Dr Scott Stiffey

A new review of the influenza drug oseltamivir (Tamiflu) has raised questions about both the efficacy of the medication

2012-01-18T12:59:00.000-08:00

New Analysis Challenges Tamiflu Efficacy

By Michael Smith, North American Correspondent, MedPage Today
Published: January 17, 2012
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco.

A new review of the influenza drug oseltamivir (Tamiflu) has raised questions about both the efficacy of the medication and the commitment of its maker to supply enough data for claims about the drug to be evaluated by independent experts.

It also raises questions about the entire process of systematic review.

Researchers led by Tom Jefferson, MD, of the Cochrane Collaboration, pored over 15 published studies and nearly 30,000 pages of "clinical study reports."

But, they reported, the clinical study information – data previously shared only with regulators – was only a part of what internal evidence suggested was available.

And many published studies had to be excluded because of missing or contradictory data, Jefferson and colleagues reported.

Action Points

Explain that a new review of an important flu drug has raised questions about the medication and the entire process of systematic review.
Point out that the review of oseltamivir showed that there was no evidence of effect on hospital admissions.

The drug's maker, Switzerland-based Roche, had promised after a previous Cochrane review to make all of its data available for "legitimate analyses." After a request for the data, Jefferson and colleagues reported, the company sent them 3,195 pages covering 10 treatment trials of the drug.
But, three of the reviewers noted in a parallel report in BMJ, the tables of contents suggested that the data were incomplete.
"What we're seeing is largely Chapter One and Chapter Two of reports that usually have four or five chapters," according to the BMJ article's lead author, Peter Doshi, PhD, of Johns Hopkins University.
Roche did not immediately respond to a telephoned request for comment.
Requests for More Data
The researchers then asked the European Medicines Agency (EMA) for the data, under a Freedom of Information request, and obtained a further 25,453 pages, covering 19 trials.
But that data, too, was incomplete, they said, although the agency said it was all that was available.
The FDA is thought to have the complete reports, but has not yet responded to requests for them, the researchers reported.
Regulatory agencies such as the EMA and FDA routinely see the large clinical study reports, Jefferson and colleagues said in BMJ, but systematic reviewers and the general medical public do not.
"While regulators and systematic reviewers may assess the same clinical trials, the data they look at differs substantially," they said.
The Cochrane group has been trying for several years to put together a clear-cut systematic review of the evidence on antivirals aimed at flu.
In 2006, the group concluded that the evidence showed that oseltamivir reduced the complications of the flu. But that conclusion was challenged on the basis that a key piece of data was flawed.
An updated review in 2009 – throwing out the flawed study -- concluded there wasn't enough evidence to show that the drug had any effect on complications.
For this analysis, the Cochrane reviewers had originally intended to perform a systematic review on both of the approved neuraminidase inhibitors – oseltamivir and zanamivir (Relenza), using the clinical study reports to supplement published trials.
In the end, they decided that for oseltamivir, they needed more detail in order to perform the review in its entirety. But, they reported, some conclusions could be drawn from published data on the 15 trials and from 16,000 pages of clinical study reports that were available before their deadline.
They also decided to postpone analysis of zanamivir (for which they had 10 trials) because the drug's maker, GlaxoSmithKline, offered individual patient data which they wanted time to analyze.
The oseltamivir analysis showed:

The time to first alleviation of symptoms in people with influenza-like illness was a median of 160 hours in the placebo groups and about 21 hours shorter in those treated with oseltamivir. The difference, evaluated in five studies, was significant at P<0.001.
There was no evidence of effect on hospital admissions: In seven studies, the odds ratio was 0.95, with a 95% confidence interval from 0.57 to 1.61, which was nonsignificant at P=0.86.
A post-protocol analysis of eight studies showed that oseltamivir patients were less likely to be diagnosed with influenza.
The data "lacked sufficient detail to credibly assess" any effect on influenza complications and viral transmission.

Data Discrepancies Found
But discrepancies between the published trial data and the clinical study reports "led us to lose confidence in the journal reports," Doshi and colleagues wrote in BMJ.
For example, they noted that one journal report clearly said there were no drug-related serious adverse events, but the clinical study report listed three that were possibly related to oseltamivir.
As well, the sheer scope of the clinical study reports meant that much was left out of journal reports. One 2010 study, on safety and pharmacokinetics of oseltamivir at standard and high dosages, took up seven journal pages and 8,545 pages of the clinical study report.
But the researchers were also shaken, they said, by the "fragility" of some of their assumptions.
For instance, they found that the clinical study reports showed that in many trials, the placebo contained two chemicals not found in the oseltamivir capsules.
"We could find no explanation for why these ingredients were only in the placebo," they wrote in BMJ, "and Roche did not answer our request for more information on the placebo content."
Jefferson and colleagues also reported they found disparities in the numbers of influenza-infected people reported to be present in the treatment versus control groups of oseltamivir trials.
One possible explanation, they noted, is that oseltamivir affects antibody production – even though the manufacturer says it does not.
Gaps in Knowledge Remain
That question is profoundly important, Doshi told MedPage Today, because it may offer clues to how the drug works – one of the gaps in knowledge about oseltamivir.
"You can't make good therapeutic decisions if you don't know how the drugs works," he said – information that he and his colleagues suspect may be buried in the mass of missing data.
It's also important, he said, because public health agencies have been making decisions to stockpile oseltamivir without a clear understanding of the facts.
Essentially, he said, those decisions have been based on the flawed study – a Roche-supported meta-analysis – that was thrown out of the 2009 Cochrane review.
"They're taking the drug manufacturer's word at face value," he said.
The results seem unlikely to resolve conflicts over the medical value of the drug, which is a major cash cow for Roche, adding some $3.4 billion to the company's bottom line in 2009 alone, according to Deborah Cohen, investigations editor of BMJ.
In an accompanying article, Cohen said that "clinicians can be forgiven for being confused about what the evidence on oseltamivir says."
She noted that the European Centre for Disease Prevention and Control, the CDC, and the World Health Organization "differ in their conclusions about what the drug does."
As well, those conclusions are often contradicted by claims on the drug labels – themselves allowed by regulators, Cohen argued.

MRI Spine Course Just Completed

2012-01-14T08:28:00.001-08:00

PRESS RELEASE

FROM: Pro Active Chiropractic Center, 219 S. Main St, Palmyra, MO 63461, USA (www.drscottstiffey.com)

CONTACT: Scott Stiffey, Chiropractor, 573-769-2400, drscottstiffey@gmail.com

FOR IMMEDIATE RELEASE

MRI Spine Interpretation Training for Local Chiropractor

Pro Active Chiropractic Center is today announcing its Chiropractor, Scotty Stiffey, has recently completed advanced training at MRI Spine Interpretation form the University at Buffalo School of Medicine.

Specialized areas in which Stiffey will concentrating are MRI History and Physic, MRI Spinal Anatomy and Protocols, MRI Disc Pathology and Spinal Stenosis , MRI Spinal Pathology, MRI Methodology of Analysis, and MRI Clinical Applications, and the clinical application of the results of space occupying lesions.

“Disc and tumor pathologies and the clinical indications of manual and adjustive therapies in the patient with spinal nerve root and spinal cord insult as sequelae, will also form part of my course of study,” said Stiffey, who sees this course of study as a plus for his patients.

As one of the leading chiropractors operating in the Tri-State area, Stiffey, who has been working in the field 11 years and has trained in over 100 hours on courses to help personal injury patients that have been in car wrecks, said the course of studies he’s embarking on will enable him to help more personal injury patients and patients with more serious spinal conditions.

With his office located at 219 South Main Street in Palmyra in Missouri, Stiffey prides himself in offering state-of-the-art natural health care for our area. “We’re always attending seminars and learning new ways to help health-conscious Northeast MO and West Central IL-area residents,” he said.

Why so much focus on education? Stiffey, who helps with neck and back pain, but also can offer treatment for a variety of other conditions such as Carpal Tunnel Syndrome and Migraine Headaches, said it is “because those who know what a chiropractor does and why seem to get the best results in the shortest amount of time.”

If you are looking for a chiropractor who offers clear explanations, then Stiffey advises you to look for a chiropractor that stays up to date on the latest treatments and research.

For further information, please contact: Scott Stiffey, Chiropractor, 573-769-2400, drscottstiffey@gmail.com, or visit www.drscottstiffey.com

90% of all low back-lumbar disc herniation patients got better with chiropractic care

2012-01-02T09:51:00.003-08:00

Back and Leg Pain (Lumbar Radiculopathy) as a Result of Disc Herniation and the Long Term Effect of Chiropractic Care

90% of all low back-lumbar disc herniation patients got better with chiropractic care

By

Mark Studin DC, FASBE (C), DAAPM, DAAMLP

The term "herniated disc" has been called many things from a slipped disc to a bulging disc. For a doctor who specializes in disc problems, the term is critical because it tells him/her how to create a prognosis and subsequent treatment plan for a patient. To clarify the disc issue, a herniated disc is where a disc tears and the internal material of the disc, called the nucleus pulposis, extends through that tear. It is always results from trauma or an accident. A bulging disc is a degenerative "wear and tear" phenomenon where the internal material or nucleus pulposis does not extend through the disc because there has been no tear, but the walls of the disc have been thinned from degeneration and the internal disc material creates pressure with thinned external walls. The disc itself "spreads out" or bulges.

