Tension Headaches

Chiropractic Treatment of Chronic Tension-type Headaches:

A Randomised Clinical Trial conducted at the Northwestern College of Chiropractic, Center for Clinical Studies, Minnesota, USA.


Background:
In the United States headaches are responsible for more than 18 million office visits annually, and are the most common reason for using over-the-counter medications. It is estimated that 156 million work days are lost each year because of headaches, translating to £15 billion in lost productivity. Of the categories of chronic headaches, tension-type headaches are most common.

Headaches are commonly treated by chiropractic doctors with spinal manipulation, and several studies have reported good outcomes. These trials however, suffered from either a lack of a control group or inadequate statistical power. The purpose of this randomised clinical trial was to evaluate the effectiveness of spinal manipulation and a common pharmaceutical treatment (amitriptyline) for chronic tension-type headache.

Methods: One-hundred-fifty patients between the ages of 18 and 70 were randomly assigned to receive either six weeks of chiropractic or pharmaceutical treatment which was preceded by a two week baseline period and included a four week, post-treatment follow up period. Main outcome measures were change in patient-reported daily headache intensity, weekly headache frequency, over-the-counter medication usage, and functional health status using the SF-36 Health Survey.

Results: During the treatment period both groups improved at very similar rates in all primary outcomes. Four weeks following the cessation of treatment patients who received spinal manipulative therapy showed a reduction of 32% in headache intensity, 42% in headache frequency, 30% in over-the-counter medication usage and 16% in functional health status.

By comparison, patients that received amitriptyline showed no improvement or a slight worsening from baseline values in the same outcome measures. The group differences at four week post-treatment follow up were considered to be clinically important and statistically significant.

There is however further need to assess the effectiveness of spinal manipulative therapy beyond four weeks and to compare spinal manipulative therapy to an appropriate placebo such as sham manipulation in future clinical trials.

Conclusion: The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches. Amitriptyline was slightly more effective in reducing pain by the end of the treatment period, but was associated with more side effects. Four weeks after cessation of treatment however, patients who received spinal manipulation experienced a sustained therapeutic benefit in all major outcomes in contrast to the amitriptyline group, who reverted to baseline values. The sustained theraputic benefit associated with spial manipulation seemed to result in a decreased need for over-the-counter medication.

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Reduce Your Stress

Relieving stress can reduce pain that is aggravated or caused by tense muscles. Managing stress on an ongoing basis may also help prevent back pain from occurring in the first place.

Relieving Stress with Exercise:

Stress can be relieved through exercise. Aerobic exercise is a particularly effective form of exercise for relieving stress -aerobic exercise burns off stress hormones and increases the body's production of endorphins - naturally occurring chemicals that relieve pain and improve mood. Stretching exercises also can relieve stress and loosen tight muscles. Yoga incorporates poses that increase strength and flexibility with breathing techniques to relieve stress.

Relaxation Techniques:

Relaxation techniques invoke the "relaxation response." Muscles relax and blood pressure, heartbeat, and respiration decrease. This is the opposite of the "stress response" where muscles tense and blood pressure, heartbeat, and respiration increase.
There are many relaxation techniques, from simple deep breathing exercises that are easy to learn on one's own to self-hypnosis that must initially be taught by a qualified professional. Other relaxation techniques include meditation, progressive muscle relaxation, guided imagery, biofeedback. Special equipment is needed for biofeedback and it must be taught by a professional.

Though most relaxation techniques are not complicated, they still take time and practice to master.

Massage Therapy:

is very beneficial for relaxing muscles, increasing circulation, and relieving stress. Regular massage can help manage stress and back pain. Soaking in warm water relaxes the muscles and has a calming effect
Stress Management is an ongoing process - as is staying strong through exercise. Keeping fit through exercise and managing stress are both important in the treatment and prevention of back pain.

