‘Surgeon Enthusiasm’ May Spur Higher Rates of Back Pain Procedures: Study

Posted in Guidelines for Treatment at 2:06 PM by Dr. Greathouse

March 28, 2011

Sounds like they are not recommending surgery based on indication and better outcome potential, but just that, they recommend surgery more than other docs!

Is that code for, they are “surgery happy”!? Hmm…

MONDAY, March 28 (HealthDay News) — “Surgeon enthusiasm” is a major reason why surgeons in some areas are more likely to recommend surgery for low back problems, according to a new study.

Researchers analyzed data on more than 50,000 low back surgeries performed in the province of Ontario, Canada, between 2002 and 2006. As in the United States, Ontario has some significant area variations in spinal surgery rates.

The study found that surgeons in counties with higher rates of spinal surgery were more likely to recommend surgery for back problems, meaning they had more enthusiasm. Spinal surgery rates were 20 percent higher in counties ranked in the top quarter of surgeon enthusiasm, compared with counties in the bottom quarter of surgeon enthusiasm.

Patient or family-doctor enthusiasm for back surgery had no effect on spinal surgery rates, nor did local differences in rates of degenerative spinal disease.

“Surgeon enthusiasm was found to be the dominant potentially modifiable factor influencing surgical rates,” wrote Dr. S. Samuel Bederman, of the University of California, Irvine, and colleagues.

Other factors include the availability of MRI and patient age, sex and income.

The study was published in the March 15 issue of the journal Spine.

“Strategies targeting surgeon practices may reduce regional variation in care and improve access disparities,” the researchers wrote in a journal news release.

More information

The American Academy of Orthopaedic Surgeons has more about low back surgery.

– Robert Preidt

SOURCE: Spine, news release, March 24, 2011


Chiropractic Featured on the Dr. Oz Show

Posted in Marketing & Promotion at 3:33 PM by Dr. Greathouse

Written on March 7, 2011 by Dr. Todd P. Sullivan
For Introductory Offer go to my website.
For established patients: March Special Free Tune-up visit for the first five responders recommending this blog.
Phone: 321 725-6314

On the show Dr. Oz aired a segment featuring the spine and the causes of back pain. Dr. Oz explained that 80% of people experiencing back pain could benefit from visiting a chiropractor and receiving a chiropractic adjustment to the spine.

On a large piece of equipment designed to represent the spine, Dr. Oz demonstrated how the spine getting out of alignment causes pressure on the discs and nerves, which in turn, causes pain. Dr. Oz said that even simple things such as sleeping wrong or getting groceries out of the car can force the spine out of alignment.

Dr. Oz explained that pain medications only mask the symptoms, but do not treat the underlying cause of back pain. He also said that a misaligned spine can result in a herniated disc which causes a lot of pain and takes quite a while to heal.

Dr. Oz had a chiropractor on the show who proceeded to give an audience member a chiropractic adjustment. Chiropractors restore health by the manual realigning of joints, particularly the spine. After the adjustment was given, he explained to Dr. Oz that realignment of the spine reduces interference to the nervous system and lets the body heal itself.

Dr. Oz has praised the benefits of chiropractic treatment before on previous shows. The majority of chiropractic clinics offer spinal and joint adjustments, massage, electrical stimulation, acupuncture, heat, cold, and exercise prescription to reduce their client’s pain.

As a side note, they didn’t get it right, vertebral misalignment has never been proven and therefore no realignment actually occurs. Chiropractic manipulation does help, we just don’t really know why. The theory still still sounds good though.


Counteract Stress

Posted in Wellness at 2:21 PM by Dr. Greathouse

Count Your Blessings

What does counting your blessings mean and does it do any good?

Counting your blessings is also a form of what is called self-affirmation, positive mental imagery, or reflecting on personal values. Oprah calls this her Gratitude List!

Over the years, multiple scientific studies on this topic have been performed and the verdict is that it does do a body good.

Stress is anything that promotes change in our body. We are all faced with stress on a daily basis, physical, mental and biochemical. Not all stress is bad, however, it becomes detrimental when overwhelming or persistent in some form or fashion. Additionally, it is not always conscious level; stress detrimentally affects us on a subconscious level as well.

One of the biochemical changes associated with stress is suppression of the immune system via a “stress hormone” called cortisol. Cortisol is not unhealthy unless it is overproduced, for too long, in which case it makes us more susceptible to infection or poor healing. It’s thought that chronic stress, conscious or subconscious plays a major role in our health. One stressful event is said to produce the release of 14,000 chemicals and 30 hormones in the body.

The literature is replete with the negative effect of stress on our bodies. The Office of Behavioral and Social Science Research, under the National Institute of Health, lists some of the biological effects of stress; heart disease, heart attacks, delay in growth and development in children, predisposition to type 2 diabetes, elevated lipid levels, depressed immunity, learning and memory disorders, advanced aging, poor wound healing, reactivation of latent virus infection such as herpes and weight gain. Of course the most common symptoms associated with stress are muscle tension, fatigue, and achy pain, along with a multitude of others.