There are various forms and degrees of disc issues, but the biggest concern of the specialist is whether nerves are being affected that can cause significant pain or other problems. The problem exists when the disc, as a result of a herniation or bulge, is touching or compressing those neurological elements, which is comprised of either the spinal cord, the nerve root (a nerve the extends from the spinal cord) or the covering of the nerves, called the thecal sac.

With regard to the structure that we have just discussed, the doctor must wonder what the herniation of the neurological element has caused. In this scenario, there are 2 possible problems, the spinal cord and nerve root. If the disc has compromised the spinal cord, it is called a myelopathy (my-e-lo-pathy). You have a compression of the spinal cord and problems with your arms or legs. An immediate visit to the neurosurgeon is warranted for a surgical consultation. The second problem is when the disc is effecting the spinal nerve root, called a radiculopathy. It is a very common problem. A doctor of chiropractic experienced in treating radiculopathy has to determine if there is enough room between the disc and the nerve in order to determine if a surgical consultation is warranted or if he/she can safely treat you. This is done by a thorough clinical examination and in many cases, an MRI is required to make a final diagnosis. Most patients do not need a surgical consultation and can be safely treated by an experienced chiropractor.

While herniations can occur anywhere, it was reported by Jordan, Konstanttinou, & O'Dowd (2009) that 95% occur in the lower back. "The highest prevalence is among people aged 30–50 years, with a male to female ratio of 2:1. In people aged 25–55 years, about 95% of herniated discs occur at the lower lumbar spine (L4/5 and L5/S1 level); disc herniation above this level is more common in people aged over 55 years" (http://clinicalevidence.bmj.com/ceweb/conditions/msd/1118/1118_background.jsp#incidence).

It was reported by Aspegren et al. (2009) that 80% of the chiropractic patients studied with both neck and low back (cervical and lumbar) disc herniations had a good clinical outcome with post-care visual analog scores under 2 [0 to 10 with 0 being no pain and 10 being the worst pain imaginable] and resolution of abnormal clinical examination findings. Anatomically, after repeat MRI scans, 63% of the patients studied revealed a reduced size or completely resorbed disc herniation. A study by Murphy, Hurwitz, and McGovern (2009) focused only on low back (lumbar) disc herniations and concluded that, "Nearly 90% of patients reported their outcome to be either 'excellent' or 'good'...clinically meaningful improvement in pain intensity was seen in 74% of patients (p. 729)." The researchers also concluded that the improvements from chiropractic care was maintained for 14 1/2 months, the length of the study, indicating this isn't a temporary, but a long-term solution. It was reported by BenEliyahu (1996) that 78% percent of the low back-lumbar disc herniation patients were able to return to work in their pre-disability occupations, which is the result of the 90% of all low back-lumbar disc herniation patients getting better with chiropractic care as discussed above.

These are the reasons that chiropractic has been, and needs to be, considered for the primary care for low back-lumbar disc herniations with resultant pain in the back or legs. This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions for herniated discs and low back or leg pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.

References:

1. Jordan, J., Konstanttinou, K., & O'Dowd, J. (2009, March 26). Herniated lumbar disc. Clinical Evidence. Retrieved from http://clinicalevidence.bmj.com/ceweb/conditions/msd/1118/1118_background.jsp#incidence
2. Aspegren, D., Enebo, B. A., Miller, M., White, L., Akuthota, V., Hyde, T. E., & Cox, J. M. (2009). Functional scores and subjective responses of injured workers with back or neck pain treated with chiropractic care in an integrative program: A retrospective analysis of 100 cases. Journal Manipulative Physiological Therapy 32(9), 765-771.
3. Murphy, D. R., Hurwitz, E. L., & McGovern, E. E. (2009). A nonsurgical approach to the management of patients with lumbar radiculopathy secondary to herniated disk: A prospective observational cohort study with follow-up. Journal Manipulative Physiological Therapy, (32)9, 723-733.
4. BenEliyahu, D. J. (1996). Magnetic resonance imaging and clinical follow-up: Study of 27 patients receiving chiropractic care for cervical and lumbar disc herniations. Journal Manipulative Physiological Therapy, 19(9), 597-606.

Chiropractic care rendered significantly greater relief of pain and significantly more mobility

2012-01-02T09:51:00.001-08:00

Arthritis and Low Back Pain:
Chiropractic Care vs. Heat Treatment

Chiropractic care rendered significantly greater relief of pain
and significantly more mobility

By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP

"31 million Americans experience low-back pain at any given time" (The American Chiropractic Association, 2010, https://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=68)

Interesting facts about back pain:¹

One-half of all working Americans state that they experience back pain each year.
One of the most common reasons people call out of work is back pain. It is also the second most common reason for a visit to the doctor's office.
Back pain is often mechanical or non-organic, meaning it is not caused by a serious condition, such as inflammatory arthritis, infection, fracture or cancer.
At least $50 billion per year is spent by Americans on back pain.
Experts estimate as much as 80% of the population will experience a back problem at some time in their lives.

What Causes Back Pain?

The back is made up of bones, joints, ligaments and muscles. Ligaments can be sprained, muscles can be strained, disks can rupture, and joints can be irritated. All of these can result in back pain. It doesn't always take a major event like a sports inury or an accident to cause back pain. Even the simplest of movements, like picking a small object up from the floor, can have painful results. There are also numerous conditions that can cause or complicate back pain, such as arthritis, poor posture, obesity, and psychological stress. Disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss, can also result in back pain.¹

The most common form of arthritis is called osteoarthritis. It is also known as degenerative joint disease and is a disease of the joints. It affects more than 20 million American adults. The cause of osteoarthritis is a breakdown of cartilage, the connective tissue that provides a cushion between the bones of the joints. Healthy cartilage is what permits bones to move over one another and acts as a shock absorber during physical movement. Those afflicted with this disease experience a breakdown of cartilage that wears away. As a result, the bones under the cartilage rub together, resulting in pain, swelling, and loss of joint motion.²

What Causes Osteoarthritis?²

There is often no known cause of osteoarthritis. Risk factors include:

Age – More people over the age of 45 are affected by osteoarthritis
Female – Osteoarthritis more often affects women than in men
Particular hereditary conditions like defective cartilage and joint deformity
Joint injuries that result from sports, work-related activity or accidents
Obesity

Signs and Symptoms of Osteoarthritis²

Osteoarthritis often begins at a slow rate. Early on, joints may be sore after physical work or exercise. The pain of early osteoarthritis dissipates and then returns over time, particularly as a result of overuse of the affected joint . Other symptoms may include:

Swelling or sensitivity in one or more joints, especially when related to a change in the weather
Loss of joint flexibility
Stiffness in the joint(s) after getting out of bed
Either a crunching feeling or sound resulting from bone rubbing on bone
Bony lumps on the finger joints or at the base of the thumb
Intermittent or regular pain in a joint

In 2006, "...an experimental design was used to compare the effects of chiropractic care (and moist heat) to the effects of moist heat alone for treating lower back pain that is secondary to [arthritis] of the lumbar spine" (Beyerman, Palmerino, Zohn, Kane, & Foster, 2006, p. 107). This was the first study of its kind. There were 3 parameters measured, pain, mobility and activities of daily living. The results conclusively revealed in every metric analyzed that chiropractic care rendered significantly better results, rendering greater relief of pain and significantly more mobility had been restored.

Low back pain and osteoarthritis is a very common condition treated daily in chiropractor’s offices nationwide. This study confirms scientifically the clinical results treating chiropractors have been experiencing for over 100 years. The degree to which pain interferes with aspects of daily living was statistically measured, specifically with walking, sitting and social life and those test subjects under chiropractic care had superior results that simply utilized moist heat.³

These studies along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions for patients with low back pain and arthritis. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.

References:

1. The American Chriopractic Association. (2010). Back pain facts and & statistics. Retrieved from https://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=68
2. Dawson, E. G., & Shaffrey, C. I. (2009, December). Osteoarthritis: Degenerative spinal joint disease. Spineuniverse. Retrieved from http://www.spineuniverse.com/conditions/spondylosis/osteoarthritis-degenerative-spinal-joint-disease 3. Beyerman, K. L., Palmerino, M. B., Zohn, L. E., Kane, G. M., & Foster, K. A. (2006). Efficacy of treating low back pain and dysfunction secondary to osteoarthritis: Chiropractic care compared with moist heat alone. Journal of Manipulative and Physiological Therapeutics, 29(2), 107-114.

