Chiropractors as Primary Spine Specialists

By Dr. Brandon Manson
For Columbia-Greene Media 

Spine related disorders (SRDs) are one of the most common and costly health problems in society, affecting almost every person at some point in life. These disorders encompass a group of conditions directly related to the spine: back pain, neck pain, many types of headache, radiculopathy or referred pain, and a variety of other symptoms.
Recent statistics indicate the cost to the United States health system is huge, and growing. Well over $100 billion is spent annually on SRDs. Yet despite the fact that between 1997 and 2005 expenditures for back and neck pain alone rose by 65 percent (inflation adjusted), patients with SRDs are now worse off than ever. In fact, measures of physical functioning, work productivity, school and social activity, and mental health among patients with SRDs all declined during the same period. Clearly, the dramatic increase in health care costs for diagnosis and medical treatment of SRDs has failed to improve the health of patients. Instead, chronicity and disability related to these disorders continues to steadily rise.

So, you might be saying, “This is just another example of the health system not working… what’s new?” Because spine related disorders account for a significant drain to our health system, it would make sense for policy makers to look at ways that these disorders can be better managed.

In the late 1990s this is exactly what a group of health economists from the University of Ottawa did. They were commissioned by the Ontario government to examine ways to reduce the financial costs of SRDs to the province’s health system. The researchers reviewed every study, every trial, every government inquiry and every scrap of evidence done to date related to treatment of back and neck associated disorders.

What these researchers found was profound: by transferring the care of back pain alone from medical doctors to chiropractors, the government health system would be able to save an estimated 12 percent of its annual health budget annually. The savings could be significantly higher if care of other spine related conditions, such as neck pain and various forms of headache, were also transferred to chiropractic doctors. The researchers showed that the benefit would be not only financial. They concluded that chiropractic care for these conditions was not only significantly more cost effective than medical care, it was more effective (better outcomes) and safer. Numerous studies on patient satisfaction have underlined this conclusion: patients are about three times more satisfied with chiropractic care for back pain than medical care.

Clearly, the time has come for a major change in our management of spine related disorders. It is time for policy makers to get serious about this crippling problem and begin to do what is best for patients and the health system: take steps to establish chiropractic doctors as “primary spine care specialists”.

Most Kids Don’t Eat Three Meals A Day, Study Says

Kids get 42% of their calories from snacks

Eating three square meals a day is the oldest nutrition advice in the book, and some of the most important for staying healthy. But new research shows that children are snacking instead of eating three meals a day on a regular basis, a habit that could be contributing to overweight and obesity and putting them at risk of heart disease later in life.

In a series of reports published in the European Journal of Clinical Nutrition, the International Journal of Obesity and the European Journal of Nutrition, Aino-Maija Eloranta, a PhD candidate at the Institute of Biomedicine and Physiology at the University of Eastern Finland, and her colleagues followed a group of 512 boys and girls enrolled in the Physical Activity and Nutrition in Children (PANIC) Study. The children, ages 6-8, and their parents reported what the kids ate and drank for four days. The researchers also measured their body mass index, waist circumference, blood pressure, cholesterol, blood glucose and insulin levels.

MORE: 7 Eating Habits You Should Drop Now

About 45% of the boys and 34% of girls in the study ate all three meals, meaning a majority of them did not. The most-skipped meal was dinner. “That was a surprise,” says Eloranta. “Among older children, adolescents and even adults, breakfast is the one that is skipped.”
Skipping dinner can have major implications for children’s health, she says, since it’s traditionally the most calorie- and nutrient-rich meal, giving growing children the energy they need to develop. In fact, the children who ate three meals a day had smaller waist circumferences and a 63% lower risk of being overweight or obese than those who skipped some of the major meals.

MORE: 5 Things Everyone Gets Wrong About Breakfast

The scientists also found that among all kids, snacks provided as much as 42% of the children’s daily calories. That’s not necessarily a bad thing, says Eloranta, except that most snacks are high in sugar and low in healthy nutrients like fiber. On average, the children consumed more saturated fat (which has been linked to a higher risk of heart disease) and salt and ate less vitamin D, iron and fiber than guidelines recommend.

MORE: Alice Waters: The Fate of Our Nation Rests on School Lunches

Eloranta did find one positive trend: lunch. Because lunch was provided at school, it was lower in sugar and higher in nutrients and healthier fats than the kids’ other meals on average. This suggests that one of the best ways to help children maintain healthy weights and avoid heart problems later might be to give them three meals a day. “Maybe we don’t have to worry about single nutrients or single foods [like sugar or fat] that much,” she says. “When you eat meals, you automatically receive the good nutrients.”

Does chronic back pain begin in the teen years?

By Dr. Michael Noonan, Special to the BDN

Posted Dec. 25, 2014, at 10:36 a.m.

 

Dr. Michael Noonan

Most people assume that teens do not have back or neck problems, or if they do, they are just sore from an injury or overuse. But when I ask an adult patient with chronic back pain when they first started having problems, it is not unusual for them to tell me they recall pain in their teens.

I started going to a doctor of chiropractic at 16, for treatment of low-back and leg pain. (The treatment was successful enough to determine my career.)

A recent study published in the BioMed Central Musculoskeletal Disorders journal followed 1,300 11- to 13-year-olds for two years, and the results will likely surprise you. Well over 80 percent said they had some kind of spinal pain, either in the neck, middle back, or low back. As expected, most of the teens just had mild, brief bouts of pain, but about 14 percent of the 11-year-olds and 20 percent of the 13-year-olds described their pain as “frequent.” They also found that, for teens with more pain at the beginning of the study, the pain had a tendency to worsen, as well as spread to other parts of the spine.

In another study, 8 percent of 13-year-olds and 34 percent of 15-year-olds sought some form of health care for spinal pain in Denmark. An earlier study looked at the changes in spinal pain over eight years of over 9,500 Danish twins, ranging in age from 12 to 30.

According to the authors, back pain in adolescence is a big risk factor for more serious pain as an adult. This means that addressing back and neck pain in teens would likely prevent a lot of problems in adults; that was certainly the case with me.

Chiropractic care gave me immediate relief, and continuing care, along with a wellness lifestyle, helps me stay pain-free most of the time, despite a lot of back arthritis. Since back pain is the single largest “chronic disease burden” in the world, according to the World Health Organization, the long-term goal would be to treat back pain when it starts, rather than waiting for it to become chronic. It is also important to treat it from many angles — including getting regular exercise, especially stretching; a healthy diet that keeps inflammation at bay; and controlling stress.

My patients with chronic back and neck pain who “follow through” with their care and self-care do much better than those who don’t. After 30 years of practice, I have many patients return for the same problem we helped a few years earlier. The ones who continued to do their exercises and perhaps improve their diets respond better than the ones who don’t. Even better off are the patients who continue with what is called “supportive” or “maintenance” chiropractic care; they choose to continue care, typically between once a month and once every three months. This not only helps them maintain the relief they got initially, but also to improve over time. There is some research that supports this observation; that is why doctors of chiropractic have always recommended preventive care.

It is very gratifying for me when a parent brings their teenaged son or daughter to me for care. I feel I can give them a fighting chance to control their problem, and perhaps prevent a lifetime of taking pain medications and dealing with pain. And who knows, they just might make a career out of it.

Dr. Michael Noonan practices chiropractic, chiropractic acupuncture and other wellness therapies in Old Town. He can be reached at noonanchiropractic@gmail.com.

American Chiropractic Association on Scoliosis

Scoliosis affects 5 to 7 million people in the United States. More than a half million visits are made to doctors’ offices each year for evaluation and treatment of scoliosis. Although scoliosis can begin at any age, it most often develops in adolescents between the ages of 10 and 15. Girls are more commonly affected than boys. Because scoliosis can be inherited, children whose parents or siblings are affected by it should definitely be evaluated by a trained professional.

 

What is scoliosis?

