, Chiropractic, Sciatica, Slipped or Herniated Disc, Work Injury Tagged With: , , , , , , , ,

Dr. Manny of Fox News Receives PEMF For His Foot Pain

September 10, 2012 by

Schuylkill County: Pulsed Electromagnetic Field therapy or PEMF is a new therapy.  We are the only facility within 60 miles that has this therapy.  In my 35 years of practice, I have never been excited over the results I have seen.  If you the click on the link below you will see a video of Dr. Manny receiving a PEMF therapy treatment for his foot pain.

Dr Manny Foot Pain Treatment

Filed Under: Arthritis, Back Pain, Car Accidents, Foot Pains, Neck Pain, Sciatica, Shoulder Pain, Slipped or Herniated Disc Tagged With: , , , , , , , ,

It’s almost Christmas Eve! Santa’s Treatment Update

December 23, 2010 by Leave a Comment

Ho! Ho! Ho! 

Christmas is almost here!  Can you feel the excitment?  We can here at Doctors’ Choice because Santa’s been here getting ready for his big night!  He’s exercising and Doc Novatnak has been treating Santa with his extra special care, making sure Santa’a able to carry all those goodies to the children of Pottsville and all of Schuylkill County. 

Santa’s a great patient.  He has made all of his appointments and cheerfully exercises and follows his treatment plan.  Good thing too, his back was a complete mess when he started treatment here at Doctors’ Choice a few weeks ago.  Dr. Novatnak is confident that Santa will make his rounds, and not have any problems with low back pain on Christmas Eve. 

Everyone at Doctors’ Choice has enjoyed having Santa here preparing for the holiday season. 

Merry Christmas to all of our wonderful patients!  Have a safe and happy holiday season!

Filed Under: Back Pain, Chiropractic, Chiropractic News, Health Tips, Local News, Uncategorized Tagged With: , , , ,

Schuylkill Chronic Back Pain, Where is the Pain Coming From?

December 5, 2010 by Leave a Comment
chiropractor pottsville Schuylkill Chronic Back Pain, Where is the Pain Coming From?

Chronic Low Back Pain

Schuylkill County:  Did you know that about 10% of back injuries do not resolve in two months time and the back pain is considered chronic?  Is there something different about backs from other tissues or joints in the body?  Yes, there is!

In 1987, the journal Spine published Dr. Vert Mooney’s Presidential Address of the International Society for the Study of the Lumbar Spine.  In his address, he presented many known facts concerning chronic low back pain. 

This is what is special about disks!  In summary, Dr. Mooney said:

  • The disk is the primary source of both back and referred leg pain. 
  • Spinal mechanical problems (from an injury or long-term distorted body mechanics) reduce disk movements, which leads to altered disk chemistry.  
  • The altered chemistry within the disk activates the pain nerve endings in the disk causing chronic pain.
  • Therefore, the most rational approach to the treatment of chronic low back pain is mechanical therapy that restores the motion to the spinal joints and especially the disk.  (This means such treatment as manipulation, mobilization, manual muscle therapy work to restore body mechanics, and therapeutic exercise.)
  • Prolonged rest is inappropriate management for chronic lower back pain.

Many studies support Dr. Mooney’s presentation. 

Dr. Stephen Kuslich and colleagues in the journal Orthopedic Clinics of North America presented one study in April 1991.  The title of their article was:

The Tissue Origin of Low Back Pain and Sciatica: A Report of Pain Response to Tissue Stimulation During Operations on the Lumbar Spine Using Local Anesthesia

Between 1987 and 1990, 193 consecutive patients were studied.  All of these patients were operated upon for complaints of intractable lower back and/or lower limb pain (sciatica).  Instead of the use of general anesthesia, only a “progressive” local anesthesia was used, leaving the patients fully awake and responsive.  (First, let us all be glad that we were not one of their patients that had spinal surgery under local anesthesia!) 

During the operation, the surgeon randomly “stimulated” various tissues in and around the exposed disk and spinal nerve/nerves by means of ‘mechanical force’, i.e., the ‘smashing of the tissue with a blunt surgical instrument, or the electric shocking of the tissue with low volt electricity.  

The patients were then asked to describe and rate any associated sensations of pain, numbness, or burning on an analog scale of 0 to 5, where 5 was severe pain that was exactly like their usual and customary pain.

Several of their important findings include:

  • Back pain could be produced by several lumbar tissues, but by far, the most common tissue of origin was the outer layer of the disk.
  • The lumbar fascia (tissue around muscles) could be “touched or even cut without anesthesia”, without producing any pain.
  • Any pain derived from muscle pressure was “derived from local vessels and nerves, rather than the muscle bundles themselves.”
  • “The normal, uncompressed, or non-stretched nerve root was completely insensitive to pain.”

In summary, these authors found the outer layer to “the disk” to be “the site” of chronic low back pain.

What To Do If You Have Chronic Low Back Pain?

A well-established finding in chronic low back pain is lumbar muscle weakness.  One of the treatments we use for chronic low back pain is MedX lumbar extension exercise.