The overall patient satisfaction rate was 94%

2012-01-02T09:50:00.002-08:00

Acute Neck Pain (Torticollis), Disability
and Chiropractic:
Patient Satisfaction Results

The overall patient satisfaction rate was 94%

By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP

"Acute neck pain means immediate neck pain. Neck pain that just started. This type of pain comes on suddenly and affects the ability to properly move your head in its proper range of motion. One serious type of acute neck pain is whiplash - the sudden jarring motion of your head going backwards and forward. This often occurs with a rear end collision. Acute neck pain can also be the result of a fall, sleeping awkwardly, a trauma or even a fall.. Often times when someone has just strained or irritated their neck in some way the pain is most severe. There is usually inflammation, immobility, and muscle tenderness. Often with acute neck pain, the muscles or ligaments are involved" (The Neck Pain Relief Shop, n.d., http://www.neckpainreliefkit.com/acuteneckpain).

The “real life” issue for the patient who either wakes up with this debilitating pain or is in an accident that causes it, is that taking drugs without narcotics is insufficient for relieving the pain. With the narcotics, one can be severely hampered and may not be able to go about his/her life. It is often a double-edged sword; take strong drugs and compromise your life or don't take drugs, receive no chiropractic care and suffer.

A 2006 study examined "...the extent to which a group of patients with acute neck pain managed with chiropractic [adjustments]...and the degree to which they were subsequently satisfied...A total of 115 patients were contacted, of whom 94 became study participants, resulting in 60 women (64%) and 34 men. The mean age was 39.6 years...The mean number of visits was 24.5...Pain levels improved significantly from a mean of 7.6...before treatment to 1.9...after treatment...The overall patient satisfaction rate was 94%" (Haneline, 2006, p. 288).

"There were reductions in disability recorded during the study that were statistically significant. Approximately 84% of the patients related that their activities were restricted before chiropractic treatment because of their neck pain, whereas only 25% still had activity restrictions at the time of the interview. Furthermore, 57% of those with physical restrictions described their disabilities as moderately severe or greater before treatment, whereas at the time of the interview, just 12% did (Haneline, 2006, p. 294).

"When comparing trauma with no-trauma cases, Trauma cases received more than 3 times as many visits. This difference may be related to tissue damage that often accompanies trauma, which, many times, heals imperfectly. In addition, patients with this type of problem may have ensuing long-term pain and physical impairment, which further shows that trauma complicates the recovery of acute neck pain (Haneline, 2006, p. 294).

This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions to acute neck pain and returning to a normal life. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.

References

1. The Neck Pain Relief Shop. (n.d.). Acute neck pain. Retrieved from http://www.neckpainreliefkit.com/acuteneckpain
2. Haneline, M. T. (2006). Symptomatic outcomes and perceived satisfaction levels of chiropractic patients with a primary diagnosis involving acute neck pain. Journal of Manipulative and Physiological Therapeutics, 29(4), 288-296.

Acute (Severe) Low Back Pain, Early Intervention and Chiropractic 87% of chiropractic patients showed improvement

2012-01-02T09:50:00.000-08:00

http://uschirodirectory.com/index.php/chiropractic-research/item/264-acute-severe-low-back-pain-early-intervention-and-chiropractic-

Fever Increases Immune System Defense, Study Shows

2011-11-06T08:32:00.001-08:00

Fever Increases Immune System Defense, Study Shows

The Huffington Post Amanda Chan Posted: 11/3/11 06:05 PM ET

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A new study adds more reason to why our bodies employ fevers as a defense against sickness.
Researchers from Roswell Park Cancer Institute found that a higher body temperature can help our immune systems to work better and harder against infected cells. The finding was published in the Journal of Leukocyte Biology.
"Having a fever might be uncomfortable, ... but this research report and several others are showing that having a fever is part of an effective immune response," John Wherry, Ph.D., deputy editor of the Journal of Leukocyte Biology, said in a statement.
Before, researchers thought that fevers worked by hindering dangerous microbes from multiplying, Wherry said.
But "this new work also suggests that the immune system might be temporarily enhanced functionally when our temperatures rise with fever," he said in the statement, though he noted that the finding should only prompt people to reconsider how they treat mild fevers, and not fevers that are dangerously high.
The secret is in a kind of immune cell, or lymphocyte, called a CD8+ cytotoxic T-cell. This kind of lymphocyte is able to destroy cells infected with viruses and even tumor cells, researchers said. Researchers found that a higher body temperature (like one achieved in a fever) raises the number of these CD8+ cytotoxic T-cells, which means a greater body response against infection.
To find this, researchers injected mice with an antigen and saw how the CD8+ cytotoxic T-cells activated to react to the antigen. Then, they raised the body temperatures of half the mice by 2 degrees centigrade, while leaving the temperatures of the other = mice alone. They found that the mice whose body temperatures were raised had more of the CD8+ cytotoxic T-cells than the mice without raised body temps.

The rise in mouse's body temperature is "similar to that that happens in fever," study researcher Elizabeth Repasky told the Toronto Star.
University of Pittsburgh Medical Center clinical associate professor Dr. Amesh A. Adalja, who wasn't involved with the study, told MSNBC that the finding shouldn't mean a fever should never be treated because too-high fevers can lead to brain cell damage. Parents should still take care to lower fevers in children, particularly if the fever is above 102 degrees Fahrenheit, since high fever can lead to seizures, Adalja told MSNBC.
MSNBC reports:

Adalja also warns it"s also not worth the risk to your own health if you have heart disease, have suffered a stroke or endure other medical complications. "This is not a blanket recommendation," he says. "Secondary consequences to the fever can cause other conditions in the patient to occur or worsen. If someone has a persistent fever of 104, it's a sign of infection, and it"s not just some viral thing you are going to get over."

This is certainly not the first research to suggest that fevers ramp up our body's immune responses. Discover magazine reported in 2007 on another Roswell Park Cancer Institute mouse study, which showed that mice that were heated up produced more immune cells to fight disease than mice that weren't heated.

Arthritis Prevention and Chiropractic

2011-11-03T14:44:00.001-07:00

Arthritis Prevention and Chiropractic

Chiropractic prevents arthritis in accident victims, the elderly and the sedentary

By Mark Studin DC, FASBE(C), DAAPM, DAAMLP

According to the Arthritis Foundation (2007), "Forty-six million [46,000,000] Americans are currently living with arthritis, the nation's leading cause of disability, and we are all paying a high price for it. The Centers for Disease Control and Prevention (CDC) announced that the annual cost of arthritis to the United States economy was $128 billion in 2003 and increased by $20 billion between 1997 and 2003.

CDC attributes the dramatic increase to the aging of the population, predominantly baby boomers, and increased prevalence of arthritis. CDC also estimates an additional 8 million new cases of arthritis will be diagnosed in the next decade" (http://www.arthritis.org/cost-arthritis.php).
Arthritis, A.D.A.M., Inc. (2010, February 5), "...is inflammation of one or more joints, which results in pain, swelling, stiffness, and limited movement. There are over 100 different types of arthritis...
Causes, incidence, and risk factors
Arthritis involves the breakdown of cartilage. Cartilage normally protects the joint, allowing for smooth movement. Cartilage also absorbs shock when pressure is placed on the joint, like when you walk. Without the usual amount of cartilage, the bones rub together, causing pain, swelling (inflammation), and stiffness.
You may have joint inflammation for a variety of reasons, including:

- An autoimmune disease (the body attacks itself because the body immune system believes a body part is foreign)
- Broken bone
- General wear and tear
- Infection (usually cause by bacteria or viruses)...　
With some injuries and diseases, the inflammation does not go away or destruction results in long-term pain and deformity. When this happens, you have chronic arthritis. Osteoarthritis is the most common type and is more likely to occur as you age. You may feel it in any of your joints, but most commonly in your hips, knees or fingers. Risk factors for osteoarthritis include:

- Being overweight
- Previously injuring the affected joint
- Using the affected joint in a repetitive action that puts stress on the joint (baseball players, ballet dancers and construction workers are all at risk)
Arthritis can occur in men and women of all ages. About 37 million people in America have arthritis of some kind, which is almost 1 out of every 7 people" (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002223). With hypomobility (less mobility or movement), adhesions occur in a joint (the region where 2 bones connect).
According to A.D.A.M., Inc. (2010, March 30), "Adhesions are bands of scar-like tissue that form between two surfaces inside the body and cause them to stick together. As the body moves, tissues or organs inside are normally able to shift around each other. This is because these tissues have slippery surfaces.
Causes, incidence, and risk factors
Inflammation (swelling), surgery, or injury can cause adhesions to form almost anywhere in the body...Once they form, adhesions can become larger or tighter over time. Symptoms or other problems may occur if the adhesions cause an organ or body part to twist, pull out of position, or be unable to move as well.
Adhesions may form around joints such as the shoulder...or ankles, or in ligaments and tendons. This problem may happen:

- After surgery or trauma
- With certain types of arthritis
- With overuse of a joint or tendon
Symptoms
Adhesions in joints, tendons, or ligaments make it harder to move the joint and may cause pain...Adhesions in the pelvis may cause chronic or long-term pelvic pain.
Signs and tests
Most of the time, the adhesions cannot be seen using x-rays or imaging tests" (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002462).
Over time, with a sedentary lifestyle as seen in many portions of the population and increasingly with the elderly, joints become hypomobile. Hypomobility is also seen in trauma-related cases and repetitive use injuries, such as reading while looking down for extended periods, carrying heavy items, holding the phone between one's shoulder and ear, prolonged use of hands, wrists, back and neck, excessive use of computers, etc. As time progresses, internal scar tissue or adhesions continue to develop and further increases the loss of mobility.
Cramer, Henderson, Little, Daley and Grieve (2010), cite previous studies that have shown that adhesions have been found in numerous hypomobile (loss of normal movement) joints and that spinal adjusting separates the articular surfaces of the joint. The researchers inquired as to whether connective tissue adhesion developed in lumbar articular joints as a consequence to intervertebral hypomobility and utilized animal studies. They concluded that "...hypomobility results in time-dependent [adhesions]..." (Cramer et al., 2010, p. 508). In other words, internal scar tissue (arthritis) developed within the joints over time.

Cramer et al. (2010) sited previous studies that found the spinal adjustment separates the joints which could break up intra-articular adhesions. In other words, in their animal studies, spinal adjustments/manipulation increased the "Z gap" or spacing between the joints/bones and the mobility of the joints. If this applied in humans, the adjustments would then prevent further development of adhesions and degeneration and osteophytes, which is how the arthritic process progresses.
While arthritis affects approximately 1 in 7 Americans, the prevention of and/or correction of arthritis would relieve a great strain on our economy. While not all arthritis is a result of hypomobility, much of it is. If every person was under chiropractic care, we could not only positively affect the lives of every American, we could potentially rescue the economy of the United States and every other country and insurer in the world that assumes risk for an aging and hypomobile society.

References:
1. Arthritis Foundation. (2007, January 17). Cost of arthritis increases to $128 billion annually. Retrieved from http://www.arthritis.org/cost-arthritis.php
2. A.D.A.M., Inc. (2010, February 5). Arthritis. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002223
3. A.D.A.M., Inc. (2010, March 30). Adhesion. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002462
4. Cramer, G. D., Henderson, C. N. R., Little, J. W., Daley, C., & Grieve, T. J. (2010). Zygapophyseal joint adhesions after induced hypomobility. Journal of Manipulative and Physiological Therapeutics, 33(7), 508-518.

Scoliosis and Chiropractic Care

2011-11-03T14:43:00.000-07:00

The average reduction of thoraco-lumbar scoliosis was 17.2° and was maintained for 24 months.

Function improved 70% and pain was reduced by 60%.

BY Mark Studin DC, FASBE(C), DAAPM, DAAMLP

According to the Mayo Clinic (2009), " Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown. Most cases of scoliosis are mild, but severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly. Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to straighten severe cases of scoliosis" (http://www.mayoclinic.com/health/scoliosis/DS00194). They go on to say that signs and symptoms of scoliosis may include, uneven shoulders, "Signs and symptoms of scoliosis may include: uneven shoulders, one shoulder blade that appears more prominent than the other, uneven waist, [and] one hip higher than the other" (Mayo Clinic Staff, 2009, http://www.mayoclinic.com/health/scoliosis/ DS00194/ DSECTION=symptoms).

"If a scoliosis curve gets worse, the spine will also rotate or twist, in addition to curving side to side. This causes the ribs on one side of the body to stick out farther than on the other side. Severe scoliosis can cause back pain and difficulty breathing. Go to your doctor if you notice signs or symptoms of scoliosis in your child. Mild curves can develop without the parent or child knowing it because they appear gradually and usually don't cause pain" (Mayo Clinic Staff, 2009, http://www.mayoclinic.com/health/ scoliosis/DS00194/ DSECTION=symptoms).

According to Lou et al. in 2010, three-dimensional lateral curvatures of the spine affect 2-3% of the adolescent population. According to ACT Youth who utilizes the 2000 US Census Bureau statistics, the number of adolescents in the United States is 41,747, 962. Averaging 2.5% of all adolescents having scoliosis equates to 1,043, 699 children facing issues as result of scoliosis. Lou et al. (2010) continue, "Brace (orthotic) treatment is recommended for growing children with curves of 25–45° Cobb angle. Surgery is the final treatment option for curves greater than 45° and its goals are to obtain safe correction, to produce a solid spinal fusion of the curve region, and to bring the spine and body into a more balanced position (p. 292). However, they conclude, " Although brace treatment for scoliosis has been used for more than fifty years, its effectiveness is still debatable... Most studies used the amount of curve progression (as measured by the Cobb angle) to determine the effectiveness of brace treatment. Some defined success as 5° or less curve progression" (Lou et al., 2010, p. 292).

While allopathic medicine is still entrenched in the debatable practice of bracing and eventually surgery with the eventual progression of scoliosis, there are proven solutions. Morningstar concluded in 2011 that as a result of chiropractic spinal adjusting and chiropractic spinal manipulation, a thoracolumbar curvature (scoliosis) averaged a 17.2° reduction that was maintained for 24 months, the length of the study. Across all spinal groups, an average of 10° reduction was realized that persisted for 24 months, again the length of the study. Morningstar also concluded that pain scales reduced by 60% at 24 months and function improved by 70% while respiratory capacity increased 7%. Although this was a limited study with 28 patients, it is the first scientific conclusion that documents and reflects the results of what chiropractors have been realizing in their offices for over a 100 years.

The real issue is that if adolescents have their curvatures reduced by 10°-17.2°, then bracing and surgery are not an option because they will not be indicated. As bracing has been deemed "highly questionable" in the literature and now the literature reflects chiropractic as a highly effective modality, the standard of care across professions should be chiropractic care for scoliosis as first line treatment and should be standardized in every discipline.

REFERENCES

1. Retrieved from http://www.mayoclinic.com/health/scoliosis/DS00194

2. Retrieved from http://www.mayoclinic.com/health/scoliosis/DS00194/DSECTION=symptoms

3. Lou, E., Hill, D., Hedden, D., Mahood, J., Moreau, M., Raso, J., (2010). An objective measurement of brace usage for the treatment of adolescent idiopathic scoliosis. Medical Engineering and Physics, 33(3), 290-294.

4. Retrieved from http://www.actforyouth.net/health_sexuality/demographics/

5. Morningstar, M. (2011). Outcomes for adult scoliosis patients receiving chiropractic rehabilitation: A 24-month retrospective analysis. Journal of Chiropractic Medicine, 10(3), 179-184.

Headaches and Migraines: Chiropractic Saves Federal and Private Insurers $13,680,000,000

2011-10-28T07:06:00.000-07:00

A great article published by a friend of mine...

Headaches and Migraines:

Chiropractic Saves Federal and Private Insurers $13,680,000,000

and Resolves Many Issues Facing Emergency Rooms Today

by Mark Studin DC, FASBE(C), DAAPM, DAAMLP

Published in Dynamic Chiropractic, Volume 29, Issue 22
It was reported by Doheny in 2006 that migraine headaches cost U.S. employers more than $24 billion annually, including direct health care costs and indirect expenses such as absenteeism. Doheny goes on to report that according to Michael Staufacker, director of program development for StayWell Health Management in St. Paul, Minnesota, "The programs are so few and far between because many companies ‘don't perceive it as a priority’" (p. 10).
Much of the public perceive headaches and migraines as normal occurrences. For example, a patient will enter a doctor's office and report they get normal headaches, not realizing that pain is never a normal occurrence. Symons, Shinde and Gilles (2008) highlighted a statement from http://www.iasp-pain.org saying that pain is "'an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage'" (p. 277). As a result of the public not taking many types of headaches as potential serious problems, they let the condition linger and that can lead to negative sequella.
According to Munakata, Hazard, Serrano, Klingman, Rupnow, Tierce, Reed and Lipton (2009) "...neuroimaging studies have provided compelling evidence that suggests progressive brain changes in persons with migraines...migraine frequency is associated with posterior circulation infarcts and diffuse white-matter lesions...Welch et al. showed that impairments in iron homeostasis in periaqueductal grey areas that were associated with migraine duration and chronic daily headache" (Munakata et al., 2009, p. 499).
Munakata et al. also reported that the economic impact of migraines in both direct healthcare costs and indirect costs of absenteeism is a huge economic burden. The direct cost of migraines ranges from $127 to $7,089 per and the indirect cost due to absenteeism ranges from $709 to $4,453 per victim, making migraines an economic burden to the individual, the insurer, the employer with absenteeism and increased benefits paid and local, state and federal entities who will experience a lowered tax base from lost wages. It was also reported that between 2005 and 2006 there were 1,729,555 physician office visits, 186,603 advanced imaging procedures, 59,589 other diagnostic procedures, and 22,168 hospital days with a primary diagnosis of migraine or headache; all of which are paid by private or public insurers or out of the pockets of individuals. In short, the costs are staggering and a burden to the economy.
Friedman, Feldon, Holloway and Fisher (2009) reported that acute headaches account for 5% of emergency department (ED) visits in hospitals. In addition, they also reported that "…the ED environment that may also contribute to unsatisfactory treatment response include limited physician contact time that may preclude a detailed history, overuse of ED by patients with substance abuse problems, the need for rapid triage, the competing distraction of patients with life-threatening conditions, and directives (or lack thereof) for care dictated by the referring physician…Thus, the treatment of migraine patients in the ED appears to be suboptimal and the high rate of recurrent headache may be attributed to underutilization of relatively ‘migraine specific’ treatment" (Friedman et al., 2009, p. 1164).