 

Because we walk on 2 feet, the human nervous system constantly works through reflexes and postural control to keep our spine in a straight line from side to side. Occasionally, a lateral (sideways) curvature develops. If the curvature is larger than 10 degrees, it is called scoliosis. Curves less than 10 degrees are often just postural changes. Scoliosis can also be accompanied by lordosis (abnormal curvature toward the front) or kyphosis (abnormal curvature toward the back). In most cases, the vertebrae are also rotated.

 

In more than 80% of cases, the cause of scoliotic curvatures is unknown; we call this condition idiopathic scoliosis. In other cases, trauma, neurological disease, tumors, and the like are responsible. Functional scoliosis is often caused by some postural problem, muscle spasm, or leg-length inequality, which can often be addressed. Structural scoliosis does not reduce with postural maneuvers. Either type can be idiopathic or have an underlying cause.

 

What are the symptoms of scoliosis?

Scoliosis can significantly affect the quality of life by limiting activity, causing pain, reducing lung function, or affecting heart function. Diminished self-esteem and other psychological problems are also seen. Because scoliosis occurs most commonly during adolescence, teens with extreme spinal deviations from the norm are often teased by their peers.

 

Fortunately, 4 out of 5 people with scoliosis have curves of less than 20 degrees, which are usually not detectable to the untrained eye. These small curves are typically no cause for great concern, provided there are no signs of further progression. In growing children and adolescents, however, mild curvatures can worsen quite rapidly—by 10 degrees or more—in a few months. Therefore, frequent checkups are often necessary for this age group.

 

How is scoliosis evaluated?

 

Evaluation begins with a thorough history and physical examination, including postural analysis. If a scoliotic curvature is discovered, a more in-depth evaluation is needed. This might include a search for birth defects, trauma, and other factors that can cause structural curves.

 

Patients with substantial spinal curvatures very often require an x-ray evaluation of the spine. The procedure helps determine the location and magnitude of the scoliosis, along with an underlying cause not evident on physical examination, other associated curvatures, and the health of other organ systems that might be affected by the scoliosis. In addition, x-rays of the wrist are often performed. These films help determine the skeletal age of the person, to see if it matches an accepted standard, which helps the doctor determine the likelihood of progression. Depending on the scoliosis severity, x-rays may need to be repeated as often as every 3 to 4 months to as little as once every few years.

 

Other tests, including evaluation by a Scoliometer™, might also be ordered by the doctor. This device measures the size, by angle, of the rib hump associated with the scoliosis. It is non-invasive, painless, and requires no special procedures. A Scoliometer™ is best used as a guide concerning progression in a person with a known scoliosis—not as a screening device.

 

Is scoliosis always progressive?

 

Generally, it is not. In fact, the vast majority of scolioses remains mild, is not progressive, and requires little treatment, if any.

 

In one group of patients, however, scoliosis is often more progressive. This group is made up of young girls who have scolioses of 25 degrees or larger, but who have not yet had their first menstrual period. Girls generally grow quite quickly during the 12 months before their first period and if they have scolioses, the curvatures tend to progress rapidly. In girls who have already had their first periods, the rate of growth is slower, so their curves tend to progress more slowly.

 

What is the treatment for scoliosis?

 

There are generally three treatment options for scoliosis—careful observation, bracing, and surgery. Careful observation is the most common “treatment,” as most mild scolioses do not progress and cause few, if any, physical problems. Bracing is generally reserved for children who have not reached skeletal maturity (the time when the skeleton stops growing), and who have curves between 25 and 45 degrees. Surgery is generally used in the few cases where the curves are greater than 45 degrees and progressive, and/or when the scoliosis may affect the function of the heart, lungs, or other vital organs.

 

Spinal manipulation, therapeutic exercise, and electrical muscle stimulation have also been advocated in the treatment of scoliosis. None of these therapies alone has been shown to consistently reduce scoliosis or to make the curvatures worse. For patients with back pain along with the scoliosis, manipulation and exercise may be of help.

 

Most people with scoliosis lead normal, happy, and productive lives. Physical activity including exercise is generally well-tolerated and should be encouraged in most cases.

Video: What to expect from your first adjustment

This video discusses a doctor's experience with treatments for low back pain, including proper methods for controlling inflammation, strength training, cold and heat therapy, and medications.

Watch this video to learn more about possible methods to treat back pain marked by inflammation.

Start watching here...

Threadmills for pain relief

One of the most popular types of home exercise equipment is the treadmill, which provides a straightforward, efficient aerobic workout.

For many, treadmills are a good choice to begin a new exercise routine because walking is well tolerated by most individuals regardless of fitness level and for most back conditions.

As strength and endurance are developed, the treadmill can be used for jogging and/or for interval training.

Learn about treadmills for exercise and pain rTelief here. 

Back-healthy snow shoveling

Using the wrong body mechanics when shoveling snow can put undue stress on the lower back and lead to a painful muscle strain, or possibly more serious back injuries.

http://www.spine-health.com/wellness/ergonomics/snow-shoveling-techniques-prevent-low-back-injuries

6.4 million total enrolled for HealthCare.gov in 2015

http://www.cnbc.com/id/102290183

There's going to be a lot of new Obamacare plans underneath Christmas trees on Thursday.
As of last Friday, about 6.4 million people had signed up for 2015 health insurance plans sold on HealthCare.gov, the federal Obamacare exchange that serves 37 states, officials announced Tuesday.

That big number included about 1.9 million new customers, existing Obamacare customers who actively re-enrolled since sign-ups began Nov. 15, and people who were automatically re-enrolled in their current health coverage in the past week, according to the Health and Human Services Department.

The tally reflects a surge in sign-ups that occurred in advance of HealthCare.gov's Dec. 15 deadline for enrolling in plans that take effect Jan. 1. It also reflects the policy of automatic re-enrollment for most current customers, which began Dec. 16 and was completed by last Thursday.

When the 6.4 million HealthCare.gov total is added to confirmed sign-ups from the 13 Obamacare exchanges run by states and the District of Columbia, total enrollment for 2015 plans in this open-enrollment season is about 7.44 million, according to data compiled by the Obamacare tracking site ACASignups.net.

"I expected a surge in enrollment as the year wound down, but this was a bigger surge than I expected," said Larry Levitt, a Kaiser Family Foundation expert on Obamacare.

Levitt also said "it seems pretty clear at this point that the Obama administration will exceed their target" of having 9.1 million people enrolled in Affordable Care Act insurance plans sold through government-run exchanges by the end of 2015. To be considered officially enrolled, a customer must make a premium payment.

He said he expects another big surge in sign-ups in advance of the Feb. 15 close of open enrollment. "If you don't sign up by February 15, you can't get insurance for the rest of 2015," Levitt noted.
He said it will be tougher this year to sign up new, currently uninsured customers for Obamacare plans than it was during the first open-enrollment season, which ended in mid-April.

Getty Images

U.S. Secretary of Health and Human Services Sylvia Burwell.

 

HHS Secretary Sylvia Burwell said, "We still have a lot of work to do before the February 15 enrollment deadline, but this is an encouraging start. People shopped for coverage and signed up—finding more choices and greater competition."

"Thanks to the Affordable Care Act, so far nearly 6.4 million consumers, including about 1.9 million new consumers, have access to quality, affordable health coverage for 2015 through the federal Health Insurance Marketplace.This law is working, and families are better off as a result."

Tuesday's enrollment report comes as most states' deadline for enrolling in coverage that takes effect Jan. 1 has passed.

Tuesday is the deadline for Massachusetts and Washington state residents to choose plans effective by the New Year. Exchanges in four other states—Vermont, Minnesota, Hawaii and Rhode Island—have given residents until Dec. 31 to select plans that take effect the next day.

However, the open-enrollment season in Obamacare plans ends Feb. 15. People will have until then to choose a plan effective in 2015 and can change a plan they had already selected.

