Wearing Back Braces At Work: Controversial

American Airlines' baggage handlers found no difference wearing the belt in terms of injury rates and days off.

(from Applied Ergonomics)

A 6-year study of workers at Tinker Air Force Base concluded that workers' injuries while wearing a belt were more expensive than their injuries while not wearing a belt.

One researcher does not believe in insisting that all workers wear back belts. If a worker sees a benefit in wearing the belt, s/he should be able to wear a belt with the following considerations:

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Monitor blood pressure and heart rate due to the cardiovascular risk of wearing the belt.

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Educate the wearer in proper lifting techniques due to false sense of security some wearers feel.

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Do not use the belt for long-term use.

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Assess the ergonomics of the job.

(from Backletter)

 

U. S. Back Surgery Rate Is The Highest In The World

The back surgery rate in the U.S. is at least 40% higher than in any other country and is at least 5 times as high as that in England and Scotland.

Also, it was found that the more neurosurgeons there are in an area, the more back surgeries that occur.

The top 3 reasons for hospitalization are:

  1. Cesarean Section

  2. Tubal Ligation

  3. Back Surgery

(from Spine)

35-37% Experience Low Back Pain Each Month

A study conducted in the United Kingdom found the one-month prevalence of low back pain in an adult population was between 35% and 37%.

(from Spine)

 

Chronic Low Back Pain Is The Most Expensive Condition

Chronic low back pain disability is the most expensive benign condition in industrial countries

In persons under 45, chronic low back pain is the #1 cause of disability.

In persons over 45, chronic low back pain is the #3 cause of disability.

(from Archives of Physical Medicine and Rehabilitation)

 

Patients Off From Work 13 Months... Do Not Return

Return-to-work rates are influenced by both organic (pain) and non-organic factors (job availability, etc.). Patients who underwent a 6-week work-hardening program in preparation for returning to work improved their cardiovascular fitness and muscular strength equally. However, patients who returned to work did so on average at 5.47 months while patients who did not return to work were off of work an average of 13.13 months.

(from Spine)

 

Chiropractic...Cheaper, Better & Needed In Hospitals

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There should be full public insurance of chiropractic services for low back pain.

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Hospital employment, privileges, and patient record accessibility should be extended to chiropractors

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Cooperation between chiropractors, physicians and other providers should be encouraged.

 

(from Journal of Neuromusculoskeletal Systems)

 

Government Urges More Exercise!

"Physical inactivity is a serious nationwide public health problem."  Acting Surgeon General Dr. Audrey Manley states in her first report on physical activity and health. For years I have said that it is not so much the genetic factors which we inherit from our parents that shape our health, rather the environmental factors such as diet, attitudes and exercise habits or lack there of.

The report went on to say that millions of Americans suffered from ailments that could be prevented or improved through regular physical activity. These include the 13.5 million people with coronary heart disease, the 8 million who have adult-onset diabetes, the 95,000 diagnosed with colon cancer each year, the 50 million who suffer from high blood pressure and the 60 million who are over weight.

Dr. David Satcher, director for the Centers for Disease Control and Prevention, noted that exercise could prevent premature death and unnecessary illness and disability and help control health costs.

The report said 60 percent of Americans do not get the recommended amount of physical activity, and 25 percent are not active at all.

Women are more likely to be inactive than men, especially as they age, and poor, less-educated people are more likely to be inactive than rich, well-educated ones.

Nearly half of all people aged 12-21 were not vigorously active on a regular basis, and young women were more sedentary then young men. Only one in four high school students took daily physical education classes in 1995, down from 42 percent in 1991.

In conclusion, moderate exercise for at least 30 minutes per day most days of the week is good for your health and good for your future.

 

Why MD's Do Not Advocate the Use of Vitamins?

 Why don't MD's advocate the use of vitamins, minerals, herbal extracts, amino acids and other natural substances which can all be classified as supplements? Nutrition is not a required course at most U.S. medical schools. Reports show that less than 40% of the U.S. schools even offer the minimum hours of nutritional training. More than 75% of the schools do not require students to take even one nutritional course. Therefore, MDs receive little or no information on the "therapeutic" use of nutritional supplements for specific conditions.