Nelson, Suter, Casha, du Plessis and Hurlbert (1998) reported on randomized clinical trials that took place over an 8-week course. The results showed there was minor statistical differences in outcomes for improvement during the trial period for chiropractic care and for amatriptyline and over-the-counter medications for treating migraine headaches. It was also reported that there was no statistical benefit in combining therapies. However, the major factor is that in the post-treatment follow-up period, chiropractic was 57% more effective in the reduction of headaches than drug therapy. In addition, it was reported that, with the drug group, "...58% experienced medication side effects important enough to report them. In the amatriptyline group, 10% of the subjects had to withdraw from the study because of intolerable side effects. Side effects in the SMT (Spinal Manipulative Therapy) group were much more benign, infrequent, mild and transitory. None required withdrawal from the study (Nelson et al., 1998, p. 511). Although this study was conducted 13 years ago, a more current study by Chaibi, Tuchin and Russell (2011) reported that that massage therapy, physiotherapy, relaxation and chiropractic spinal manipulative therapy might be equally effective as propranolol and topiramate in the prophylactic management of migraine, supporting the previous findings. Although more research is desperately needed, the above conclusions give the public clear directions with migraines and headaches.

Using the 57% increased effectiveness that chiropractic has over drug therapy (leaving out the overlap that chiropractic could help without drugs) and the $24,000,000,000 ($24 billion) Americans pay for headaches and migraines, the savings would result in $13,680,000,000. back in the insurers, the public's and the government's pockets. In addition, if chiropractic reduced the necessity for emergency room visits by 57%, then the ED doctors could focus on what their primary purpose is, to save lives in urgent scenarios.
Chiropractic offers solutions to the federal government, local government, public and private insurance companies, eases the burden on emergency rooms and prevents unnecessary side effects of drugs that are not clinically indicated, with a more viable and proven drugless solution. Although much more research is desperately needed to explore the benefits of chiropractic with migraines and headaches, the research that is available clearly reports that chiropractic offers immediate solutions. These solutions will add to the economy of local, state and federal governments by increasing the tax base and productivity in the marketplace as a result of keeping workers at work and circulating money into local economies with increased paychecks at the end of the year and productivity avoiding absenteeism. The research is conclusive and chiropractic has solutions to many of the economic and societal problems in the United States and worldwide.
References:
1. Doheny, K. (2006). Recognizing the financial pain of migraines. Workforce Management, 85(16), 10-12.
2. Symons, F. J., Shinde, S. K., & Gilles, E. (2008). Perspectives on pain and intellectual disability. Journal of Intellectual Disability Research, 52(Pt 4), 275-286.
3. Munakata, J., Hazard, E., Serrano, D., Klingman, D., Rupnow, M. F. T., Tierce, J., Reed, M., & Lipton, R. (2009). Economic burden of transformed migraine: Results from the American Migraine Prevalence and Prevention (AMPP) Study. Headache, 49(4), 498-508.
4. Friedman, D., Feldon, S., Holloway, R., & Fisher, S. (2009). Utilization, diagnosis, treatment and cost of migraine treatment in the emergency department. Headache, 49(8),1163-1173.
5. Nelson, C. F., Bronfort, G., Evans, R., Boline, P., Goldsmith, C., & Anderson, A. V. (1998). The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache. Journal of Manipulative & Physiological Therapeutics, 21(8), 511-519.
6. Chaibi, A., Tuchin, P. J., & Russell, M.B. (2011). Manual therapies for migraine: A systematic review. The Journal of Headache and Pain, 12(2), 127-133.

his research indicates that chiropractic is 457% more effective than medicine for chronic low back pain.

2011-08-23T12:12:00.001-07:00

Low Back Pain:

Chiropractic Adjustments vs. Muscle Relaxants

by Mark Studin DC, FASBE(C), DAAPM, DAAMLP

Chiropractic had a better outcome in 24% of the patients

Low back pain is one of the most common maladies among the general population and the incidence of occurrence was reported by Ghaffari, Alipour, Farshad, Yensen, and Vingard (2006) to be between 15% and 45% yearly. Hoiriis et al. (2004) reported it to be between 75% and 85% over an adult lifetime in the United States. Chou (2010) writes that, "Back pain is also the fifth most common reason for office visits in the US, and the second most common symptomatic reason..." (p. 388). Historically and based upon this authors 3+ decades of treating low back pain with treatment options that range from heating pads, ice packs, over-the-counter drugs, prescription drugs, surgery, acupuncture and beyond, the most important questions are, "What works? What's proven and what has the best results with the least side effects allowing the patient to regain a normal lifestyle as quickly as possible."
Muscle relaxers are a common drug that has been prescribed by medical doctors for years for nonspecific low back pain. According to Chou (2010), " The term ‘skeletal muscle relaxants’ refers to a diverse collection of pharmacologically unrelated medications, grouped together because they are approved by regulatory agencies for treatment of spasticity or for musculoskeletal conditions such as tension headache or back pain." They are drugs that has been long studied and the effects and side effects have been well documented. Van Tudlar, Touray, Furlan, Solway, and Bouter (2003) concluded that, "Muscle relaxants are effective in the management of nonspecific low back pain, but the adverse effects require that they be used with caution"(p. 1978).
Chou (2010) also stated that, "Skeletal muscle relaxants are an option for acute nonspecific low back pain, although not recommended as first-line therapy because of a high prevalence of adverse effects" (p. 397). He reported that muscle relaxants had a moderate success rate defined by a 1-2 decrease in pain scales rated out of 10. Simply put, if a patient had a pain scale of 9, one could expect the muscle relaxers prescribed to bring the pain to an 8 or 7 at best and include all of the side effects. According to Drugs.com, side effects of muscle relaxants include:
More common
Blurred or double vision or any change in vision; dizziness or lightheadedness; drowsiness
Less common
Fainting; fast heartbeat; fever; hive-like swellings (large) on face, eyelids, mouth, lips, and/or tongue; mental depression; shortness of breath, troubled breathing, tightness in chest, and/or wheezing; skin rash, hives, itching, or redness; slow heartbeat (methocarbamol injection only); stinging or burning of eyes; stuffy nose and red or bloodshot eyes
Less common or rare
Abdominal or stomach cramps or pain; clumsiness or unsteadiness; confusion; constipation; diarrhea; excitement, nervousness, restlessness, or irritability; flushing or redness of face; headache; heartburn; hiccups; muscle weakness; nausea or vomiting; pain or peeling of skin at place of injection (methocarbamol only); trembling; trouble in sleeping; uncontrolled movements of eyes (methocarbamol injection only)
Rare
Blood in urine; bloody or black, tarry stools; convulsions (seizures) (methocarbamol injection only); cough or hoarseness; fast or irregular breathing; lower back or side pain; muscle cramps or pain (not present before treatment or more painful than before treatment); painful or difficult urination; pain, tenderness, heat, redness, or swelling over a blood vessel (vein) in arm or leg (methocarbamol injection only); pinpoint red spots on skin; puffiness or swelling of the eyelids or around the eyes; sores, ulcers, or white spots on lips or in mouth; sore throat and fever with or without chills; swollen and/or painful glands; unusual bruising or bleeding; unusual tiredness or weakness; vomiting of blood or material that looks like coffee grounds; yellow eyes or skin.(http://www.drugs.com/cons/skeletal-muscle-relaxants.html)
　
When comparing chiropractic spinal adjustments to muscle relaxants for low back pain, it first must be clarified that we are not discussing physical therapy or osteopathic manipulation. While different specialists render tremendous benefits to patients specific to various diagnoses, this research review is limited to a chiropractic spinal adjustment.
Wilkey, Gregory, Byfield, & McCarthy (2008) studied randomized clinical trials comparing chiropractic care to medical care in a pain clinic. "The treatment regimens employed by the pain clinic in this study consisted of standard pharmaceutical therapy (nonsteroidal anti-inflammatory drugs, analgesics, and gabapentin), facet joint injection, and soft-tissue injection. Transcutaneous electrical nerve stimulation (TENS) machines were also employed. These modalities were used in isolation or in combination with any of the other treatments. Chiropractic group subjects followed an equally unrestricted and normal clinical treatment regimens for the treatment of [chronic low back pain] were followed. All techniques that were employed are recognized within the chiropractic profession as methods used for the treatment of [low back pain]. Many of the methods used are common to other manual therapy professions" (p. 466-467).

