How chiropractic examinations work

How chiropractors examine the structure and function of the spine and then determine specific chiropractic treatments separate chiropractic care from other disciplines.

http://www.spine-health.com/treatment/chiropractic/chiropractic-examination

Could my back pain be a spinal tumor?

Could my back pain be a spinal tumor?

Gonzalo and Kathryn’s metastatic spinal tumors caused them excruciating pain and inability to do daily activates. Then they had their spinal tumor treated with STAR. Hear their stories and how they got their life back.


Click to hear Gonzalo's story


Click to hear Kathryn's Story

Back pain is commonly the symptom that patients notice first when cancer has spread to cause tumors in the spine.

However, some people with metastatic spinal tumors do not have symptoms.

Who is most at risk for metastatic spinal tumors?

If you:

• Have a primary cancer elsewhere in the body
• Are experiencing sudden onset of unexplained back pain (mild to severe)
• Are experiencing neurological problems (such as weakness or numbness of the arms or legs or a change in normal bowel or bladder habits)
• Are experiencing loss of appetite, unplanned weight loss, nausea, vomiting, or fever, chills or shakes.
  
  

...then, you may be at risk for, or have, a metastatic spinal tumor.

Learn More and Download a Free Information Kit

The spine is the most common site for bone metastases, with studies showing that metastatic spinal tumors will develop in between 10% and 40% of all cancer patients, with even higher rates in elderly patients.¹

There are an estimated 160,000 people living with painful metastatic spinal tumors.² Are you, or could you be, one of them?  Are you a caregiver for someone who may be at risk?

Next: Take Action

• Receive information about spinal tumors and the t-RFA/STAR procedure
• Get a discussion guide about STAR to take to your doctor
• Find a STAR physician in your area

References

1. Cardoso ER, et al. Percutaneous tumor curettage and interstitial delivery of samarium-153 coupled with kyphoplasty for treatment of vertebral metastases. J. Neurosurg Spine 2009;10:336-342.
2. Constans, et al., J Neurosurg 59:111-118, 1983; Gokaslan, et al., J Neurosurg 89:599-609, 1998; Wong, et al., Spine 15:1, 1-4.

A Healthy Weight for a Healthy Back

Experts agree that the best way to achieve and maintain a healthy weight level is through a balanced diet and exercise. For people with many types of back problems, regular exercise and, when necessary, weight loss, can help ease existing back problems and prevent future ones.

Obesity and Extra Weight Can Cause Low Back Pain

Along with other health issues that arise from having an unhealthy weight level, obese and overweight patients have an increased risk for back pain, joint pain and muscle strain¹. In particular, overweight patients are more likely to experience problems in their low back than patients at a healthy weight level.

This is especially true for people with extra weight around their midsection as the extra weight pulls the pelvis forward, strains the low back and creates low back pain.

In addition to muscle strain, spinal structures such as the discs can be negatively impacted by obesity. Patients with significant excess weight also may experience sciatica and low back pain from a herniated disc or from a pinched nerve if the discs have been damaged from compensating for the extra weight.²

Weight Loss Can Lower Risk for Other Back Problems

Managing weight through nutrition, diet and exercise not only reduces existing back pain, but can also help prevent certain types of back problems in the future.
For example, overweight and obese patients have an increased risk for osteoarthritis. The additional strain on the joints from the excess weight can cause arthritis in patients whose Body Mass Index (BMI) is too high. For patients who already have osteoarthritis, weight loss is one of the recommended treatments³.

• Read more in the Arthritis Health Center
  In addition, successful recovery from back surgery may also be affected by a patient’s weight because obese patients run a higher risk of complications and infections from surgery³. As a result, overweight or obese patients may consider weight loss before major surgery in order to improve their outcome as well as to avoid contributing to further back problems.
  
  For more information about how obesity affects back health and tips for weight loss, please see Weight Loss for Back Pain Relief.

