Organized medicine considers chiropractic as a “first-line” solution to the opioid epidemic.
Prominent among prescription drug related deaths and emergency department visits are opioid pain relievers (OPR), also known as narcotics or opioid analgesics, a class of drugs that includes Oxycodone, Methadone, and Hydrocodone, among others. OPR’s now account for more overdose deaths than heroin and cocaine combined!
DeBar et al. (2011) reports alarming recent data showing the significant increase in pain med prescription use and the need to seek viable alternatives.
In 2012, Dr. William Owens, a chiropractor from Buffalo, New York, was conferred as an adjunct associate clinical professor at the State University of New York at Buffalo School of Medicine and Biomedical Sciences, Family Medical Practice. He was invited to participate in the research department, to consider a formal study showing the benefits of family practitioners comanaging cases with chiropractors.
Ciffuentes et al., 2011 showed that care provided by physical therapists or physician services was associated with higher disability recurrence than with chiropractic services. Additionally, those cases treated with chiropractic consistently tended to have lower severity, less pain med use and less surgery. Also, the cases were less costly and the patients experienced shorter initial periods of disability.
Other outcome studies show that when chiropractic care was pursued, the cost of treatment was reduced by 28%, hospitalizations reduced by 41%, back surgery was reduced by 32%, and the cost of medical imaging, including x-rays and MRIs was reduced by 37%.
Hey, for what it’s worth, this is pretty much par for the course! Chiropractic outcome studies have always been good. Of course, some chiros abuse the system and give us all a black eye, but, for the most part we do well in managing acute, subacute and chronic spinal problems as well as extremity problems too, like shoulders and knees etc.
Got a back or neck problem? I can probably help. Plus, I can probably teach you to help yourself! If I can’t help, I’ll send you to someone who can. I promise you that.
The above idiom can be quite literal, as what you consume can and does adversely affect how you feel, and your health. The problem is we don’t realize it or simply ignore it!
The negative response to the food we eat can range from anaphylactic shock to fatigue and pain that seemingly comes from nowhere. Many food sensitivities symptoms are latent, and do not present until hours or evens days later, thus difficult to associate with what you’ve consumed.
There remains a significant population of individuals with chronic or recurrent symptoms that remain in a nonspecific pain or syndrome category, without a specific diagnosis. These individuals experience multiple signs & symptoms, such as, weight gain, fatigue, signs of ADD/ADHD, skin disorders, migraines, digestive problems and so on…
The cause of these symptoms many times is manifested by what we consume. For some reason, our body’s immune system adversely reacts to certain foods we eat or drink. This is sometimes called Food Intolerance. Some experts call the reaction leukocytosis, which is an abnormally high level of white blood cell production. Chronic leukocytosis is very detrimental to ones health and now thought to be a leading cause of degenerative illnesses like cardiovascular disease, arthritis, dementia etc…
What slips through the cracks in healthcare are the people who just feel sick and tired but have no specific diagnosis. They get treated for their symptoms but the root cause of their symptoms goes undetected and many times are given a “surrogate” diagnosis. I call this group, Prodromal People. People with generalized nonspecific signs & symptoms that may lead to a disease or illness.
This is commonly seen in practice, many times with a mechanical back or neck problem but also with the other signs and symptoms that fit no pattern. A great deal of the time it’s the foods and beverages that these patients are consuming that are causing their nonspecific illness symptoms.
The foods and processing/preservative chemicals causing this disturbance can be identified with lab testing in many instances. Once identified and managed, these signs and symptoms resolve.
Blood testing for food and chemical sensitivity is called the ALCAT Test
Go to ALCAT.COM.
Ask me about the ALCAT Tests.
Dr. James E Greathouse Jr., Chiropractic Physician
Chronic joint pain can be complicated. Sometimes there are complex neurological as well as psychological reasons why joint pain remains recurrent. But, these are actually low on the totem pole for causes. More commonly the problem is the misconception of two little suffixes, itis vs. osis. Itis means inflammation and osis means abnormal tissue. Joints that repeatedly cause pain every time you use them develop abnormal tissue. For example, an inflamed tendon is called tendonitis. Once healed and repeatedly worn, the tissue develops abnormally and the condition becomes pain even with normal use. In other words, tendonitis has become a condition called tendonosis. Many doctors fail to recognize this and continue to treat for inflammation. Given that there’s really no inflammation, anti-inflammatories usually don’t have much effect.
Aside from the fact that there’s little to no inflammation with a bout of tendonosis, the main consideration is that these conditions are simply no longer repairing or healing, as if in a dormant state, so it persists and wreaks havoc on the sufferer.
Another issue is reduced blood flow. Inflamed areas are rich in blood flow, which is necessary for healing; chronic problems typically have poor blood flow to the region. This has been demonstrated with very sensitive diagnostic ultrasound studies, more sensitive than MRI.