Chiropractic Therapy is regarded as being highly successful in both the treatment and management of stress related Back Pain. Visit http://www.backtrouble.co.uk/

Neck Pain

The efficacy (Efficacy is the ability to produce a desired amount of a desired effect).

of chiropractic for neck pain has been well documented in numerous studies conducted in the United Kingdom, United States, Canada, and the Netherlands. In a joint U.S./Canadian study published in 1996, researchers from UCLA, the West LA Veterans Affairs Medical Centre, and two chiropractic colleges found that for some patients with sub-acute or chronic neck pain, spinal adjustment proved to be a more effective treatment than mobilisation or physical therapy.

In a study conducted by the Canadian Memorial Chiropractic College in Toronto in 1997, researchers found spinal adjustments to improve neck mobility and decrease neck pain. An additional Canadian investigation published in 1997 by the University of Calgary found spinal adjustments to improve neck mobility and decrease neck pain in patients having back and/or neck complaints.

General practitioners in private practice at the Welsh National School of Medicine in the United Kingdom conducted a study of the efficacy of spinal adjustment in alleviating neck and shoulder pain. The results, published in 1983, indicated that pain and discomfort improved significantly after adjustment, as well as range of motion and flexibility of the affected areas.

A 1992 Netherlands study conducted by medical physicians and other professionals investigated different methods of treatment for patients with chronic back and neck pain. After 12 weeks of care, manual therapy (which consisted of adjustment and mobilisation of the spine) had showed a "faster and larger improvement in physical functioning" relative to the other types of treatment such as massage, exercises, and physical therapy.

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Where Does It Hurt?

The Book "Where does it Hurt?"

Empowers the back pain sufferer with information that will enable them to confidently manage their back pain, treatment and rehabilitation.

If You Suffer from Back Pain

Whether it's lower back pain, upper back pain, disc problems or sciatica you can find out the best treatment for your particular problem by reading a copy of

"Where Doe’s it Hurt?"

This book will provide you with:

Unique information that you will never get from your Doctor.

Covers back pain, sciatica, lower back pain, upper-back pain, disc problems plus more.

An explanation of all the things in life that contribute to back and neck pain.

How to get rid of your sciatica or back pain.

A clear explanation of what exercises NOT to do with back pain and why.
The important role stress plays in causing and prolonging back pain.
Plus so much more unique, original information.

"Where does it Hurt?" © 2007.

Now released on http://www.backtrouble.co.uk/

If you would like any further information on "Where does it Hurt?" please contact

consultants@backtrouble.co.uk

Ruptured Disk

Description:

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You have probably heard people say they have a "slipped" or "ruptured" disk in their neck or lower back. What they are actually describing is a herniated disk, a common source of neck, or lower back and arm or leg pain.
Disks are soft, rubbery pads found between the hard bones (vertebrae) that make up the spinal column. In the middle of the spinal column is the spinal canal-a hollow space that contains the spinal cord and other nerve roots. The disks between the vertebrae allow the back to flex or bend. Disks also act as shock absorbers.
Disks in the lumbar spine (low back) are composed of a thick outer ring of cartilage (annulus) and an inner gel-like substance (nucleus). In the cervical spine (neck), the disks are similar but smaller in size.

A disk herniates or ruptures when part of the center nucleus pushes through the outer edge of the disk. The centre nucleus pushes backwards toward the spinal canal. This puts pressure on the nerves. Spinal nerves are very sensitive to even slight amounts of pressure. Pain, numbness or weakness may occur in one or both legs.

Risk Factors & Prevention:
In children and young adults, disks have high water content. As people age, the water content in the disks decreases. They become less flexible. The disks begin to shrink. The spaces between the vertebrae get narrower. The disk itself becomes less flexible. Conditions that can weaken the disk include:
Improper lifting
Smoking
Excessive body weight that places added stress on the disks (in the lower back)
Sudden pressure (which may be slight)
Repetitive strenuous activities

Symptoms:
Lower Back: Low back pain affects four out of five people. Pain alone isn't enough to recognise a herniated disk. See your GP if back pain results from a fall or a blow to your back. The most common symptom of a herniated disk is sciatica - a sharp, often shooting pain that extends from the buttocks down the back of one leg. It is caused by pressure on the spinal nerve.