4 ways to detoxify Obamacare: Bossidy</p> <p>Larry Bossidy, former Honeywell CEO, discusses the outlook on the U.S. economy and explains why changes need to be made to the Affordable Care Act in order to help small business.

 

Under the ACA, nearly all Americans must have some form of health insurance—such as Obamacare plans, employer-provided coverage, Medicare or Medicaid—or pay a tax penalty.

People who lacked health coverage in 2014 are subject to a potential fine of up to 1 percent of their taxable income. In 2015, that rises to up to 2 percent.

Before open enrollment began Nov. 15, about 6.7 million people nationally were enrolled as paying customers in Obamacare health plans sold on the government-run exchanges.

About 85 percent of those people received federal government subsidies to help pay for their monthly premiums. Such tax credits are available to people who earn between one and four times the federal poverty level, or $11,670 to $46,680 for a single adult, or $23,850 to $95,400 for a family of four.
In a report issued in early December, HHS said an analysis of plans available for 2015 shows that almost 8 in 10 customers on HealthCare.gov would be able to buy coverage for $100 or less per month after the application of those tax credits.

Weight training wards off age-related abdominal fat better than aerobic activity

Weight training for 20 minutes per day helped healthy men stave off age-related abdominal fat gain better than engaging in aerobic activities for the same amount of time, according to research published in Obesity.

 

Although aerobic exercise alone was associated with less weight gain than weight training overall, a combination of the two optimized waist circumference results, Harvard School of Public Health researchers and colleagues found.

“To combat sarcopenia that is inevitable with aging, older adults are recommended to engage in physical activities that achieve the most favorable changes in their body composition, such as loss of fat mass while preserving lean body mass,” Rania Mekary, PhD, of the Department of Nutrition at Harvard, told Endocrine Today. 

“Because long-term weight training leads to this concomitant fat loss and muscle gain, this has been shown to prevent and treat many chronic diseases, including obesity, diabetes, heart disease and osteoporosis,” she said.

Mekary, with Frank B. Hu, MD, PhD, and colleagues, prospectively examined the effects of weight training, moderate to vigorous aerobic activity and replacement between the two on waist circumference and body weight in 10,500 healthy men (mean age 58±7) from the ongoing Health Professionals Follow-up Study over 12 years.

All participants were followed through mailed biennial questionnaires regarding medical history, lifestyle and health-related behaviors, including physical activity. Multiple linear regression models (partition/substitution) were used to assess associations; diet components known to predict weight gain, smoking status, antidepressant use, sleep duration and baseline age were considered.

With adjustments for potential confounders, an inverse dose-response relationship was seen between weight training and waist circumference change (P-trend <.001). Less age-associated waist circumference increase was seen when activity was increased 20 minutes per day; the benefit was stronger for weight training (–0.67 cm; 95% CI, –0.93 to –0.41) than for moderate to vigorous aerobic activity (–0.33 cm; 95% CI, –0.40 to –0.27), other activities (–0.16 cm; 95% CI, –0.28 to –0.03) or television watching (0.08 cm; 95% CI, 0.05–0.12). 

The strongest inverse association with waist circumference change was seen when weight training for 20 minutes per day was substituted for any other discretionary activity. Moderate to vigorous aerobic activity showed the strongest inverse association with body weight change (–0.23 kg; 95% CI, –0.29 to –0.17).

“Incorporating weight training with aerobic exercise is crucial to maintain a healthy waistline,” Mekary said. “Further studies are needed among women, older men, and other ethnic groups to compare the frequency and volume of weight training on waist circumference change.” — by Allegra Tiver

For more information: Rania A. Mekary can be reached at Harvard School of Public Health

Nutrition Department, 655 Huntington Avenue, Boston, MA, 02115; email: rania.mekary@mcphs.edu.

Disclosure: The research was supported by NIH grants.

Pilot study suggests wearable devices can help alleviate back pain

http://news.yahoo.com/pilot-study-suggests-wearable-devices-142202857.html

A major missing element, according to healthcare analytics startup Vivametrica, is context for the data generated and presented by these devices: what's needed is a comparison of an individual's activity pattern with the relevant sector of the general population, an assessment of the relative risks of different diseases based on these patterns, and personalised interventions designed to reduce those risks.

Vivametrica has been researching lower back pain caused by lumbar spinal stenosis (LSS), which, according to cofounder and chief operating officer Dr Christy Lane, "is the top reason for orthopaedic surgery in North America; it's a huge, costly problem, and what's happening is that people are getting thrown into surgery, which is often very successful, but there also are a lot of people who could avoid surgery through something like this".

Vivametrica's pilot study, released today, finds that body mass index is the best predictor of daily function in people with LSS, suggesting that weight loss and increased physical activity may improve the condition. The study also finds that objective activity measures from wearable devices eliminate the guesswork inherent in patient feedback such as questionnaires, allowing more targeted treatment. The use of wearable devices also empowers LSS patients to be more involved in their own health and encourages them to change their behaviour.

The Most Important Thing You Should Do In The Morning

Article From Wellness.com

Have you heard it said that breakfast is the most important meal of the day? Do you know why?

Wellness Tip: The body is an exquisitely engineered machine - with muscles, nerves, and hormones, all operating within a cycle. You sleep, you eat, you play, you flex your muscles and you rest. After a full night's sleep of, say, seven or eight hours, while your body has been resting and regenerating, you have been fasting. No food or drink has been taken, and your digestion has been at a low ebb. Once you are awake, your entire body, including all life hormones, begins to percolate and react to its environment, including your metabolism and your digestive system. It is therefore imperative that you supply something for those awakening digestive juices to "chew" on; not to mention revving up your metabolism that has been asleep for several hours. A glass of water, some fresh organic eggs, avocado and/or a piece of fruit is a great way to start your day and break that fast.

10 Best Dietary New Year's Resolutions

Many people think that New Year's resolutions are a waste of time. People who hold on to this perception, however, base their views on the many failures they have either experienced personally or watched others go through. Yes, too many people spend time coming up with resolutions which are eventually forgotten or only partially implemented.

For these people, resolutions are indeed exercises in futility.

On the other hand, there are some people out there who not only come up with great New Year's resolutions but they actually end up completing and benefitting from them. Subscribing to New Year's resolutions, then, is not the problem. Problems arise either because participants lack the stick-to-itiveness/discipline to complete their goals or they simply create or espouse poorly-constructed resolutions.

For the record, a good New Year's resolution is:

• Practical
• Realistic
• Measurable
• Based on sound (scientific) reasoning
• Compatible with one's lifestyle, resources and abilities

Beyond choosing the right type of resolution, it's also about having the right attitude, expectations and a workable plan. For example, do you realize that your dietary habits will greatly affect how you feel mentally/intellectually, what kinds of activities you can safely engage in, and, more importantly, how long you may live.

With that in mind, here are 10 realistic and likely-to-be beneficial dietary New Year's resolutions:

1. Eat fewer processed foods. Processed foods are heavily laced with all kinds of dangerous chemicals--most of them of a preservative, appetite-enhancement or appearance/taste amelioration type. Instead, go for natural foods; examples are raw fruits and vegetables, meats cut at your local butcher and nuts/grains obtained from local farms.

2. Eliminate or greatly reduce consumption of fast foods. There are very few nutrients in fast foods--most probably because they are often fried or processed. While you are on the road, these foods may be convenient but a viable alternative is to bring your own snacks and meals.

3. Be choosy as to how you quench your thirst. Most beverages out there are bad for your health, especially alcoholic beverages, carbonated drinks, and even otherwise-healthy drinks injected with artificial sweeteners. Your best bet is to drink filtered water (if drinking tap) or bottled water from a reputable dealer.

4. Stay well-read on the latest dietary development, trends and concerns. The best decisions regarding your diet need to come from the best-informed/updated sources--preferably those that base conclusions and theories on studies, tests and the opinions of well-respected experts.