  Exercise Helps With Weight Loss and Back Pain

  Maintaining a healthy weight usually helps patients to be more consistent with exercise. This is because overweight patients often have fatigue, difficulty breathing or shortness of breath as they exercise, which may cause them to avoid regular physical activity³.
  
  • See Exercise and Back Pain.
    
  As a general rule, many patients with back problems believe that they should avoid all exercise in an effort to protect their back from further injury or back pain. However, in reality, inactivity and lack of exercise can actually contribute to future pain and worsen existing problems.
  
  Patients are often unaware that movement through gentle exercise stimulates healing and a flow of nutrients within the spine. This is especially important for the discs in the spine. Physical activity causes the discs to swell with water and then squeeze it out, which exchanges nutrients between the discs and other spinal structures. When the patient does not engage in enough physical activity, the spinal discs are deprived of the nutrients they need to stay healthy and functional.
  
  • For further reading: Exercise and Fitness to Help Your Back.

  Developing a Safe Weight Loss, Diet and Exercise Program

  The key to a healthy diet and good nutrition is balance. Patients should consume adequate amounts of vitamins and nutrients but should avoid exceeding the daily intake recommendations for some.
  
  Consuming a balanced amount of recommended vitamins and nutrients is also important because certain nutrients and vitamins work in concert while others work against each other. A balanced diet should include a range of healthy foods and, if appropriate, nutritional supplements.
  
  
  Back Exercise
  Videos
  
  Because of the complexities of developing a healthy diet, exercise and weight loss program, patients should always consult a health professional before starting an exercise routine, changing their diet or taking nutritional supplements.
  
  The health professional should help the patient determine any potential limitations and guidelines to follow specific to his or her back problem. With attention to the nutritional content and quantities of food consumed, combined with gentle exercise to control weight, patients will enjoy better back health as well as improved overall health.
  
  References:
  
  1. American Obesity Association. “Health effects of obesity.” AOA Fact Sheets. 2002. http://www.obesity.org.
  2. Fishman L., Ardman C. Back Pain: How to Relieve Low Back Pain and Sciatica. New York: W.W. Norton & Company, 1997:248.
  3. American Obesity Association. “What is obesity?” AOA Fact Sheets. 2002. http://www.obesity.org.

Exercise and Fitness to Help Your Back

A common (and harmful) misconception is that exercise should be avoided when a patient is experiencing back pain. Understandably, many patients are reluctant to exercise out of the fear that any exercises or stretching will aggravate their existing back pain. This may make them rely too heavily on medical treatments and underemphasize the importance of exercise for healing and long term back pain relief.

For most back problems, exercise and movement are the natural stimuli for the healing process. Controlled, gradual and progressive exercise, rather than inactivity and bed rest, most often provides the best long-term solution for reducing back pain and preventing (or lessening) future episodes of pain.

Most experts recommend no more than one or two days rest at the onset of most episodes of back pain. Prolonged inactivity can actually increase back pain as the back becomes stiff, weak, and deconditioned. As the pain increases, many patients reduce their activity and exercise levels, resulting in even more back pain and aggravating the cycle of inactivity and back pain recurrence.

Exercise plays the dual role of both treating back pain and helping prevent future episodes of pain.

• By nourishing and repairing spinal structures, exercise helps alleviate existing back problems.
• Movement and exercise keep the anatomy of the back healthy, flexible and strong in order to reduce the chances of further injury and back pain.

It is always advisable for patients to first consult with a health professional before beginning any exercise or fitness program. Working with a physician or experienced spine specialist will ensure that patients' activities are safe for their back and for their overall health. With back pain, it's particularly important to get an accurate diagnosis for the cause of the patient's pain from a physician or chiropractor in order to rule out possible types of back pain that may be aggravated by exercise (such as spinal instability).

More Exercise Info:
Sciatica Exercises
Stretching and Back Pain
Back Strengthening Exercises

Make Exercise a Priority for Better Back Health in 2015

Is exercise part of your New Year's plan?