Other symptoms include:
Weakness in one leg
Tingling (a "pins-and-needles" sensation) or numbness in one leg or buttock
Loss of bladder or bowel control (If you also have significant weakness in both legs, you could have a serious problem. Seek immediate attention.)
A burning pain centered in the neck

Neck: Like pain in the lower back, neck pain is also common. When pressure is placed on a nerve in the neck, it causes pain in the muscles between your neck and shoulder (trapezial muscles). The pain may shoot down the arm. Sometimes the pain causes headaches in the back of the head.

Other symptoms include:
Weakness in one arm
Tingling (a "pins-and-needles" sensation) or numbness in one arm
Loss of bladder or bowel control (If you also have significant weakness in both arms or legs, you could have a serious problem. Seek immediate attention.)
Burning pain in the shoulders, neck or arm.

Diagnosis:
To diagnose a herniated disk, give the physician your complete medical history. Tell him or her if you have neck/back pain with gradually increasing arm/leg pain. Tell the them if you were injured. The physician will physically examine you. This can determine which nerve roots are affected (and how seriously). A simple X-ray may show evidence of disk or degenerative spine changes.
MRI (magnetic resonance imaging) or CT (computed tomography) scans (imaging tests to confirm which disk is injured) or an EMG (a test that measures nerve impulses to the muscles) may be recommended if pain continues.

Treatment Options:
Conservative treatment is effective in treating symptoms of herniated disks in more than 90 percent of patients. Most neck or back pain will resolve gradually with simple measures.
Moderate short term Bed rest and over-the-counter pain relievers may be all that's needed.
Muscle relaxers, analgesic and anti-inflammatory medications are also helpful.
You can also apply cold compresses or ice for no more than 20 minutes at a time, several times a day.
After any spasms settle, you can switch to gentle heat applications.

However it may be advisable to seek specialist advice from a Chiropractic Doctor.

Any physical activity should be slow and controlled, especially bending forward and lifting.

This can help ensure that symptoms do not return. Take short walks and avoid sitting for long periods. For the lower back, exercises may also be helpful in strengthening back and abdominal muscles. For the neck, exercises or traction may also be helpful. It's essential that you learn how to properly stand, sit and lift. This can help you avoid future episodes of pain.

Surgical Treatment Options:
If conservative treatment fails, epidural injections of a cortisone-like drug may lessen nerve irritation and allow better participation in physical therapy. These shots are given on an outpatient basis over a period of weeks.
Surgery may be required if a disk fragment lodges in the spinal canal and presses on a nerve, causing significant loss of function. Surgical options in the lower back include microdiskectomy or laminectomy depending on the size and position of the disk herniation. In the neck, an anterior cervical discectomy and fusion is usually recommended. This involves removing the entire disk to take the pressure off the spinal cord and nerve roots. Bone is placed in the disc space and a metal plate may be used to stabilise the spine. On occasion, a smaller surgery may be performed on the back of the neck that does not require fusing the bones together. Each of these surgeries is performed under general anesthesia. It may be performed as an outpatient or require an overnight hospital stay. You should be able to return to work in two to six weeks.

My Back Ache's

What causes backache?
Backache usually is caused by minor strains in the muscles or ligaments, but more serious lower back pain usually is the result of an injury to one of the many joints in the base of your spine. The joints include the facet joints and discs, which push when disturbed against painful tissue or nerve roots just behind them.

The injury usually happens while bending your spine forwards (flexing it), especially while lifting something heavy.
Never bend forward with your legs straight to perform any task. Once you have experienced back trouble, it has a tendency to recur, and so be careful to protect your back.