5. Keep a close eye on condiment and seasoning consumption. The fact is that people in developed countries overdo it when comes to condiments and seasonings. This is especially true when it comes to salt and refined sugar. To put it more bluntly: we eat too much salt and refined sugar!

6. Stay away from carb-rich foods, especially if they threaten to burden you with more calories than your body needs. As a general rule, baked goods (e.g., breads, cakes, muffins, cookies, etc.) contain exorbitant amounts of fat and cholesterol. Another thing to keep a close eye on is bleached flour.

7. Greatly increase your consumption of fiber. This substance (naturally found in fruits and vegetables) can help relieve constipation (which can contribute to many medical problems), reduce chances of getting colon cancer, and help your body more efficiently digest foods (thereby improving nutritional absorption).

8. Be exceedingly careful as to how you cook foods. For example, avoid microwaving foods whenever possible. While the jury is still out as to whether microwaved foods pose an immediate danger, there are still too many questions regarding it's long term safety. Also, avoid using Teflon-coated cooking surfaces, as well as painted pots and pans (since some of them may contain lead paints).

9. Avoid uncooked foods whenever possible. When eating out, for example, choose meals that have been cooked, as opposed to things like sandwiches, raw fruits/vegetables and partially-raw meats (especially seafood). Some cultures have traditionally favored raw seafood delicacies but the oceans today are much more heavily polluted than they were in the past.

10. Reject so-called high-technology processed/created foods (until their safety has been definitively proven). These include GMOs (genetically modified organisms), irradiated foods, animals for human consumption injected with hormones and antibiotics, lab-created foods (like sucralose or Splenda), etc. Instead, grow your own fruits and vegetables (when possible) or buy organic products.

Conclusion
By all means, don't give up on New Year's resolutions just because they have not worked well for you in the past. If you take the time to come up with good resolutions, there is no reason why they may not ultimately be beneficial. This is especially true when it comes to dietary New Year's resolutions. If indeed we are what we eat, then we need to make sure that we eat the right things--more importantly, we need to develop the right attitude toward dietary habits.
The first step is to avoid things and practices that have proven to be troublesome for others or about which there are simply too many questions/concerns. After that, it's a matter of sticking to initiatives and endeavors more likely to do us good than harm.

Copyright, 2014. Fred Fletcher. All rights reserved.

References & Resources
1. http://www.apa.org/helpcenter/resolution.aspx
2. http://postscript.com.au/features/health/keep-new-years-resolutions/
3. http://www.processedfreeamerica.org/resources/health-news/48
4. http://www.ecomall.com/greenshopping/teflon4.htm
5. http://healthimpactnews.com/2014/how-eating-processed-food-made-the-world-sick-and-fat/

U.S. Military Health Care Reform

 Michael E. O'Hanlon | December 22, 2014 2:30pm 

On December 19, the Center on 21st Century Security and Intelligence (21CSI) at the Brookings Institution held a wide-ranging event on military health care reform. The conversation included a diverse group of speakers from the Department of Defense (DoD) to the think tank and management consultancy worlds to the Congressional Budget Office.

Michael O’Hanlon of 21CSI hosted the event and was pleased to welcome Assistant Secretary of Defense for Health Affairs Jonathan Woodson as keynote speaker. Woodson described the value of the DoD health care system—which cares for nearly 10 million beneficiaries, costs more than $50 billion a year and has treated more than 50,000 war wounded in the conflicts of the 21st century to date. It employs roughly 140,000 full-time personnel at more than 50 hospitals and some 600 medical or dental clinics. It also involves a network of private providers who treat DoD patients as well; that network includes some 400,000 providers in round numbers.

Among Woodson’s most important points were that the value of military medicine has to be determined across the broad missions that the military health system is responsible for— readiness, health and hospital care, public health, research and development and education and training; and that global security and global health crises have increased the demand for DoD's health expertise even as combat operations are diminishing. Woodson pointed out that the DoD has made important strides in military health care in recent years, including in technologies such as advanced prosthetics, in battlefield survival rates for casualties and also in responsibly holding down cost growth through reforms in areas such as pharmaceutical prescriptions, payment reform and the stand-up of a Defense Health Agency to better integrate care across the military departments. He also spoke of progress in linking the DoD health care system to the Veterans Affairs (VA) system (a separate organization with a separate and even larger health care budget), while acknowledging that a great deal of integration and further improvement remains. He also noted, in response to a question, that it is important to facilitate the access to health care services for activated reservists, and DoD is working hard to make the associated procedures simpler for reservists and families.

After his remarks, a panel made up of former DoD Comptroller Robert Hale, Carla Tighe-Murray of the Congressional Budget Office, Alice Rivlin of the Engelberg Center on Health Care Reform at Brookings, Henry Aaron of the Economic Studies Program at Brookings and Jack Mayer, Executive Vice President at Booz-Allen-Hamilton, convened to continue and broaden the discussion, with O’Hanlon moderating. Among the key points raised were the following:

• Secretary Hale noted the success DoD has had in recent years in reducing provider costs and having beneficiaries share a modestly greater fraction of the military cost burden. Further efforts are underway, motivated in part by the assessment of the Joint Chiefs of Staff that in a budget-constrained environment, resources for training and equipment could be compromised if compensation costs were allowed to grow excessively. Hale made this argument while defending the premise that military compensation should be adequate to meet recruiting and retention needs, that those personnel less able to afford any premium increases should be assisted, and that in general the goal of compensation reform should be to limit future cost growth rather than to make significant cuts. Secretary Hale also advocated closing or streamlining some military treatment facilities that have inadequate caseloads to justify their expense. He suggested a new way of budgeting – return of health care funds to the military services along with centralized execution financed with a working capital fund – that might increase the incentives for the military services to streamline facilities.
  
• Tighe-Murray explained that much of the growth in military health care costs in recent times has been due, not to the wars in Iraq and Afghanistan, but to expanded benefits, as well as a failure of DoD premiums and co-payments to keep up with the general growth in health care costs in the United States. This set of factors has translated into more enrollees, more use of services and higher costs per doctor or hospital visit than would have otherwise been the case. While Secretary Hale had talked about options for DoD health care reform that would save the Pentagon, and taxpayer, perhaps a couple billion dollars a year, Tighe-Murray outlined options that might ultimately save nearly $10 billion annually.
  
• Rivlin and Aaron placed DoD health care in broader context. They recognized that the Department of Defense must provide certain kinds of capabilities, including for battlefield expeditionary medical care, that the private sector does not need to offer in similar ways. But nonetheless, they talked of the pros and cons of more fundamental possible DoD health care reform. For example, in less densely populated parts of the country or for population groups such as retirees that had other options, it might seek to encourage migration of more individuals from the military health care system to the private sector and the civilian system. This option may take on new feasibility in light of the Affordable Care Act. Rivlin and Aaron were careful to emphasize, however, that the DoD could still subsidize the health care costs of its personnel, and perhaps particularly its lower-salaried personnel, under such an approach. Acknowledging the complexities of the issue, however, Aaron also pointed out that it was not clear that the DoD (or the VA system) were necessarily any less efficient as health-care providers than the private sector, at least in some areas of the country.
  
• Jack Mayer underscored the need to think comprehensively about military health care as one element of compensation policy. With an all-volunteer force, the goal of compensation policy is to be fair to the men and women of the U.S. military, to be sure, but also to attract and retain a sufficiently large and high-quality pool of talent. In this regard, the country needs to be careful about providing benefits that may have limited relevance to the recruiting and retention mission and cost the country a good deal as well. Generous health care for able-bodied military retirees and their families may be a case in point—though Mayer also underscored the need for a consensual approach that recognized the interests and equities of many stakeholders. As such, his proposals for reforms focused more on rethinking benefits for future recruits than on changing existing "contracts" with current beneficiaries.

A number of the very useful and often spirited questions and comments during the discussion period came from military personnel, their families and some of their various organizations represented at the event. For those wishing more information, CSPAN covered the discussion and will feature it on the cspan.org website, and Brookings will post a transcript as well.