Common name problems associated with chronic pain include rotator cuff (shoulder) pain, patellar tendonosis (runners knee pain), Achilles heal (tendonosis), medial epicondyle elbow pain (golfers elbow) and of course tennis elbow as well on the lateral aspect, commonly called lateral epicondylitis and should be called epiconylosis. Any joint problem that has become chronic may fall into this category of pain production. In the spine it’s called spondylosis.
Because it’s a problem that commonly results from repeated wear, over time, it’s more commonly an adult problem.
Innovative treatment techniques have arisen over the years to help with osis’s but many times can only be found at specialized orthopedic or sports centers.
Treatment is typically designed to jump start healing and blood flow to the area. Techniques such as shockwave therapy and prolotherapy needling, act as wakeup calls to the painful region. Other techniques include nitroglycerin patches and platelet injection.
Physical therapy techniques that break down scar tissue in the involved regions basically do the same thing on a simpler scale. This might include different forms of joint and soft tissue mobilization and manipulation. Repetitive end range or mid-range therapeutic movement exercises literally remodel dysfunctional tissue, improving the tissue qualities over time. Cold laser has a jump start effect too, as it promotes increased circulation to the region and wakes up dormant cells, activating the natural repair process. It also has a natural analgesic (pain reducing) effect as well.
We provide the physical therapy techniques in combination with cold laser, both of which we’ve had good success with. So, if you have chronic joint pain, give it go. If that fails, then you can opt for the more expensive and invasive techniques out there.
Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of
NEW ORLEANS — Seven different drugs are proven to be effective for preventing episodic migraine attacks and another half-dozen are probably helpful, according to new guidelines released here by the American Academy of Neurology (AAN).
For many years chiropractors have been getting positive results with migraine headaches as well as other form of headaches. Unfortunately, the chiropractic profession has relied heavily on anecdotal evidence to promote these results, without good research to back it up, but there’s good data to suggest that there’s more to care than placebo effect. The key seems to be in the upper neck. Exactly what that is, has yet to be determine, but there are safe and effective ways to address joint problems in the upper neck. The Youtube clip I’m adding to this post is a good example of one of the safe ways to address headaches mechanically. We provide that technique. The McKenzie mechanical appraoch is also a valid & reliable technique as well, and is extremely effective. Not only is it effective but it puts you in control, not a drug or health care provider! I’ve even had great results with cold laser. If you are looking for an alternative to the medications, these techniques are well worth a try and can be determined in short order as to whether effective or not; saving you time and money. Even if you have been to a chiropractor before, these procedures may be new to you and prove beneficial.
If you have questions please feel free to call me so that I may address some of your concerns before you come.
Medicare is set to withdraw most coverage of transcutaneous electrical nerve stimulation (TENS) for chronic low back pain, the Centers for Medicare and Medicaid Services indicated Tuesday.
Reimbursements for this indication would be available only when patients are participating in a randomized, controlled trial of the technology’s clinical effectiveness, according to a proposeddecision memo from CMS.
Currently, Medicare pays for FDA-approved TENS equipment and supplies when prescribed by a physician for chronic intractable pain, and reimburses physicians and physical therapists for evaluating patients’ suitability for the treatment, which is typically used at home.
CMS decided on its own to review its coverage of TENS for chronic low back pain in the wake of a 2010 report by an American Academy of Neurology panel that found the treatment was not effective.
The panel had conducted a systematic review of published studies of TENS. “The review concluded that there was conflicting evidence for the use of TENS in the treatment of chronic low back pain and that TENS should be deemed ineffective for this purpose,” the CMS memo said.
CMS also cited a series of other reviews that failed to find clear support for the technology’s efficacy. On the other hand, some individual studies had shown that it can reduce pain and improve patients’ physical function.
The memo also noted that the National Institute of Neurological Disorders and Stroke has listed TENS as a “possible treatment option” for lower back pain that has not responded to conventional therapies.
But in the absence of consistent evidence of TENS’s efficacy in this indication, CMS plans to withhold coverage except in the context of randomized trials.
Patients in such trials must have been suffering for low back pain for at least three months, with the pain not resulting from conditions such as inflammatory autoimmune disease or metastatic spinal tumors. The trials must also directly address TENS’s clinical efficacy and be designed and powered to yield clear-cut answers. Listing on the Clinicaltrials.gov website is mandatory.
CMS emphasized that Medicare will continue to reimburse for TENS when prescribed for chronic, treatment-refractory pain indications other than low back pain, such as for patients with chronic or severe post-operative pain.
CMS is accepting public comments on the proposed decision through April 12, after which it will issue a final determination.
By Emily P. Walker, Washington Correspondent, MedPage Today
Published: June 30, 2011
WASHINGTON — Chronic pain affects 116 million Americans and costs the U.S. as much as $635 billion each year, according to a new report from the Institute of Medicine (IOM) that called for changes in how chronic pain is managed.
Chronic pain is so widespread and poorly understood that it’s a public health issue and a major “national challenge,” concluded the Committee on Advancing Pain Research, Care, and Education, which was made up of 18 experts in pain management, anesthesiology, bioethics, statistics, and immunology.