Probably one of the most commonly made resolutions, and toughest to fulfill, is the one 'to exercise'. If you have back pain, exercise is crucial to easing chronic pain symptoms and preventing future pain and back problems.

Most of us don't make all of our resolutions a reality each year, so here are some tips for really making exercise a part of your life in 2015. Begin to plan now so that as soon as 2015 is here, you are ready to implement your exercise plan.

Starting an exercise program

One of the most difficult things about exercise is just getting started. It's easy to come up with reasons to put exercise off for just another few weeks, but your back will thank you if you just do it. Here are a few tips to get going:

• Consult with a physical therapist or personal trainer. Going to a gym for the first time can be somewhat intimidating if you don't know your way around all the machines and weights. A trainer or physical therapist can get you comfortable with the various machines. More importantly, they can help to design an exercise program that is right for your unique situation (including any back problems) and demonstrate proper techniques.
• Learn more in Specific Exercise Strategies
  
• Start with low impact aerobic exercise. If you are new to exercising, your muscles, including your heart, may be out of shape. This can leave you prone to frustration (or intimidation) if you become easily winded from just a few minutes of brisk exercise. It's better to start out with low impact aerobic exercise (read 'not running') that creates less jarring on the joints. Equipment like an exercise bike or exercise ball gives a good workout with low stress. Techniques that require some initial training but provide excellent results, including relaxation, for many patients with back problems include yoga and water therapy.
• Learn more in Yoga for Back Problems , Water Therapy Exercises, and Low-Impact Aerobic Exercise.
  
• Learn simple exercises you can do anywhere. When starting to exercise, it's easy to get thrown off by schedule changes and use them as an excuse to not start and/or stop exercising. Getting busy at work, going out of town, holidays, extreme weather – these all can cause disruptions in your new exercise routine. The solution is to have some simple exercises in your fitness toolkit that can weather these disruptions and allow some amount of exercise to continue. For example, walking only requires a good pair of walking shoes and some basic knowledge of good walking technique; otherwise, outdoor pavement or a treadmill is all that you need.
  • See Exercise Walking for Better Back Health
    
When going to a gym or accessing exercise equipment is totally out of the question, it's good to know some simple, yet effective, exercises that can be performed anywhere. An easy-to-do exercise program might include warm up, simple stretching exercises (e.g., for the piriformis and hamstring muscles), strengthening exercises (including abdominal and gluteal exercises), and cool-down exercises (such as walking and gentle stretching).
• Learn more: Easy Exercise Program for Low Back Pain Relief

Sticking to an exercise program

To get true benefit from all your hard work and exercise, exercise must be performed on a regular basis. That usually means some form of activity for at least 30 minutes a day, 3 to 4 times per week. Here are some tips for staying with it:

• Make exercise part of your normal routine. Design an exercise regimen that fits with your unique lifestyle. If you need external motivation, work out with a friend or join a class. If you have kids, join a fitness club that offers childcare; some even have exercise programs for the kids. If you aren't a morning person, don't plan to exercise before work at 6 a.m. The key is finding what exercise program works for you.
• See more tips in Specific Exercise Strategies.
  
• Use exercise goals for motivation. When you feel a slump coming on, it can be helpful to remind yourself why you started exercising in the first place. There are no right or wrong exercise goals, but often they include one or more of the following:
  • To lose weight. Overweight individuals often are at greater risk for back pain, joint pain, and muscle strain than those who are not. Weight loss is usually best achieved through a combination of exercise and diet.
  • Learn more in Weight Loss for Back Pain Relief.
    
  • To tone your body. Not only does a toned body boost self-confidence, it has true therapeutic benefits for back pain patients. In particular, strong stomach and back muscles are important to reduce the likelihood of back pain episodes and to protect against future injury by helping the body respond efficiently to stresses on the spine.
  • Read more in Back Exercises and Abdominal Exercise Recommendations.
    