 Michael E. O'Hanlon | December 22, 2014 2:30pm 

Easy Do-It-Yourself Ice Massage Therapy

To do ice massage therapy, a regular ice cube may be used, but it’s better to use a larger piece of ice. One easy way to do this is to freeze water in a paper or Styrofoam cup, then peel the top inch or two of the cup to expose the ice surface. Read more about how to use ice massage for back pain relief.

Work Steals Valuable Sleep Time, Study Finds

http://consumer.healthday.com/mental-health-information-25/behavior-health-news-56/work-steals-valuable-sleep-time-study-finds-694678.html

Work Steals Valuable Sleep Time, Study Finds

Flexible start times, less late-night TV would help solve America's problem, experts say

By Kathleen Doheny
HealthDay Reporter

TUESDAY, Dec. 16, 2014 (HealthDay News) -- Chronic sleep loss is rampant in America, and work commitment is a big reason why, new research suggests.

"Work is the No. 1 sleep killer," said Dr. Mathias Basner, an assistant professor of sleep and chronobiology in psychiatry at the University of Pennsylvania Perelman School of Medicine.

A time-use survey of nearly 125,000 Americans, ages 15 years and older, found that work is the main activity exchanged for sleep. Short sleepers -- those who slept six hours or less -- worked 1.55 more hours on weekdays and nearly two more hours on weekends and holidays than those who slept longer, the researchers found.

Short sleepers were also more likely to have longer commutes or more than one job. Adults with multiple jobs were 61 percent more likely to sleep six hours or less on weekdays, the researchers said.
This finding "is telling us something about a trend that is a bit worrisome," said Dr. Alon Avidan, director of the University of California, Los Angeles Sleep Disorders Center.

Chronic sleep deprivation can lead to ill health, including blood sugar problems and weight gain, said Avidan, who wasn't involved in the study.

Changes in public policy are needed to remedy the problem, said Basner. He suggested employers and schools consider later starts or flexible hours.

Reducing commute times is another imperative, Basner said. With every hour that work or schools started later in the morning, sleep time rose by about 20 minutes, suggesting later starts or flexible start times might be a solution.

Adults need about seven to nine hours of nightly sleep for best health, productivity and daytime alertness, says the American Academy of Sleep Medicine. But the study authors cited data from the U.S. Centers for Disease Control and Prevention showing that 30 percent of employed American adults typically sleep six hours or less in a 24-hour period.

The study found that unemployed and retired people got more sleep than job holders. Self-employed workers logged more shut-eye, too, and were 17 percent less likely to be short sleepers. Basner thinks that's due to their ability to be more flexible in their working hours.

The study is published in the December issue of Sleep.

The telephone survey -- sponsored by the U.S. Bureau of Labor Statistics and conducted annually by the U.S. Census Bureau -- asked respondents how they spent their time between 4 a.m. the previous day and 4 a.m. on the interview day. The researchers looked at responses from 2003 to 2011.

They combined responses into 40 activities that capture nearly all of the 24-hour day. In the sleeping category were napping, waking up and dreaming.

Work wasn't the only sleep thief. Grooming and watching nighttime television were also culprits, Basner said.
"What we are doing instead of sleep are other activities," he said. "That cuts down our ability to get seven hours of sleep."

Avidan saw two teens recently who had sleep issues. They were evaluated for a sleep disorder known as narcolepsy, in which people fall asleep while engaged in everyday activities. He found that simple sleep deprivation was the problem.

Workers and students can take measures to increase sleep, Avidan and Basner agreed. Cutting down on nighttime TV viewing is one way.

"Some people have elaborate hairstyles," Basner said. Simplifying them can cut down on bathroom time in the morning and boost sleep, he said.

Living closer to work can shorten commute time, Basner said. Aim for a 15- or 20-minute commute, said Avidan, although he acknowledged that might not be realistic in some areas.

Asking for flexible hours might help, Avidan said. You could argue that you will be more productive if you are well-rested, and research would back you up, he said.

"We find people who are sleep deprived are more likely not only to make errors objectively but subjectively," he said. "They are also going to be more irritable."

More information
For more about healthy sleep, visit the American Academy of Sleep Medicine.

SOURCES: Alon Avidan, M.D., M.P.H., professor, neurology, and director, University of California, Los Angeles Sleep Disorders Center; Mathias Basner, M.D., Ph.D., assistant professor, sleep and chronobiology in psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia; Dec. 2014 Sleep

Last Updated: Dec 16, 2014

Copyright © 2014 HealthDay. All rights reserved.

Applying heat therapy

The most effective heat therapy products are the ones that can maintain their heat at the proper temperature.

"Warm" is the proper temperature. Patients should not have their heat source be hot to the point of burning the skin.

Read more about how to apply heat therapy.

Heat therapy info from Spine-Health

While the overall qualities of warmth and heat have long been associated with comfort and relaxation, heat therapy goes a step further and can provide both pain relief and healing benefits for many types of lower back pain. Read more about the benefits of heat therapy.

Childhood obesity may be prevented through reducing the amount of time kids spend using screen media

http://www.dailyrx.com/childhood-obesity-may-be-prevented-through-reducing-amount-time-kids-spend-using-screen-media

Reduce Screen Time To Trim the Fat

Childhood obesity may be prevented through reducing the amount of time kids spend using screen media

(dailyRx News) Trimming TV time may take childhood obesity down a notch. To help parents and inactive kids take a stand against childhood obesity, public health experts recommended cutting down screen media time among kids.

In a recent report, the Community Preventive Services Task Force (CPSTF) found that reducing the amount of TV and screen media helped lower kids' risk of being overweight and obese. Screen media time is time spent in front of a television, computer or cellphone screen.

Based on a past study, the task force confirmed that childhood obesity was tied to screen media exposure. In this new report, strong evidence supported that limiting screen time was effective in improving youth health and weight status, the task force authors wrote.

Barry Sears, MD, president of the Inflammation Research Foundation in Marblehead, MA, and creator of the Zone diet, told dailyRx News that simply reducing kids’ screen time alone would not be enough to stop childhood obesity. Parents can take other steps to keep their children healthy, he said.

“If the goal is to reduce childhood obesity, then there are more effective measures than simply reducing sedentary screen time," Dr. Sears said. "First and foremost is better meal planning that promotes [fullness] as opposed to hunger."

Dr. Sears continues, "The second is spending more interactive time with the child as opposed to using the computer or TV as a babysitter. Third is getting the child outside the house making it less likely to easily get to the kitchen."

The CPSTF — a group of public health experts formed by the US Department of Health and Human Services — reviewed 49 past studies that focused on the benefits of interventions only limiting screen time (screen-time-only interventions) and those both limiting screen time and adding other health components (screen-time-plus interventions).

Interventions were defined as ways to reduce inactive leisure screen time. They were also designed to help kids change their behavior to maintain low screen time. The CPSTF said this would help kids spend less time in front of the TV or computer in the long run.

The CPSTF noted that interventions could include classroom-based education, family- or friend-based social support, ways to track and monitor screen time, and coaching or counseling sessions.

The data showed that, for screen time watched, screen-time-only interventions reduced about 82 minutes of media per day. Screen-time-plus interventions reduced about 22 minutes per day.

Screen-time-plus interventions helped kids become more physically active. Kids who reduced their screen media time took and average of 130 more steps per day.

Concerning diet, screen-time-only interventions resulted in kids eating about 75 calories fewer per day on average. Screen-time-plus interventions resulted in kids eating about 118 calories fewer per day.

Reducing screen time among kids improved their health, the CPSTF said.

“Behavioral screen time interventions were found to be effective among children aged 13 years and younger,” the task force wrote.

The CPSTF noted, though, that only children ages 13 and younger were included in this review. They recommended that future reviews also study the effects of reducing screen time among middle and high school students, as well as adults.

This study has not yet been published but is available in The Guide to Community Preventive Services.