How can you care for it?
Adjust your activity to your back discomfort. Take care with posture. Avoid fatigue. Ideally you should perform a set of exercises to strengthen the muscles of your spine and abdomen.

Sport and exercise:

Be careful of sudden twisting movements and sudden overloading of muscles, as in cricket, golf, squash, sailing, weight lifting and horse riding. Walking, jogging (avoid hard surfaces) and swimming are good activities.

Sitting:
Avoid sitting for long periods, especially in the car. Your knees should be higher than your hips and your back straight. Maintain the hollow in your back.

Bed rest and sleep:
Use a low pillow and lie on your side. Do not lie face-up or face-down. Use a firm mattress.

Lifting:
Avoid lifting anything heavier than 10 kg (20 lb). Squat close to the load and keep your back straight. Do not stoop over the load to get a grip and pick it up. Lift using your knees and legs (not your back) as leverage. Keep your back straight, not bent forwards or backwards.

Cleaning floors, Housework and gardening:
Your hands should be as far forward of you as necessary to keep your back straight. Do not flex your back by having your hands working too close to your knees.

Bending:
Take care when bending, for example tying shoelaces or putting on stockings. Put your foot on a stool, chair or box that is near enough to your body and high enough so that you do not have to bend down to your foot.

For professional advice on Back Care and Back related problems consider obtaining advice from a Chiropractic Doctor.
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Baby Colic and Chiropractic Treatment

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If you have a colicky baby, and other forms of treatment don't seem to be helping very much, you may want to investigate taking your baby to a chiropractor.

As your child is being born, the neck and back vertebrae can go out of alignment due to the stretching and compressing of the body as it emerges into the world. If your delivery included a prolonged pushing stage, forceps or vacuum extraction, or other form of assisted delivery, the chances of a misalignment are great.

If the misalignments, called vertebral subluxations, are big enough, the functioning of major systems in the body can be compromised. The digestive system can be affected and ineffective digestion of breast milk and formula can cause major discomfort in your baby, leading to colic episodes.

Many parents are wary of taking their small, helpless babies to see a chiropractor. The main reason being the "Snap, Crackle and Pop" stereotype that chiropractic invokes.

In actuality, the adjustments that a chiropractor will do on your baby are basically applying gentle pressure with the finger to areas on the neck and back. You may see your baby totally relax before your eyes as the misalignments are corrected.

As with selecting any health care provider, you need to ask questions first. In this case, "Have you adjusted other infants?" would be most important. Do ask for referrals that you can contact if you are unsure.

Chiropractic care can be very valuable in helping to calm the colic tendencies.

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Children with Low Back Pain

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Published in 2003 an issue of the peer-reviewed periodical, Journal of Manipulative and Physiological Therapeutics (JMPT), is the results of a very interesting study on lower back pain in children. The journal article starts off by noting that about 50% of children suffer from lower back pain at one time or another. It also notes that about 15% of children experience frequent or continual pain.

The study was conducted on 54 children between the ages of 4 and 18 in the cities of Calgary, Alberta, and Toronto, Ontario, Canada. In the study the children with lower back pain received chiropractic care from a variety of volunteer chiropractors in Canada. The children were tracked regularly during the study to monitor their progress.

Results were obtained in several ways including responses from the patients themselves on how they felt their progress was coming.
Results of the study showed improvement over the follow-up period was observed in 46% to 92% of the children for various criteria. In a period of 30 days 82% of the children reported that they were "much improved."

The researchers conclusions were, "Patients responded favorably to chiropractic management, and there were no reported complications."

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Scoliosis

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Scoliosis is an abnormal curvature of the spine.

A certain degree of spinal curvature is often considered normal and usually requires no formal treatment. This may not be considered an abnormal finding in some cases.

Scoliosis has many causes and can be associated with:
• Neuromuscular disorders
• Bone disease
• Soft tissue disordersScoliosis can occur in infancy or during adolescence.
• Infantile scoliosis is rare and typically presents itself before the age of three.
• Adolescent idiopathic scoliosis is the most common type of scoliosis.