After 8 weeks of treatment, the 95% confidence intervals based on the raw scores showed improvement was 1.99 for medicine and 9.03 for the chiropractic group. This research indicates that chiropractic is 457% more effective than medicine for chronic low back pain.
Within that group of 457% falls patients cared for by muscle relaxants.
Hoiriis et al. (2004) reported in their raw data that the chiropractic groups responded 24% better in reducing pain and concluded that, "Statistically, the chiropractic group responded significantly better than the control group with respect to a decrease in pain scores" (p. 396). This was done in "blinded, randomized clinical trials [which] are considered the gold standard of experimental design" (Hoiriis et al., 2004, p. 396).
　
REFERENCES
1. Ghaffari, M., Alipour, A., Farshad, A. A., Yensen, I., & Vingard, E.(2006).Incidence and recurrence of disabling low back pain and neck-shoulder pain. Spine, 31(21), 2500-2506.
2. Hoiriis, K. T., Pfleger, B., McDuffie, F. C., Cotsonis, G., Elsangak, O., Hinson, R., & Verzosa, G. T. (2004). A randomized clinical trial comparing chiropractic adjustments to muscle relaxants for subacute low back pain. Journal of Manipulative and Physiological Therapeutics, 27(6), 388-398.
3. Chou, R. (2010). Pharmacological management of low back pain. Drugs, 70(4) 387-402.
4. van Tudlar, M. W., Touray, T., Furlan, A. D., Solway, S., & Bouter, L. M. (2003). Muscle relaxants for nonspecific low back pain: A systematic review within the framework of the cochrane collaboration. Spine, 28(17), 1978-1992.
5. Drugs.com, (2004). Skeletal muscle relaxants (systemic). Retrieved from http://www.drugs.com/cons/skeletal-muscle-relaxants.html
6. Wilkey, A., Gregory M., Byfield, D., & McCarthy, P. W. (2008). A comparison between chiropractic management and pain clinic management for chronic low-back pain in a national health service outpatient clinic. The Journal of Alternative and Complementary Medicine, 14(5), 465-473.

Chiropractic Care Saves Money

2011-08-22T07:21:00.000-07:00

Work Related Injuries, Recurring Low Back Pain, Chronic Care and Chiropractic Treatment:

A Proven Solution to Save Federal, State and Private Insurers $2,871,485,223

by Mark Studin DC, FASBE(C), DAAPM, DAAMLP

Published in Dynamic Chiropractic 8/26/2011

Low back pain and its treatment are a worldwide epidemic in human suffering and as a result, an economic burden to federal, state, public and self-insured risk takers who insure the injured. In 2009, Russo, Weir and Elixhauser reported that hospital stays for low back pain were 3.9 out of every 1000 people aged 55-64 years. That was rated as the #8 reason for hospital stays and fell closely behind cardiac conditions and degenerative arthritis. While low back pain has been well chronicled, recurring low back pain and the necessity for chronic care is now beginning to realize results that necessitate the proper approach to mitigate its frequency, duration and economic impact as sequella.
A very significant component of low back patient is its recurrence after initial care has been rendered as well as complications that ensue. Wasiak, Kim and Pransky reported in 2006 that, "Recent studies suggest that acute low back pain evolves into a chronic or recurrent condition more often than previously suspected" (p. 220). They went on to report that 40% of individuals with recurring low back pain sought additional care when the pain recurred and 42.9% of those had continued care and work disability lasting more than 201 days, underscoring the significance of the problem.
According to Dagenais, Caro and Haldeman in 2007, "The economic burden of a disease is the sum of all costs associated with that condition which would not otherwise be incurred if that disease did not exist. Given the many categories of costs that must be considered, it can be challenging to fully estimate the economic burden of an illness as data are often unavailable. The term 'cost' in health economics refers to the value of the consequences of using a particular good or service rather than its price...Despite this example, it should be made clear that estimating the economic burden of a disease is not simply a matter of tabulating the amount reimbursed for all clinician services related to a particular diagnosis. The total cost of illness—or economic burden—has three components: (1) direct (medical and nonmedical) costs; (2) indirect costs; and (3) intangible costs" (p. 9). Although indirect and intangible costs are significant burdens, this paper will focus solely on direct costs.
When considering direct costs for work related claims, studies indicate that non-work related indemnity plans should be included for work related low back injuries. Lipscomb, Dement, Silverstein, Cameron, and Glazner reported in 2009 that, "The private health insurance payment rates for workers with one work-related injury were 40% higher than for those with no history of work injury..." (p. 1188). The reasons are simple; indemnity carriers are victims of many workers' compensation carrier tactics created by the indemnity carriers, as reported by Griffin (2007), to deny, delay and defend. Patients need care and will access any system at their disposal so they can get necessary care and return to a normal, pain free lifestyle, leaving the indemnity carriers to absorb those financial costs. Although this is a significant factor, it is difficult to assign numbers and amounts that are directly tied to work related injuries, although those statistics undoubtedly tally in the billions.
Utilizing the Joint Report to the Governor by New York State Workers’ Compensation Board in 2009 as a reference, in 2004 the total number of claims in New York was 143,667 and out of those claims, 19.3% were low back related. The total costs for treating low back was $579,675,476.96, calculated for inflation to 2011 (Tom's Inflation Calculator, 1997-2011, http://www.halfhill.com/inflation.html). This equates to $29.88 per resident to treat work related low back pain. Nationally, this equates to $9,262,855,559 based upon US Census statistics.
Cifuentes, Willets and Wasiak (2011) compared the treatment of recurrent or chronic low back pain. They considered any condition recurrent or chronic if there was a recurrent disability after a 15 day absence and return to disability. Anyone with less than a 15 day absence was excluded from the study.
The study concluded that chiropractic care during the health maintenance care period resulted in:
16% Decrease in disability duration of first episode compared to physical therapy
240% Decrease in disability duration of first episode compared to medical physician's care
6.6% Decrease in opioid (narcotic) use during maintenance care compared to physical therapy care
17.2% Decrease in opioid (narcotic) use during maintenance care compared medical physician's care
32% Decrease in average weekly cost of medical expenses during disability episode compared to physical therapy care
21% Decrease in average weekly cost of medical expenses during disability episode compared to medical physician's care
The study concluded that chiropractic care during the disability episode resulted in:
24% Decrease in disability duration of first episode compared to physical therapy
250% Decrease in disability duration of first episode compared to medical physician's care
5.9% Decrease in opioid (narcotic) use during maintenance care compared to physical therapy care
30.3% Decrease in opioid (narcotic) use during maintenance care compared medical physician's care
19% Decrease in average weekly cost of medical expenses during disability episode compared to physical therapy care
43% Decrease in average weekly cost of medical expenses during disability episode compared to medical physician's care
Based upon the Joint Report to the Governor (2009) and the statistics rendered by Cifuentes et al. (2011), the savings with chiropractic care utilized exclusive from medicine and physical therapy ranges from $1,759,942,556 with physical therapy to $3,983,027,890 with medicine. Understanding that most medical physicians utilize physical therapy as a primary tool for back related pain, we will average the savings to $2,871,485,223 by utilizing chiropractic care.
Cifuentes et. al (2011) started by stating, "Given chiropractors are proponents of health maintenance care...patients with work related Low back pain who are treated by chiropractors would have a lower risk of recurrent disability because that specific approach would be used (p. 396). They concluded by stating, " After controlling for demographic factors and multiple severity indicators, patients suffering nonspecific work-related LBP who received health services mostly or only from a chiropractor had a lower risk of recurrent disability than the risk of any other provider type (Cifuentes et. al, 2011, p. 404).
References
1. Russo, A., Wier, L. M., & Elixhauser, A. (2009, September). Hospital utilization among near-elderly adults, ages 55 to 64 years, 2007. Agency for Healthcare Research and Quality, Retrieved from http://www.hcup-us.ahrq.gov/reports/statbriefs/sb79.jsp
2. Wasiak, R., Kim, J., & Pransky, G. (2006). Work disability and costs caused by recurrence of low back pain: Longer and more costly than in first episodes. Spine, 31(2), 219-225.
3. Dagenais, S., Caro, J., & Haldeman, S. (2008). A systematic review of low back pain cost of illness studies in the United States and internationally. Spine, 8(1), 8-20.
4. Lipscomb, H., Dement, J., Silverstein, B., Cameron, W., & Glazner J. (2009). Who is paying the bills? Health care costs for musculoskeletal back disorders, Washington State Union Carpenters, 1989-2003. Journal of Occupational and Environmental Medicine, 51(10), 1185-1192.
5. Griffin, D. (2007, February 7). Insurance companies fight paying billions in claims. Anderson Cooper Blog 360°, Retrieved from http://www.cnn.com/CNN/Programs/anderson.cooper.360/blog/2007/02/ insurance-companies-fight-paying.html
6. New York State Workers’ Compensation Board (2009, March). Joint report to the Governor, From the Superintendant of Insurance and Chair, Workers' Compensation Board, summarizing and benchmarking workers' compensation data and examining progress on prior recommendations for improvement in data collection, Retrieved from http://www.wcb.state.ny.us/content/main/TheBoard/ 2009DataCollectionReport.pdf
7. Halfhill, T. R. (1997-2011). Tom's Inflation Calculator. Retrieved from http://www.halfhill.com/ inflation.html
8. U.S. Census Bureau (2010, December 22). U.S. POPClock Projection, Retrieved from http:// www.census.gov/population/www/popclockus.html
9. Cifuentes, M., Willets, J., & Wasiak, R. (2011). Health maintenance care in work-related low back pain and its association with disability recurrence. Journal of Occupational and Environmental Medicine, 53(4), 396-404.
　