The authors disclosed no funding sources or conflicts of interest.

Joint dysfunction and subluxation

Joint dysfunction in the spine can produce pain, and mobilizing the spine joints through manipulations (also called adjustments) can decrease that pain.

http://www.spine-health.com/conditions/arthritis/more-osteoarthritis-treatments

The term "subluxation" is used by doctors of chiropractic to depict the altered position of the vertebra and subsequent functional loss, which determines the location for the spinal manipulation.

http://www.spine-health.com/treatment/chiropractic/subluxation-and-chiropractic

Pulled Back Muscle Treatment

http://www.spine-health.com/conditions/lower-back-pain/pulled-back-muscle-treatment

Fortunately, back muscle strains usually heal with time, with most healing within a few days and almost all resolving within 3 to 4 weeks. The large muscles in the low back have a good blood supply, which bring the necessary nutrients and proteins for healing to take place.

• See Back Muscles and Low Back Pain

If the lower back muscle pain is severe, the patient may be advised to rest, but for no more than one or two days.

Initial Treatments for Pulled Back Muscles

Typical first line treatments include some combination of:

• Pain medication (such as acetaminophen), to interrupt transmission of pain signals to the brain
• See Pain Medication
• Anti-inflammatory medication (such as ibuprofen, or possibly oral steroids), to reduce the local inflammation that is a cause of the pain
• See NSAIDs
• Muscle relaxants, which may be prescribed on a short-term basis to relieve severe lower back pain associated with muscle spasms.
• See Muscle Relaxants
• Massage, which can help promote blood flow in the lower back (to help with healing), loosen tight lower back muscles, and release endorphins, the body’s natural pain killers.
• See Massage Therapy for Lower Back Pain
• Chiropractic. Gentle manual manipulation is an option to help loosen tight back muscles and promote healing in the lower back.
• See Chiropractic Treatments for Lower Back Pain.

Article continues below

• Ice or cold packs. Application of some type of cold pack can help reduce inflammation, which is helpful immediately following the injury.
• See Ice Massage Therapy
• Heat therapy. Application of heat to the lower back is helpful longer term to stimulate blood flow and healing to the injured area.
• See Heat Therapy

If an episode of low back pain lasts for more than two weeks, the muscles may start to weaken. Because using the lower back muscles is painful, the natural tendency for most patients is to avoid using them. However, lack of activity leads to disuse atrophy (muscle wasting) and subsequent weakening, which in turn causes more low back pain because the muscles are less able to help hold up the spine.

In This Article:

• Pulled Back Muscle and Lower Back Strain
• Pulled Back Muscle Treatment
• Lower Back Strain Video

Back Exercises as Muscle Strain Treatments

Importance of Lower Back Exercise Video

As a general rule, people who are active and well-conditioned are much less likely to suffer from low back pain due to muscle strain, as regular exercise stretches the muscles so they are less likely to strain, tear or spasm.

• For further reading: Exercise and Back Pain

There are three types of muscles that support the spine:

• Extensors (back muscles and gluteal muscles)
• Flexors (abdominal muscles and iliopsoas muscles)
• Obliques or Rotators (side muscles)

While some of these muscles are used in everyday life, most do not get adequate exercise from daily activities and tend to weaken with age unless they are specifically exercised.

• More about Exercises for the Back and Abdominals

A complete exercise program for the low back should consist of a combination of:

• Stretching for Back Pain Relief
• Back Strengthening Exercises
• Low-Impact Aerobic Exercise

Finally, a regular, sustained program of hamstring stretching will help reduce and prevent back muscle tightness and injury. The hamstring muscle runs through the back of each thigh. Tightness in this muscle limits motion in the pelvis which can strain the lower back. Regular hamstring stretching can gradually lengthen these muscles and reduce the stress felt in the lower back.

• See also Specific Hamstring Stretches for Back Pain Relief.

Travel Aches and Strains Can Be a Pain In Your Back

Traveling can be rough on the body. Whether you are traveling alone on business or on your way to a sunny resort with your family, long hours in a car or an airplane can leave you stressed, tired, stiff and sore.

"Prolonged sitting can wreak havoc on your body," says Dr. Scott Bautch, an ACA media spokesperson. "Even if you travel in the most comfortable car or opt to fly first class, certain pressures and forces from awkward positions can result in restricted blood flow. One of the biggest insults to your system from prolonged sitting is the buildup of pressure in the blood vessels in your lower legs. Contracting and relaxing the muscles helps the blood flow properly."

Dr. Bautch and the ACA suggest the following tips and advice to fight the pains and strains of travel before they occur.

Warm Up, Cool Down
Treat travel as an athletic event. Warm up before settling into a car or plane, and cool down once you reach your destination. Take a brisk walk to stretch your hamstring and calf muscles.

In the Car:

• Adjust the seat so you are as close to the steering wheel as comfortably possible. Your knees should be slightly higher than your hips. Place four fingers behind the back of your thigh closest to your knee. If you cannot easily slide your fingers in and out of that space, you need to re-adjust your seat.
• Consider a back support. Using a support behind your back may reduce the risk of low-back strain, pain or injury. The widest part of the support should be between the bottom of your rib cage and your waistline.
• Exercise your legs while driving to reduce the risk of any swelling, fatigue or discomfort. Open your toes as wide as you can, and count to 10. Count to five while you tighten your calf muscles, then your thigh muscles, then your gluteal muscles. Roll your shoulders forward and back, making sure to keep your hands on the steering wheel and your eyes on the road.
• To minimize arm and hand tension while driving, hold the steering wheel at approximately 3 o'clock and 7 o'clock, periodically switching to 10 o'clock and 5 o'clock.
• Do not grip the steering wheel. Instead, tighten and loosen your grip to improve hand circulation and decrease muscle fatigue in the arms, wrists and hands.
• While always being careful to keep your eyes on the road, vary your focal point while driving to reduce the risk of eye fatigue and tension headaches.
• Take rest breaks. Never underestimate the potential consequences of fatigue to yourself, your passengers and other drivers.

In an Airplane:

• Stand up straight and feel the normal "S" curve of your spine. Then use rolled-up pillows or blankets to maintain that curve when you sit in your seat. Tuck a pillow behind your back and just above the beltline and lay another pillow across the gap between your neck and the headrest. If the seat is hollowed from wear, use folded blankets to raise your buttocks a little.
• Check all bags heavier than 5-10 percent of your body weight. Overhead lifting of any significant amount of weight should be avoided to reduce the risk of pain in the lower back or neck. While lifting your bags, stand right in front of the overhead compartment so the spine is not rotated. Do not lift your bags over your head, or turn or twist your head and neck in the process.
• When stowing belongings under the seat, do not force the object with an awkward motion using your legs, feet or arms. This may cause muscle strain or spasms in the upper thighs and lower back muscles. Instead, sit in your seat first, and using your hands and feet, gently guide your bags under the seat directly in front of you.
• While seated, vary your position occasionally to improve circulation and avoid leg cramps. Massage legs and calves. Bring your legs in, and move your knees up and down. Prop your legs up on a book or a bag under your seat.
• Do not sit directly under the air controls. The draft can increase tension in your neck and shoulder muscles.

Safe Travel For Children:

• Always use a car seat in a car when traveling with children below the age of 4 and weighing less than 40 pounds.
• Ask the airline for their policy on child car seat safety. Car seats for infants and toddlers provide added resistance to turbulent skies, and are safer than the lap of a parent in the event of an unfortunate accident.
• Make sure the car seat is appropriate for the age and size of the child. A newborn infant requires a different seat than a 3-year-old toddler.
• Car seats for infants should always face the rear. In this position, the forces and impact of a crash will be spread more evenly along the back and shoulders, providing more protection for the neck.
• Car seats should always be placed in the back seat of the car-ideally in the center. This is especially important in cars equipped with air bags. If an air bag becomes deployed, the force could seriously injure or kill a child or infant placed in the front seat.
• Make sure the car seat is properly secured to the seat of the vehicle and is placed at a 45-degree angle to support the head of the infant or child.