Females are affected eight times as frequent as males. School screening programs have provided for earlier detection and treatment of scoliosis, which has led to improved outcomes.

A careful spinal evaluation is a part of all chiropractic examinations. The examination should also include a thorough neurological examination and inspection for skin lesions to rule out non-idiopathic causes.

Diagnostic evaluation:

• X-rays of the cervical, thoracic and lumbar spine should be performed to measure the exact location and degree of curvature.
• Bone scans may be indicated
.Treatment varies based on criteria including:

• Location of curve
• Type of curve
• Degree of curvature
• Age
• Underlying condition(s)
• Skeletal maturityIn general, curves less than 20 degrees can be observed and followed every six months. Curves above 20 degrees typically require bracing.

Exercise is important for maintaining flexibility and strength of spinal muscles.
Surgery is performed if the curve continues to progress despite bracing, or if the curvature angle is too severe.

Curves above 50 degrees have been shown to progress over the years, and progression of a thoracic curve above 60 degrees can impair heart and lung function. Surgical fusion is important in these cases to prevent further medical problems.

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Continuing with Chiropractic Care

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A LASTING RECOVERY:

Research suggests ligaments and muscles that support your spine take longer to heal than indicated by how you feel. Your body continues to heal these soft tissues after your symptoms are gone. Continuing with chiropractic care encourages more complete healing. This helps assure a lasting recovery.

PREVENTING A RELAPSE:

Before obvious symptoms provided a warning, your body adapted to the soft tissue damage caused by improper spinal function. Without continued chiropractic care, muscles and connective tissue are predisposed to assume unhealthy patterns. Rehabilitative care continues to retrain and strengthen your spine to help avoid a relapse.

AVOID FUTURE PROBLEMS:

Long periods of sitting, financial worries, toxic environments, and many everyday activities can stress your spine. Even the slightest trauma can cause interference to your nervous system and compromise optimum health. Maintenance care can help keep you healthy and avoid small problems from becoming big ones.

SAVE MONEY:

Besides keeping you at your best, continuing your care can save money. Just as brushing and cleaning your teeth can prevent expensive dental treatment, regular chiropractic check-ups help avoid the expense of having to correct preventable problems.

FEELING GOOD:

Continue your chiropractic care so you can enjoy life to the fullest. Your doctor will recommend a schedule of preventive care visits based on his or her clinical experience. Most patients who enjoy a chiropractic lifestyle report they have more energy and feel better.

THE LEARNING EXPERIENCE:

Proper spinal care is new for most people. Ask questions, Get involved, Learn how to become an active partner in the recovery of your health. Make sure you fully understand the role of your spine and nervous system in the maintenance of good health - your most valuable possession.

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Trigger Point Therapy.

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Designed to aid in the treatment of pain or injuries, an orthopaedic massage offers a conceptual approach to the management of soft tissue spasm and dysfunction’s.

The Neuromuscular (Trigger Point Therapy) massage is geared toward the trigger points of the body, which are highly sensitive areas in the muscles that cause localised pain and/or refer pain to other areas of the body.

Chiropractic Doctors apply concentrated finger pressure to these points to break the cycles of spasm and pain. Numerous research studies conducted in the United States, Europe, and Asia have documented that far beyond simply "feeling good"; massage therapy has an impressive range of physical, mental, and emotional benefits.

Benefits of Massage:

• Stimulates the release of endorphins - (the body’s natural painkiller)
• Calms the nervous system

• Improves sleep

• Strengthens the immune system
• Aids in the removal of toxins from the body

• Reduces muscular tension
• Improves circulation of blood & lymph
• Increases the flow of oxygen and nutrients to cells and tissues
• Calms the nervous system
• Improves posture

• Increases flexibility & improves joint range of motion
• Enhances overall performance
• Relieves mental & physical stress
• Overall feeling of well-being

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