Further, why don't drug companies make lots of money on these products? They can't. There is no money in products that you can't patent.

(from Health Security)

 

Spine Surgery Cost Increase By 97%

Between 1986 & 1993, the hospital cost for a single or double-level spinal arthrodesis surgery increased from $7457 to $19,712 which translates into an actual increase of 97% when adjusting the 1993 dollars for inflation.

Even more dramatic a cost increase, implant costs increased 638% after adjusting for inflation: $300 to $2967.

(from American Journal of Orthopedics)

 

Most People Do Not Know What Caused Their Back Pain

"Spontaneous onset is the natural history of most back pain."

In a study of 11,000 people, low back pain is usually not caused by clearly defined injury. Only a third of patients who are not involved with worker compensation, insurance claims, or pending litigation can name an event that caused their back problem.

(from Backletter)

 

Low back pain: 10% of Cases Are 80% of Costs To Treat

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Low back pain is the number one cause of disability in people less than 45 years old. It is the most expensive condition in industrialized countries.

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50% of patients with acute low back pain (first stage of pain) are no longer disabled within two weeks

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70% of patients recover within 1 month

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90% of patients recover in 3 to 4 months

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The 10% who remain disabled after 3 to 4 months of pain will continue to be disabled after two years and cost about 80% of the money spent in a variety of industries

(from the book, Functional Restoration for Spinal Disorders: the Sports Medicine Approach)

 

Chiropractic Personnel "Out-Read" Medical Counterparts On Lumbosacral X-rays

In a study of 496 volunteers, chiropractic radiologists, residents and students interpreted x-rays more accurately than medical counterparts when reading lumbosacral spine x-rays.

(from Spine)

 

Spinal Manipulation Is Superior To Amitriptyline For Headache Relief

For tension headaches, spinal manipulation therapy (SMT) is an effective treatment. Amitriptyline drug therapy was slightly more effective in pain relief at the end of treatment period but had more side effects. Four weeks post treatment, patients who received SMT sustained their relief in comparison to those who had amitriptyline therapy who reverted back to the same pain prior to therapy.

(from Journal of Manipulative & Physiological Therapeutics)

 

Statistics On Low Back Pain & Its Sufferers

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At least $16 billion each year is spent on low back pain in the U.S.

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Chronic low back pain is the third most common cause of disability among people aged 45 to 64 years.

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Only 1% of patients with acute low back pain will eventually require surgery

(from Canadian Family Physician)

 

Manipulation Relieves Back Pain After Weeks of Suffering

Patients who have suffered with chronic low back pain - longer than 50 days - report immediate benefit from spinal manipulation therapy after just 2 weeks of care.

(from Spine)

 

Proven Relief From Sciatic Pain!

A study entitled, "A Series of Consecutive Cases of Low-Back Pain with Radiating Leg Pain Treated by Chiropractors," was published in the Journal of Manipulative Physiological Therapy by P.J. Stern and J.D. Cassidy. The authors of this new case series from the Royal University Hospital in Saskatoon, Canada, concluded that a course of non-operative treatment, including spinal manipulation, can be effective and safe for treatment of back and radiating pain. A sample population of 71 patients were diagnosed with leg pain from low back disc herniation, most of whom were referred by medical doctors for chiropractic manipulation, electrical stimulation, and flexion exercises. The researcher's conclusion: 90% reported improvement with chiropractic care! Patients showed clinical improvements, greater range of movement, and improvements of the straight leg stretch test. There was no evidence of any increase in leg pain nor were there any complications resulting from the chiropractic treatment of these sciatica cases. Once again, chiropractic has been proven to be safe and effective!

(from Journal of Manipulative Physiological Therapy)

 

Headache Facts

Headaches are of the most common reason that a person seeks chiropractic care. In fact, headaches are experienced by nearly everyone at some time in their life. For nearly 29% of the population, headaches are more than just an occasional discomfort; they are chronic, recurrent and debilitating. They are the most painful condition affecting young adults each year (70%-80%).