Can I borrow $25?

2011-07-20T12:31:00.001-07:00

Can I Borrow $25?

Can I borrow $25?
A man came home from work late, tired and irritated, to find his 5-year old son waiting for him at the door.

SON: 'Daddy, may I ask you a question?'
DAD: 'Yeah sure, what it is?' replied the man.
SON: 'Daddy, how much do you make an hour?'
DAD: 'That's none of your business. Why do you ask such a thing?' the
man said angrily.
SON: 'I just want to know. Please tell me, how much do you make an
hour?'
DAD: 'If you must know, I make $50 an hour.'
SON: 'Oh,' the little boy replied, with his head down.
SON: 'Daddy, may I please borrow $25?'

The father was furious, 'If the only reason you asked that is so you
can borrow some money to buy a silly toy or some other nonsense, then
you march yourself straight to your room and go to bed. Think about why you are being so selfish. I don't work hard everyday for such childish frivolities.' The little boy quietly went to his room and shut the door.

The man sat down and started to get even angrier about the little boy's questions. How dare he ask such questions only to get some money? After about an hour or so, the man had calmed down , and started to think:

Maybe there was something he really needed to buy with that $25.00 and
he really didn't ask for money very often. The man went to the door of
the little boy's room and opened the door. 'Are you asleep, son?' He
asked. 'No daddy, I'm awake,' replied the boy. 'I've been thinking,
maybe I was too hard on you earlier' said the man. 'It's been a long
day and I took out my aggravation on you. Here's the $25 you
asked for.'

The little boy sat straight up, smiling. 'Oh, thank you daddy!'
He yelled. Then, reaching under his pillow he pulled out some crumpled
up bills. The man saw that the boy already had money, started to get
angry again. The little boy slowly counted out his money, and then
looked up at his father. 'Why do you want more money if you already
have some?' the father grumbled. Because I didn't have enough, but now
I do,' the little boy replied. 'Daddy, I have $50 now. Can I buy an
hour of your time? Please come home early tomorrow. I would like to
have dinner with you.'

The father was crushed. He put his arms around his little son, and he
begged for his forgiveness. It's just a short reminder to all of you
working so hard in life. We should not let time slip through our
fingers without having spent some time with those who really matter to
us, those close to our hearts. Do remember to share that $50 worth of
your time with someone you love.

If we die tomorrow, the company that we are working for could easily
replace us in a matter of hours. But the family & friends we leave
behind will feel the loss for the rest of their lives.

Can I Borrow $25?

Why your desk job is killing you?

2011-06-03T07:32:00.001-07:00

Why your desk job is slowly killing you

Even if you exercise, the more hours a day you sit, the greater your risk of early death

By Maria Masters, Men's Health

Mens Health

updated 10/26/2010 8:38:01 AM ET 2010-10-26T12:38:01

Do you lead an active lifestyle or a sedentary one? The question is simple, but the answer may not be as obvious as you think. Let's say, for example, you're a busy guy who works 60 hours a week at a desk job but who still manages to find time for five 45-minute bouts of exercise. Most experts would label you as active. (Put your body to the test: 10 standards to assess your fitness level.) But Marc Hamilton, Ph.D., has another name for you: couch potato. Perhaps "exercising couch potato" would be more accurate, but Hamilton, a physiologist and professor at the Pennington Biomedical Research Center , in Baton Rouge , Louisiana , would still classify you as sedentary. "People tend to view physical activity on a single continuum," he says. "On the far side, you have a person who exercises a lot; on the other, a person who doesn't exercise at all. However, they're not necessarily polar opposites."

Hamilton's take, which is supported by a growing body of research, is that the amount of time you exercise and the amount of time you spend on your butt are completely separate factors for heart-disease risk. New evidence suggests, in fact, that the more hours a day you sit, the greater your likelihood of dying an earlier death regardless of how much you exercise or how lean you are. That's right: Even a sculpted six-pack can't protect you from your chair.

But it's not just your heart that's at risk from too much sitting; your hips, spine, and shoulders could also suffer. In fact, it's not a leap to say that a chair-potato lifestyle can ruin you from head to toe.

Statistically speaking, we're working out as much as we were 30 years ago. It's just that we're leading more sedentary lives overall. A 2006 University of Minnesota study found that from 1980 to 2000, the percentage of people who reported exercising regularly remained the same—but the amount of time people spent sitting rose by 8 percent.

Now consider how much we sit today compared with, say, 160 years ago. In a clever study, Dutch researchers created a sort of historical theme park and recruited actors to play 1850s Australian settlers for a week. The men did everything from chop wood to forage for food, and the scientists compared their activity levels with those of modern office workers. The result: The actors did the equivalent of walking 3 to 8 miles more a day than the deskbound men. That kind of activity is perhaps even more needed in today's fast-food nation than it was in the 1800s, but not just because it boosts calorie burn. (Tied to the treadmill? Try these seven ways to burn more fat on the belt.)

A 2010 study in the Journal of Applied Physiology found that when healthy men limited their number of footsteps by 85 percent for 2 weeks, they experienced a 17 percent decrease in insulin sensitivity, raising their diabetes risk. "We've done a lot to keep people alive longer, but that doesn't mean we're healthier," says Hamilton .

Today's death rate is about 43 percent lower than it was in 1960, but back then, less than 1 percent of Americans had diabetes and only 13 percent were obese. Compare that with now, when 6 percent are diagnosed with diabetes and 35 percent are obese.

The definition of an active life
Make no mistake: "Regularly exercising is not the same as being active," says Peter Katzmarzyk, Ph.D., Hamilton 's colleague at Pennington, the nation's leading obesity research center. Katzmarzyk is referring to the difference between official exercise activity, such as running, biking, or lifting weights, and so-called nonexercise activity, like walking to your car, mowing the lawn, or simply standing. "A person may hit the gym every day, but if he's sitting a good deal of the rest of the time, he's probably not leading an overall active life," says Katzmarzyk.

You might dismiss this as scientific semantics, but energy expenditure statistics support Katzmarzyk's notion. In a 2007 report, University of Missouri scientists said that people with the highest levels of nonexercise activity (but little to no actual "exercise") burned significantly more calories a week than those who ran 35 miles a week but accumulated only a moderate amount of nonexercise activity.

"It can be as simple as standing more," Katzmarzyk says. For instance, a "standing" worker—say, a sales clerk at a Banana Republic store—burns about 1,500 calories while on the job; a person behind a desk might expend roughly 1,000 calories. That goes a long way in explaining why people gain 16 pounds, on average, within 8 months of starting sedentary office work, according to a study from the University of North Carolina at Wilmington .

Work your entire body in 15 minutes with these three moves for fast muscle.

Why sitting too much is never a good thing
But calories aren't the only problem. In 2009, Katzmarzyk studied the lifestyle habits of more than 17,000 men and women and found that the people who sat for almost the entire day were 54 percent more likely to end up clutching their chests than those who sat for almost none of the time. That's no surprise, of course, except that it didn't matter how much the sitters weighed or how often they exercised. "The evidence that sitting is associated with heart disease is very strong," says Katzmarzyk. "We see it in people who smoke and people who don't. We see it in people who are regular exercisers and those who aren't. Sitting is an independent risk factor."