  • To simply reduce back pain. For people with back problems, the above 2 benefits of exercise may be motivating, but the greatest motivator of all may be pain relief. Lack of exercise can worsen back pain by contributing to stiffness, weakness, and de-conditioning of spinal discs, muscles, ligaments, and joints. Movement distributes needed nutrients into the disc space and soft tissues -- so get moving!
  • Read more in Exercise and Back Pain
    

For many patients with low back pain, it is usually advisable to consult a physician first, who can diagnose the patient's condition and rule out any serious contraindications, such as a fracture or tumor, for certain types of exercise.

Weight Loss for Back Pain Relief

This article examines the heightened risk and severity for certain back problems that obese or overweight patients may experience as a result of their weight. The article also provides practical tips and guidelines for how patients can use exercise, diet and weight loss to reduce their back pain.

How Obesity Leads to Back Pain

According to the American Obesity Association, episodes of musculoskeletal pain, and specifically back pain, are prevalent among the nearly one-third of Americans who are classified as obese.²
The American Obesity Association also reports that more obese persons say they are disabled and less able to complete everyday activities than persons with other chronic conditions.¹

Article continues below

Some of the most common obesity-related problems include musculoskeletal and joint related pain.¹ For people who are overweight, attention to overall weight loss is important as every pound adds strain to the muscles and ligaments in the back.
In order to compensate for extra weight, the spine can become tilted and stressed unevenly. As a result, over time, the back may lose its proper support and an unnatural curvature of the spine may develop.
In particular, pain and problems in the low back may be aggravated by obesity. This occurs for people with extra weight in their stomachs because the excess weight pulls the pelvis forward and strains the lower back, creating lower back pain. According to the American Obesity Association, women who are obese or who have a large waist size are particularly at risk for lower back pain.¹

In This Article:

• Weight Loss and Exercise for Patients
• Nutrition and Diet for Weight Loss

Conditions Related to Obesity

Obese or overweight patients may experience sciatica and low back pain from a herniated disc. This occurs when discs and other spinal structures are damaged from having to compensate for the pressure of extra weight on the back.

• See What's a Herniated Disc, Pinched Nerve, Bulging Disc...?

In addition, pinched nerves and piriformis syndrome may result when extra weight is pushed into spaces between bones in the low back area.³

Osteoarthritis Video

 

Arthritis of the spine that causes back pain may be aggravated when extra body weight strains joints. Those patients with a Body Mass Index (BMI) of greater than 25 are more likely to develop osteoarthritis than those with a lower BMI. The American Obesity Association recommends modest weight loss as a treatment for some types of osteoarthritis.²

The effectiveness of back surgery may also be affected by a patient’s weight. Obese patients are at higher risk for complications and infections after surgery compared to patients who are not obese.² For seriously overweight patients, paying attention to weight loss before undergoing back surgery may improve the healing process after surgery.

Identifying the Need for Weight Loss

Body Mass Index (BMI) is a measure commonly used by medical practitioners. BMI is a mathematical formula (BMI=kg/m2) that takes into account a person’s weight in kilograms and height in meters and calculates a number. The higher a person’s BMI falls on a pre-determined range of values, the higher the likelihood for obesity.

Although there is some debate over the specific meaning of BMI measurements, a BMI of 30 or higher is typically considered to be obese, while a measure of 25 to 29.9 is typically considered to be overweight.⁴
It is also important to evaluate where excess fat is carried on the patient’s body. Patients who carry more weight around their midsection are at greater risk for obesity-related health problems, such as low back pain. Weight loss for health considerations is often advisable for women with a waist measurement of more than 35 inches or men with a waist measurement of more than 40 inches.⁴

References

1. American Obesity Association. "Health effects of obesity." AOA Fact Sheets. 2002.
2. American Obesity Association. "What is obesity?" AOA Fact Sheets. 2002.
3. Fishman L., Ardman C. Back Pain: How to Relieve Low Back Pain and Sciatica. New York: W.W. Norton & Company, 1997: 248.
4. National Institutes of Health. National Institute of Diabetes & Digestive & Kidney Diseases. "Understanding adult obesity." 2001. http://win.niddk.nih.gov.

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.