Chiropractic Care Can Help...
"If you follow these simple tips, you can enjoy pain-free, safe travel," says Dr. Bautch. "If you do experience pain and stress on your back, doctors of chiropractic are trained and licensed to diagnose and treat problems of the spine and nervous system."

American Chiropractic Association Launches New YouTube Channel

The American Chiropractic Association (ACA) has launched a new YouTube channel for consumers, Get Healthy with Chiropractic, features videos about work ergonomics, the importance of conservative care, what to expect at one's first visit to a DC and patient testimonials. Go to

www.youtube.com/chirohealthy

Seniors Still Given Potentially Dangerous Sedatives: Study

http://consumer.healthday.com/general-health-information-16/misc-drugs-news-218/seniors-still-given-potentially-dangerous-sedatives-study-694704.html

Seniors Still Given Potentially Dangerous Sedatives: Study

Drugs such as Xanax, Valium tied to confusion and falls, experts say

WEDNESDAY, Dec. 17, 2014 (HealthDay News) -- Doctors continue to prescribe sedatives such as Xanax or Valium for seniors despite the significant risks they pose, a new study contends.

The drugs in question are a class of medications called benzodiazepines. This class includes drugs such as Xanax, Valium and Ativan. As people get older, these drugs are known to put seniors at risk for confusion and falls. Yet, the researchers found that older folks are increasingly being prescribed these medications.

The analysis included national data from 2008. It showed that about 5 percent of Americans aged 18 to 80 (11.5 million people) were prescribed these drugs. Just under 3 percent of people between the ages of 18 and 35 were given these sedatives. But among those aged 65 to 80, nearly 9 percent were on the drugs, according to the study.

Almost one-third of seniors given these sedatives stayed on them for at least four months, the researchers found. Long-term use may make the medications less effective. There's also a greater risk of dependence on the drugs with long-term use, according to the study authors.

"These prescribing patterns likely put a large number of older adults at unnecessary risk of falls, motor vehicle accidents and confusion," study senior author Dr. Mark Olfson, a professor of psychiatry at Columbia University Medical Center and a research psychiatrist at the New York State Psychiatric Institute, said in a university news release.

"As life expectancy increases and the population ages, an increasing number of older adult Americans will face these risks from long-term benzodiazepine use unless steps are taken to promote safer alternative treatments," Olfson said.

The researchers hope the study is a wake-up call for health care professionals. They suggested that health care professionals could teach older adults who have trouble sleeping or experience anxiety about non-drug options for their problems.

"Examples include increasing light-to-moderate exercise, promoting supportive relationships, ensuring adequate exposure to natural light, avoiding stimulants such as caffeine late in the day, avoiding naps, establishing a regular, relaxing bedtime routine, and accepting that quality of sleep naturally tends to decline as we age."

The study was published online Dec. 17 in the journal JAMA Psychiatry.

More information
HealthinAging.org has more about older adults and medications.

SOURCES: Columbia University, news release, Dec. 17, 2014

-- Robert Preidt

Last Updated: Dec 17, 2014

Copyright © 2014 HealthDay. All rights reserved.

Chiropractic manages pain naturally

“Almost everyone can benefit from chiropractic,” says Dr. Nancy J. Trimboli, owner of Trimboli Chiropractic with offices in Munster and Cedar Lake, about managing pain. “Every person on the planet has had a fall, has done sports, and has been involved in a vehicle crash of some type, however minor. These bumps and bruises of life cause spinal misalignments which irritate or interrupt normal joint function and nerve function. If left uncorrected, this will definitely lead to problems. Chiropractors correct those misalignments, allowing the body to heal and function normally. It’s a simple concept yet the ramifications are huge.”

According to Trimboli, chiropractic care has shown through individual patient cases and published research to be not only highly effective for long term back—and other--pain resolution, but to be highly cost effective.

“We have helped countless numbers of people over the years avoid surgery,” she says. “Back surgery obviously should be a last resort. You should do every treatment possible prior to surgery. That should include Chiropractic, massage therapy, physical therapy, acupuncture, even yoga and other exercise. There are specific reasons to have back surgery and pain is not on that list. This is because you most certainly will have pain after back surgery from the surgery itself.”

But that doesn’t mean surgery isn’t totally off the table in certain cases.

“If someone has a progressive muscle weakness or loss of sensation that does not improve with conservative care, they may need a surgical intervention,” says Trimboli. “Also, you need to remember that most people have multiple issues creating their discomfort. Sciatic type pain can be caused from the nerve as it exits the spine, or from disc issue, from a pelvic misalignment, from a muscle spasm, or adhesions on the nerve itself. Chiropractic can address all of these issues, where surgery may only address one of them.”

This approach to pain management has long been a goal for Trimboli who knew from a young age she wanted to work the in medical field. Despite achieving high grades, after completing her undergraduate studies in pre-med, Trimboli decided attending med school was not for her. When a friend’s mother suggested she talk to a chiropractor, it didn’t take long for Trimboli to realize that was the field for her.

“Even when I was 18 I knew there had to be a different way,” she says. “I wanted to study a style of healing that was different than drugs and surgery.”

Choosing chiropractic school, Trimboli spent the first three years taking the same courses and using the same books as medical students. It was then that chiropractic and medical studies began to differ. That divergence formed the foundation for her work. Her mission, she says, is giving to people, young and old, the power and knowledge of chiropractic, so that they may get their greatest enjoyment out of life.

“We offer low force chiropractic adjustments for infants, children and adults,” says Trimboli noting that means there is ‘no popping’ when adjustments are made. “To help us in our work, we have 15 massage therapists on staff that do therapeutic massage, myofascial release, lymphatic drainage, and cranial sacral therapy. Our trainers teach our patients effective at-home exercises to stretch and strengthen spinal muscles. Modalities, such as cold laser therapy, help patients to feel better more quickly and heal more completely.”

It’s also important for people to work at keeping their spines remain flexible and functional including doing specific stretches at home on a routine basis to alleviate or prevent pain.

“Exercise by doing something you enjoy,” says Trimboli. “Challenge your balance and strengthen your core with a yoga, tai chi or Pilates class. Ask for help when lifting things or doing heavy work that you don’t often do. Watch your diet and avoid foods that inflame the spinal joints, which for everyone is sugar.”

Holiday Survival

Holiday Survival

It's fun to get into the holiday spirit and participate in all of the festive activities that abound this time of year, but the added demands of the season can also stress the capacities of our bodies. Remember to take the time to care for yourself, too. Try these tips for handling the holidays in a healthy, happy way.

• Eating healthy can be a year-round challenge, but it's especially difficult during the holidays with office parties and family get-togethers complete with cookies and holiday treats. You can enjoy the festive desserts -- just don't overload on them.
  
• Manage your stress better so it doesn't affect your holiday fun. Try thinking positively, using aromatherapy, drinking tea or getting a massage.
  
• Treat travel as an athletic event. Warm up before settling into a car or plane, and cool down once you reach your destination. While seated, vary your position occasionally to improve circulation and avoid leg cramps.
  
• With all of the parties, the shopping, the decorating and the baking, sleep often takes a backseat during the holidays, but sleep is critical to good health and functioning. Exercise regularly, limit your intake of caffeine and keep your bedroom at a cool, comfortable temperature to help your body get the rest that it needs.

If you're going to be standing in line this season, check out some additional tips to avoid aches and pains.