This treatment strengthens the weak muscles and uses controlled motion to create and restore motion in the painful disk as Dr. Mooney almost 25 years ago.

To find out how successful the MedX treatment can be see:

Chronic Low Back Pain in Pottsville, Remarkable Treatment Results

 

We are committed to help you or a loved one that is suffering with chronic low back pain, and sharing this information may be one of most evident acts of kindness you can give.

This information is solely advisory, and should not be substituted for medical or chiropractic advice.  Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your medical history.

Filed Under: Back Pain, Chiropractic, Health Tips, Sciatica, Slipped or Herniated Disc Tagged With: , , , , , , , , ,

Chronic Low Back Pain in Pottsville, Remarkable Treatment Results

February 10, 2010 by 1 Comment

Pottsville, Schuylkill County PA: Do you have chronic low back pain?  Were you told that you have weak back muscles?   

 

How do you know if that statement is true? 

 

Has the strength of your back muscles ever been tested?

 

Pointed questions, almost no one can answer these questions affirmatively.

 

Would you like to know what 629 chronic back suffers found out about the strength of their back muscles and the difference it made in their suffering?

 

In this study, of 895 chronic back pain suffers were chosen to participate in a testing and treatment program.  Over 100 never started and others dropped out for a variety of reasons.  629 were still in the program and completed the study at the end of one year.  Our focus will be on them.   

 

The testing and exercises were performed on MedX lumbar extension rehabilitation equipment.  MedX equipment been shown to be valid and reliable.  We have this testing and exercise equipment at our office in Pottsville.  In fact, we have to only machine in the area. 

 

The Chronic Back Pain Sufferers Were Previous Multiple Treatment Failures

 

These patients were tough cases!

  • Average duration of back and/or leg complaints was 26 months (range 3 months to 30 years).
  •  The patients on average had seen three previous providers.
  • 14% had previous surgery for the complaint.
  • The patients had tried an average of 6 different types of treatments.
  • 89% had already failed a “supervised exercise program”.
  • 47% tried and failed chiropractic.
  • The patients low back extensor strength was about 40% to 45% weaker than established norms.
  • Range of motion was about 18 degrees less than normal.

The Treatment

 

The treatment involved progressive, resistive exercises of the isolated lumbar spine on the MedX lumbar extension machine.  The patients also did aerobic exercise and strength training of other muscles at each visit.

 

Treatment was discontinued when either of the following occurred:

 

  • The patient was pain-free or nearly pain-free and objective functional levels were at or near normal.
  • The patient was no longer making objective gains in spinal function.
  • The patient refused to cooperate or give a good effort.

The average number of treatment required to complete the program was 18 but ranged between 4 and 35.

 

A home exercise program was instituted when treatment goals were reached.

 

The Results

 

Static and dynamic strength and range of motion all increased significantly to normal or near normal levels.

  • 64% reported a substantial decrease in low back pain; in some cases, it was dramatic.
  • 12% reported no change and 3% reported worse.
  • Patients with leg pain 62% reported a substantial improvement.
  • 71% reported a substantial improvement in perceived ability to perform the activities of daily living.
  • The diagnosis did not significantly affect results.
  • Psychosocial factors did affect the results, however many patients who originally showed signs of symptom exaggeration no longer showed those signs at the end.

The 13 Month Follow-up

  •  94% with initial treatment results of good to excellent maintained their improvement.
  • Compliance with the home exercise was less than 50%.
  • 70% of patients who completed the program obtained substantial relief for at least 1-year vs. 29% of the control group. 

The Conclusions of the Study

  • The presence or absence of leg pain did not affect the results.
  • The failure of a supervised exercise program does not preclude a patient from a specific lumbar exercise program.  In fact, this study suggests that much of the exercise done without complete pelvic stabilization is worthless for these type of patients.  This includes the use of Nautilus and Cybex exercise equipment, equipment found in a gym.
  • Specific isolated lumbar extension exercises are effective for chronic low back pain regardless of the underlying condition.
  • Many patients, by their own report, were able to avoid surgery.
  • This study supports the use of specific intensive exercise for chronic back pain patients on the MedX lumbar extension machine.

Our Recommendations

If you are a chronic back pain sufferer, do not give up hope.  Odds are you may not have to “live with it”.

 

These results are typical of the results we have seen in our office, both for chronic back and neck pain.  We also have a MedX cervical extension machine for neck problems.  Our office is the only facility that has the MedX equipment in eastern Pennsylvania outside of York, Lancaster, and Philadelphia.

 

If you’re ready to start living again, give us a call.

 

http://www.chiropractorpottsville.com

Doctors’ Choice Physical Medicine and Rehab

Dr. David Novatnak

Glee Pascual, Physical Therapist

Pottsville, Schuylkill, PA

 

Source:

 

If you would like to read the entire article, it is available at: http://medxonline.com/downloads/articles/focusonthespine.pdf

 

Filed Under: Back Pain, Work Injury Tagged With: , , , , , , , , , , ,