There are many different varieties of headaches, but the most common are related to physical, chemical or mental stresses. The cervicogenic headache is frequently overlooked or misdiagnosed by the medical doctor. The cause of these headaches is vertebral subluxations (misalignment of spinal bones) most commonly located in the upper neck region. When a subluxation in this region occurs, pressure is placed on the nerves that supply the pain sensitive structures of the head. These include the arteries of the brain and skull, veins, dura mater (tissue covering the brain) and nerves in the head called cranial nerves.

Chiropractors are the only health care professionals who are trained and licensed to analyze, detect and correct vertebral subluxation. In one of the most thorough studies of migraine headache sufferers ever conducted, chiropractic care recorded a tremendously high success rate. The report conducted over a 50 year period, showed an improvement of cure rate of 72% to 90%.

In a separate study of 87 migraine patients, the success rate for marked improvement or cure was a significant 74.7%. Importantly, patients maintained this relief for at least two years after chiropractic care was completed.

(Today's Chiropractic )

 

M.D.'s May Recommend Manipulation As Option To Surgery

In 1989 Congress created the Agency for Health Care Policy and Research (AHCPR) within the U.S. Department of Health and Human Services. One of the primary tasks given this agency was: "Facilitating the development of clinical practice guidelines and measurements of quality care."

Among the topics selected by AHCPR for guideline development was "low back" pain. Those protocols were released in December 1994.

The AHCPR convened a 23-member panel, composed of medical and chiropractic doctors, nurses, experts in spine research, physical therapists, psychologists and occupational therapists: The guidelines are based upon a review of all the existing medical literature on the treatment of low back pain.

Study findings:

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Spinal manipulation is a recommended treatment for acute low back problems in adults

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Conservative treatment, such as manipulation, should be pursued-in most cases-before surgical intervention is considered

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Prescription drugs, such as oral steroids, anti-depressant medications and colchicine are not recommended for acute low back problems

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Surgery Benefits 1 in 100

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Traction, Massage, Ultrasound, Biofeedback, Electrical Stimulation, Acupuncture and injection procedures are ineffective

Study's Impact:

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All medical doctors and emergency care providers have a duty to inform patients about the alternatives available for the treatment of low back pain. Under the legal principle of "informed consent", all health-care providers must give patients enough information that they can give their informed consent. Courts have long held that doctors must inform patients of conservative alternatives to more drastic forms of treatment. A valid informed consent requires the doctor to advise the patient of:

Informed Consent:

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The nature of the procedure to be employed

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The material risks inherent in such treatment

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The probability of those risks occurring

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The availability and nature of other treatment options, if any

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The material risks inherent in such options and the probability of such risks occurring

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The risks and dangers of remaining untreated

The consumer brochure produced by AHCPR advises the public, "Your health-care provider may recommend spinal manipulation to help relieve your symptoms." The brochure adds, "It should be done by a professional with experience in manipulation."

(AHCPR Study)

 

Chiropractic Demand Increases

There is no doubt that consumer demand seriously influences the goods and services of preference in the free market place. Health care is no exception and those working with the injured consumer (primary care physicians and insurance companies) seeking health care services need to perceive these trends. Certainly, a significant trend in those who have sustained injuries to their lower back or neck is a rapidly increasing demand for chiropractic care.

The largest and most recent study was conducted by Richard Deyo, M.D. of the department of Medicine at the University of Texas. He found that the use of chiropractors for low back pain treatment was about 31%; nearly equal to those seeking medical orthopedists and exceeding any other type of medical specialist. Another study of these trends in Canada has shown similar results. Researchers at the University of Toronto Rheumatic Disease Unit found 34% of Canadians experiencing disabilities from musculo-skeletal disorders chose chiropractic treatment. Once again, this was only second to medical doctors, and only if all medical specialists were lumped together as a group. The third study was conducted at the University of Iowa School of Medicine and only included the elderly population. Results found chiropractic and medical usage to be equal with about 75% seeking each type of care at some time.

While these statistics may be surprising to some, they are very reflective of current times. In regards to high numbers of patients seeking chiropractic care, the researcher at the University of Toronto stated, "These rates may reflect several problems within the medical profession...including an inability to cure or dramatically improve such chronic disorders (spinal pain) and their associated disability." Dr. Deyo summarized the data of this group by stating that research of chiropractic treatment should be a priority.

 

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