Stress Reduction and Healing With Music

Stress Reduction and Healing With Music

Jeffrey Sklar

MUSIC IS COMMONLY HEARD IN THE LOBBIES AND WAITING ROOMS of doctors’ offices. Current literature reports how music facilitates stress reduction in patients while they sit in emergency and surgery waiting rooms.1,2,3

Because music is so diverse, it is imp ortant to consider specific forms to evaluate the impact on patient perception. For instance, the classical genre can be very relaxing. In 1998, research from the Department of Management Science, Science University of Tokyo looked at the influence of music on the body by comparing the difference of influence on heart rate variability and comfort when subjects listen to music and are exposed to noise. Researchers used rock, classical music and noise. The following conclusions were made:4 1) Hearing classical music results in a small variance of Mayer wave-related sinus arrhythmia (MWSA) component and respiratory sinus arrhythmia (RSA) component compared with a body at rest. This is because the sympathetic nerve is suppressed by the sound of classical music. With rock music and noise, however, the MWSA component increases and the RSA component decreases. 2) From a psychological evaluation, classical music tends to cause comfort, while rock music and noise tend to cause discomfort. 3) A correlation exists between the balance of the MWSA component and the RSA component and the psychological evaluation. As the comfort increases, the variance of MWSA decreases; as discomfort increases, the variance of MWSA increases.

Music for Pain Relief
A 2006 systematic review of the literature5 found that when patients are able to select their own music, there is no decline in pain intensity. However, significant pain relief was noted in four studies that reported the proportion of subjects with at least 50 percent pain relief; subjects exposed to music had a 70 percent higher likelihood of having pain relief than unexposed subjects. Moreover, researchers found post-surgical patients who were exposed to music required between 15 percent and 18 percent less opioids than patients who were not exposed.

Researchers at the Institute of Music and Neurologic Function, a non-profit research center founded in 1995 in New York City, study music’s extraordinary power to awaken, stimulate and heal as they work with severely disabled patients at the Beth Abraham long-term residential care facility. Concetta Tomaino, DA, a board-certified music therapist and the institute’s director, has seen music decrease agitation and stimulate memory in patients with dementia, help stroke patients recover the power of speech, strengthen muscle groups and increase range of motion in patients beyond the help of traditional rehabilitation.

Cancer Patients
It is clear that music makes an impact in the healing process. In addition to reducing heart rate (or increasing the heart rate depending on the genre), music may be applied to assist with some common side effects that cancer patients experience with chemotherapy. Maria Montserrat Gimeno investigated the effects of music and imagery versus imagery-only interventions on inducing relaxation and reducing nausea and emesis in cancer patients undergoing chemotherapy treatment.6 She found a significant decrease in the frequency of nausea and emesis over time, that is, across the six weeks of treatment. Because vomiting is more of a parasympathetic function than sympathetic, it is fair to say that music may offer positive effects in either activating or blocking the sympathetic or parasympathetic pathway depending on the desired applications and outcomes.

Music and Chiropractic
In 2000 in the Journal of Manipulative & Physiological Therapeutics, researcher Budgell7 states that it is the collective experience of the chiropractic profession that aberrant stimulation at a particular level of the spine may elicit a segmentally organized response, which may manifest itself in dysfunction within organs receiving autonomic innervation at that level. He discusses how this belief about the potential for somatic stimulation of spinal structures to affect visceral function has been at odds with classical views. However, after a major recent review of the literature on the influences of somatic stimulation on autonomic function and from recent original physiologic studies concerning somatoautonomic and spinovisceral reflexes, Budgell found that current neuroscience research supports a neurophysiologic rationale for the concept that aberrant stimulation of spinal or paraspinal structures may lead to segmentally organized reflex responses of the autonomic nervous system, which in turn may alter visceral function.

In exploring the application of music alongside chiropractic care, Miller and Redmond8 noted there is a philosophical basis for the integration of treatment using music therapy and chiropractic. Perception is intimately linked to the nervous system. A relationship between spinal integrity and consciousness does exist.They noted that as spinal distortions diminish and awareness increases, there is a natural attraction toward the higher or more loving state of consciousness.They say that rhythms of healing and suffering are a key concept in combining music therapy with chiropractic manipulation. Although this is conceptual, they subscribe to Donald Epstein’s model of the rhythmic stages of consciousness corresponding to prescribed physiological patterns that serve as a starting point for the use of rhythm in the healing process. They state that music can be used as a significant tool in chiropractic work to aid healing.

Patient Encounters
For a more practical application and clinical reference, anecdotal references shed light on the importance of including music as an integral part of chiropractic treatment: for example, patient CT, a 43-year-old white male who was diagnosed with rectal cancer in February 2012. His treatment consisted of surgery followed by radiation. CT received adjunct therapy throughout his oncology treatment, including rehabilitation exercises, acupuncture, Reiki, massage, mind-body medicine (included guided imagery), naturopathic and nutritional supplementation and chiropractic care. The patient was monitored for side effects. After surgery, CT received six weeks of radiation daily. At the completion of treatment, the patient reported the integrative support played a key role in his accelerated recovery from surgery and he experienced minimal side effects from his radiation treatments. He also attributed a major part of treatment success to chiropractic, which he received three times per week. He reported that during his initial visit, the chiropractic physician offered to play his choice of music genre on Pandora. The patient, a practicing Hindu, requested chanting, and he believes that this expedited his healing process and assisted in keeping his body, mind and spirit in a state of optimal wellness.

Music healing is not by any means genrespecific, as emphasized by the story of patient BB, a 63-year-old man diagnosed in May 2012 with adenocarcinoma of the head of the pancreas. The patient was a physical laborer most of his life and had a history of low-back pain with stenosis and degenerative disk disease. He used a cane daily. During his cancer treatment, he experienced an exacerbation of back pain and requested to be seen by the chiropractic physician. The DC took a genre request for music from him. The patient asked for bluegrass. The music seemed to help him transcend his state of pain during treatment (i.e., flexion distraction and drop adjustments). At the completion of his adjustment, the patient sprung up from a prone position, stood up, shook the doctor’s hand and headed down the hall. The chiropractic physician chased after him, yelling, “Sir, you forgot your cane!”

The knowledge that chiropractic is a patient-centered (not disease-centered) healing arts profession brings to light the need to offer patients any natural and available means of healing. Using music in combination with the adjustment may be a method for improving the effectiveness of the treatment as well as patient satisfaction. With the innovation of websites like Pandora, and the evidence-based literature that music can facilitate many positive physiological aspects of being, there should be mindful efforts made by not only DCs but all healthcare providers to furnish treatment rooms with music.

Footnotes

1. Routhieaux RL, Tansik DA. The benefits of music in hospital waiting rooms. Health Care Supervisor. 16(2):31-40, 1997 Dec.

2. Holm L, Fitzmaurice L. Emergency department waiting room stress: can music or aromatherapy improve anxiety scores? Pediatric Emergency Care. 24(12):836-8, 2008 Dec.

3. Verheecke G, Troch E. Music while you wait. Patient acceptance of music in the preanesthetic period. Acta Anaesthesiologica Belgica. 31(1):61-7, 1980.

4. Umemura M, Honda K. Influence of music on heart rate variability and comfort—a consideration through comparison of music and noise. J Hum Ergol (Tokyo). 1998 Dec; 27(1-2):30-8. Department of Management Science, Science University of Tokyo, Shinjuku-ku, Tokyo, 162-8601 Japan.

5. Cepeda MS, Carr DB, Lau J, Alvarez H. Literature review of music for pain relief. Cochrane Database of Systematic Reviews. (2):CD004843, 2006.

6. Montserrat Gimeno, M. The Effect of Music and Imagery to Induce Relaxation and Reduce Nausea and Emesis in Patients With Cancer Undergoing Chemotherapy Treatment. Music and Medicine. July 2010 vol. 2 no. 3 174-181, first published on June 25, 2010.

7. Budgell, B. Reflex effects of subluxation: the autonomic nervous system. Journal of Manipulative & Physiological Therapeutics Volume 23, Issue 2, Pages 104–106, Feb 2000.

8. Miller EB, Redmond P. Music therapy and chiropractic: an integrative model of tonal and rhythmic spinal adjustment. Alternative Therapies in Health & Medicine. 5(2):102-4, 1999 Mar.