“Given the large number of people who experience pain and the enormous cost in terms of both dollars and the suffering experienced by individuals and their families, it is clear that pain is a major public health problem in America,” said committee chair Philip Pizzo, MD, professor of microbiology and immunology at Stanford University School of Medicine, in a press release.
Chronic pain is “more than a physical symptom” and can be influenced by genetics, stress, depression, and behavioral, cultural, and emotional factors, the committee wrote.
Moreover, long-term, persistent pain, which may have been caused by an injury or a disease, can cause changes in the nervous system, which in turn cause the pain to become its own distinct chronic disease.
The report called for a cultural change in order to prevent, assess, treat and understand all types of pain and laid out a blueprint for providing relief from pain.
It directs the Department of Health and Human Services to develop a plan to increase awareness about pain and its health consequences; improve how pain is assessed in the healthcare setting and how treatment of pain is paid for by the federal government; and to address disparities in how different groups of people experience pain.
It also called for the National Institutes of Health to designate a lead institute tasked with “moving pain research forward,” and it called for coordinated efforts between public and private organizations to create recommended changes to how chronic pain is managed.
The committee said that while pain is prevalent, the full scope of the problem is unclear, especially among groups of people where pain might be underdiagnosed and underrated, including minorities, women, children, the elderly, military veterans, and people who are at the end of life. More data should be collected to study trends over time and to pinpoint certain populations at risk for chronic pain, the committee wrote.
The panel offered some advice for doctors as well: Primary care physicians should collaborate with pain specialists in cases where a patient’s pain persists even after treatment. The committee acknowledges that healthcare providers need to be better educated about how to understand pain and its causes, especially primary care doctors who are often the first stop for patients seeking treatment for chronic pain.
The report recommends healthcare providers engage in continuing education programs, and that licensure, certification, and recertification should include assessment of providers’ knowledge of pain management.
Disclaimer:This column is for information only and no part of its content should be construed as medical advice, diagnosis, recommendation or endorsement by Dr. Greathouse.
Always get clearance from your medical doctor before use!
Curcumin (Turmeric) An herb, a major ingredient in curry powder and also used in mustard. Curcumin dosage as anti-inflammatory, 200 to 400 mg, three times per day. To achieve similar amounts of curcumin using turmeric would require 4,000 to 40,000 mg. In combination with Bromelain (also an anti-inflammatory) increases absorption. Best taken on empty stomach 20 minutes before meal.
Quercetin 250 mg 3 times per day, between meals.
Bromelain 500 mg 3 times per day (pineapple enzyme).
Ginger, 2 grams per day in powdered form or 500 to 1000 mg per day in extract form.
Omega-3, Essential fatty acids (EPA/DHA), 360 mg per day.
Comfrey Root Extract Ointment Relieves Back (topical).
Vitamin C, 3 to 4 grams per day.
Zinc, 50 mg per day, also promotes white blood cell production which clean-up the injured cellular debris.
Vitamin E, (D-Alpha-tocopheral), 600 IU.
Creatine & L-tryptophan suppress acute and chronic inflammation.
MSM (methylsulfonylmethane) If allergic to sulfur, do not use! Dosage recommendations, 400 mg to 8,000 mg per day in divided doses for severe pain.
Green drinks, barley, wheat grass juice provide powerful anti-inflammatory and pain-relieving effects.
Magnesium 400-1000 mg / day
Increase water intake, and eat fruits and vegetables.
Avoid products (omega-6 fatty acid), such as safflower oil, corn oil & sunflower oil.
Boswellia extract, from India medicine. Effective for arthritis; 100 mg daily in divided doses, with food.
Sea Cucumber: 200 mg daily. You can take as much as 1,000 mg per day and cut back as you feel better.
Penetran+Plus: a topical product sold in health food stores, works by re-establishing electrical balance in cell membranes. Studies show good effectiveness.
Magnets; some studies do support pain relief effectiveness.
Prolotherapy: Before you have surgery and when all else fails you may want to consider this approach. Basically it’s utilized for lax or loose joints (unstable). Injections are used to stimulate production of new collagen. Contact American Association of Orthopedic Medicine 800 992-2063, a $10 charge for info.
Acupuncture: plenty of evidence this helps. Like anything else though, works for some but not for others. Well worth a try.
Nerve Injury repair
Vitamin B6 (pyridoxine) utilized in almost all biochemical functions. Used for neurotransmitter (nerve) disorders, 250-mg/day safe dose. Scientific study indicates a possible causal relationship between carpal tunnel syndrome and B6 deficiency. A recommendation for additional supplementation of 50 to 100 mg/day, not to exceed 250mg/day, is suggested for carpal tunnel syndrome.
Joint Repair and Associated Pain Relief
Glucosamine sulfate beneficial for joint repair (500mg 3x per day) & Chondroitin sulfate 200 mg per day. These two are normally found in combination and have good supporting evidence in the literature. Still has data that’s not supportive as well.
Knox Gelatin, 2 ounces per 100 lb. body weight.
Always get clearance from your medical doctor before use!