Stress stimulates the part of the autonomic (automatic) nervous system called the sympathetic nervous system; better recognized as the fight or flight response to danger or perceived danger. The counter part is called the parasympathetic nervous system or the calming, relaxing part of the autonomic nervous system. The parasympathetic part can be stimulated by various techniques such as deep breathing, meditation, mental imagery and self-affirmation (counting you blessings).

Science has shown that these techniques help counteract & reduce the bad biochemistry of stress and actually promote the good biochemistry of well-being. Thus, reducing the signs & symptoms associated with stress and reducing predisposition to the diseases associated with stress.

Considering the amount of stress we are all under on a regular basis, it makes sense to practice these techniques on a regular daily basis.

Make a list of anything you can think of that has positive meaning in your life, even if as simple as spitting a watermelon seed the farthest; list all your positive virtues and values and read it to yourself daily.  Studies show we recall and subconsciously harbor negative thoughts a multitude more than we do positive thoughts, therefore, repeated positive self-affirmation is needed to counterbalance the negative.

  • This keeps stress and the negative effects of stress at bay! It really does!


A Physical Therapist’s View of Back Care

Posted in Truths About Back & Neck Pain at 11:55 AM by Dr. Greathouse

"The health care system is collapsing.  Eventually (and it's already
happening), people will not be able to afford a gazillion non productive
visits and insurance companies WON'T pay for it."

The above excerpt comes from a physical therapy discussion board and gives you some insight to the turmoil that
that goes on within. The therapists on this board are primarily made up of outcome oriented therapists. They
commonly lament about lack of specificity, over utilization (too many visits) and poor outcomes associated with
many physical therapists and their methods. 

Physical therapists aren't the only healthcare providers who are guilty of these transgressions. Chiropractors
are arguably much worse, at least from my perspective. Surgeons, as well, must face the music.

Meanwhile, healthcare consumers are still faced with finding providers who are goal and outcome oriented, offering
clinically indicated services with known outcome expectations.


If you have sciatic leg pain… I CAN HELP!

Posted in Uncategorized at 2:15 PM by Dr. Greathouse

Of all the health care practitioners & specialties, with all the bells & whistles out there in the back care world, very few can reliably make an assessment of your problem and tell you, yes, it’s likely we can help you; (with 90% positive outcome ) or, no, it’s not likely we can help you with your sciatic pain. With the McKenzie Method we can!

I have such great confidence and success now with sciatic pain patients, that years ago, before learning this protocol, would have failed trial after trial of different treatment strategies by multiple healthcare providers.

Some sciatic problems do not respond and may indeed require surgery, but that should always be a last resort treatment.

I’m still always amazed when a patient comes in bent over 90 degrees with leg pain to the foot and they walk out upright, without leg pain!

If you or someone you know has mild to severe sciatic pain, it’s well worth a try!

Don’t go through weeks of unreliable meds, physical therapy, traction or standard chiropractic care with poor results, as most do.

Give us a call at 312 725-6314.


Effectiveness of manual therapies: the UK evidence report

Posted in Manual Therapy Works at 11:22 AM by Dr. Greathouse

Effectiveness of manual therapies: the UK evidence report

Chiropractic & Osteopathy 2010, 18:3 doi:10.1186/1746-1340-18-3


Spinal manipulation/mobilization is effective in adults for:

Ø    Acute, subacute, and chronic low back pain.

Ø    Migraine and cervicogenic headache; cervicogenic dizziness.

Manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain.

The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham manipulation, or for Stage 1 hypertension when added to an antihypertensive diet. In children, the evidence is inconclusive regarding the effectiveness for otitis media (ear aches) and enuresis (bedwetting), and it is not effective for infantile colic and asthma when compared to sham manipulation.

Massage is effective in adults for chronic low back pain and chronic neck pain. The evidence is inconclusive for knee osteoarthritis, fibromyalgia, myofascial pain syndrome, migraine headache, and premenstrual syndrome. In children, the evidence is inconclusive for asthma and infantile colic.


Depression After Car Accident Common

Posted in Uncategorized at 1:43 PM by Dr. Greathouse

Frequency, timing, and course of depressive symptomatology after whiplash.

Spine. 2006 Jul 15;31(16):E551-6. Link

CONCLUSIONS: Depressive symptomatology after whiplash is common, occurs early after the injury, and is often persistent or recurrent. This suggests that, like neck pain and headache, depressed symptomatology is part of the cluster of acute whiplash symptoms. Clinicians should be aware of both physical and psychologic injuries after traffic collisions.

We treat personal injury and represent in legal proceedings.


Mechanical Back & Neck Pain

Posted in Uncategorized at 3:13 PM by Dr. Greathouse

Mechanical Pain

Kuritzky, MD. Physician and Sports Medicine 1997;25(l):56-64.

Bend your index finger backward until it’s intensely painful. A biopsy of the finger won’t reveal a tumor, infection or any identifiable lesion, because there is none. But releasing the finger and letting it return to its “position of comfort” will allow the pain to subside.

I want practitioners to understand that surgery is a last resort. If we prescribe mobilization and allow sufficient time, with rare exception, people will get better.

Manual therapy is a viable intervention for back and neck pain!