This isn't actually a new discovery. In a British study published in 1953, scientists examined two groups of workers: bus drivers and trolley conductors. At first glance, the two occupations appeared to be pretty similar. But while the bus drivers were more likely to sit down for their entire day, the trolley conductors were running up and down the stairs and aisles of the double-decker trolleys. As it turned out, the bus drivers were nearly twice as likely to die of heart disease as the conductors were.

A more recent interpretation of that study, published in 2004, found that none of the participants ever exercised. But the two groups did sit for different amounts of time. The analysis revealed that even after the scientists accounted for differences in waist size—an indicator of belly fat—the bus drivers were still more likely to die before the conductors did. So the bus drivers were at higher risk not simply because their sedentary jobs made them resemble Ralph Kramden, but also because all that sitting truly was making them unhealthy.

Hamilton came to call this area of science "inactivity physiology" while he was conducting studies to determine how exercise affects an enzyme called lipoprotein lipase (LPL). Found in humans as well as mice, LPL's main responsibility is to break down fat in the bloodstream to use as energy. If a mouse (or a man) doesn't have this enzyme, or if the enzyme doesn't work in their leg muscles, the fat is stored instead of burned as fuel.

Hamilton discovered that when the rodents were forced to lie down for most of their waking hours, LPL activity in their leg muscles plummeted. But when they simply stood around most of the time, the gene was 10 times more active. That's when he added an exercise session to the lab-rat routine and found that exercise had no effect on LPL. He believes the finding also applies to people.

"Humans sit too much, so you have to treat the problem specifically," says Hamilton . "The cure for too much sitting isn't more exercise. Exercise is good, of course, but the average person could never do enough to counteract the effect of hours and hours of chair time."

If you're chair-bound, perform these seven easy office stretches every 20 minutes.

"We know there's a gene in the body that causes heart disease, but it doesn't respond to exercise no matter how often or how hard you work out," he says. "And yet the activity of the gene becomes worse from sitting—or rather, the complete and utter lack of contractile activity in your muscles. So the more nonexercise activity you do, the more total time you spend on your feet and out of your chair. That's the real cure."

"Your body adapts to what you do most often," says Bill Hartman, P.T., C.S.C.S., a Men's Health advisor and physical therapist in Indianapolis , Indiana . "So if you sit in a chair all day, you'll essentially become better adapted to sitting in a chair." The trouble is, that makes you less adept at standing, walking, running, and jumping, all of which a truly healthy human should be able to do with proficiency. "Older folks have a harder time moving around than younger people do," says Hartman. "That's not simply because of age; it's because what you do consistently from day to day manifests itself over time, for both good and bad."

Inactivity affects more than the heart
Do you sit all day at a desk? You're courting muscle stiffness, poor balance and mobility, and lower-back, neck, and hip pain. But to understand why, you'll need a quick primer on fascia, a tough connective tissue that covers all your muscles. While fascia is pliable, it tends to "set" in the position your muscles are in most often. So if you sit most of the time, your fascia adapts to that specific position.

Now think about where your hips and thighs are in relation to your torso while you're sitting. They're bent, which causes the muscles on the front of your thighs, known as hip flexors, to contract slightly, or shorten. The more you sit, the more the fascia will keep your hip flexors shortened. "If you've ever seen a guy walk with a forward lean, it's often because of shortened hip flexors," says Hartman. "The muscles don't stretch as they naturally should. As a result, he's not walking tall and straight because his fascia has adapted more to sitting than standing."

This same effect can be seen in other areas of your body. For instance, if you spend a lot of time with your shoulders and upper back slumped over a keyboard, this eventually becomes your normal posture. "That's not just an issue in terms of how you look; it frequently leads to chronic neck and shoulder pain," says Hartman. Also, people who frequently cross their legs a certain way can experience hip imbalances. "This makes your entire lower body less stable, which decreases your agility and athletic performance and increases your risk for injuries," Hartman says. Add all this up, and a person who sits a lot is less efficient not only at exercising, but also at simply moving from, say, the couch to the refrigerator.

There's yet another problem with all that sitting. "If you spend too much time in a chair, your glute muscles will actually 'forget' how to fire," says Hartman. This phenomenon is aptly nicknamed "gluteal amnesia." A basic-anatomy reminder: Your glutes, or butt muscles, are your body's largest muscle group. So if they aren't functioning properly, you won't be able to squat or deadlift as much weight, and you won't burn as much fat. After all, muscles burn calories. And that makes your glutes a powerful furnace for fat—a furnace that's probably been switched off if you spend most of the day on your duff.

It gets worse. Weak glutes as well as tight hip flexors cause your pelvis to tilt forward. This puts stress on your lumbar spine, resulting in lower-back pain. It also pushes your belly out, which gives you a protruding gut even if you don't have an ounce of fat. "The changes to your muscles and posture from sitting are so small that you won't notice them at first. But as you reach your 30s, 40s, 50s, and beyond, they'll gradually become worse," says Hartman, "and a lot harder to fix."

So what's a desk jockey to do? Hamilton 's advice: Think in terms of two spectrums of activity. One represents the activities you do that are considered regular exercise. But another denotes the amount of time you spend sitting versus the time you spend on your feet. "Then every day, make the small choices that will help move you in the right direction on that sitting-versus-standing spectrum," says Hamilton . "Stand while you're talking on the phone. It all adds up, and it all matters."

Of course, there's a problem with all of this: It kills all our lame excuses for not exercising (no time for the gym, fungus on the shower-room floor, a rerun of The Office you haven't seen). Now we have to redefine "workout" to include every waking moment of our days. But there's a big payoff: more of those days to enjoy in the future. So get up off your chair and start nonexercising.

Learn six more health threats you can't ignore.

Whiplash or Fibromyalgia?

2011-04-18T13:07:00.001-07:00

A recent study published in the journal Pain sheds some light on the ongoing debate about the causal relationship between neck injuries sustained during a car accident and the development of the pain condition fibromyalgia. Chiropractors commonly treat patients with both conditions, and separating these diagnoses can improve treatment. The latest research suggests that fibromyalgia may be overdiagnosed in patients who have a history of whiplash injury due to a motor vehicle accident.
People with fibromyalgia experience a range of life-disrupting symptoms, include general and localized pain, fatigue, and difficulty sleeping. Neck and shoulder tenderness is one common indicator that practitioners use to diagnose fibromyalgia; general pain lasting longer than three months is another. However, these symptoms also are common among patients experiencing the lingering effects of whiplash. Some past research has shown that people with neck injuries incurred in a motor vehicle accident are 13 times more likely to develop fibromyalgia than those with other injuries. Other studies have questioned these conclusions.
Researchers at the University of Washington set out to investigate the prevalence of fibromyalgia in whiplash patients with persistent neck pain. They questioned whether the most common set of criteria used for diagnosing fibromyalgia may rely too heavily on evaluating trigger points located in the neck and shoulder. The study participants included 326 individuals with whiplash-associated neck pain that had lasted longer than 3 months. The participants were enrolled in a 6-week treatment program for their symptoms that consisted of educational therapy sessions.
The researchers evaluated the patients for fibromyalgia both at the beginning and the end of the program. Two sets of criteria were used to diagnose fibromyalgia: the standard guidelines and adjusted guidelines that discounted the importance of pain in the neck and shoulder area. Using the standard guidelines, the researchers initially diagnosed 14% of the whiplash participants with fibromyalgia. This rate dropped to 8% using the adjusted guidelines.
These findings suggest that health practitioners who treat patients with persistent neck pain, such as chiropractors, may be led to significantly overdiagnose fibromyalgia in their patients. People with a history of whiplash-associated injuries should be aware of this unintended bias, and report their injury history.

Robinson JP, Theodore BR, Wilson HD, Waldo PG, Turk DC. Determination of fibromyalgia syndrome after whiplash injuries: Methodologic issues. Pain. 2011 Mar 16.

More Reasons to Eat Your Fruits!

2011-04-11T09:41:00.000-07:00

APRIL 7, 2011

Strawberries Fight Cancer, Study Finds

By JENNIFER CORBETT DOOREN

Strawberries have the potential to prevent esophageal cancer, according to a preliminary study released Wednesday.
Researchers, led by Ohio State University, were able to show that freeze-dried strawberries slowed the growth of dysplastic, or precancerous, lesions in about 30 people who consumed the fruit for six months.
The study's lead researcher, Tong Chen, an assistant professor in the oncology division of Ohio State University, presented the study at the American Association for Cancer Research's annual meeting.

European Pressphoto Agency

Strawberries have the potential to prevent esophageal cancer, according to a preliminary study released Wednesday.

Esophageal cancer is the third most common gastrointestinal cancer and the sixth most frequent cause of cancer death in the world, Dr. Chen said. About 16,000 new cases of esophageal cancer a year are diagnosed in the U.S., according to the American Cancer Society.
Dr. Chen and a group of researchers are studying esophageal squamous cell carcinoma, the dominant type of esophageal cancer world-wide. They are looking at whether food or other substances might prevent cancer. Previous work showed that freeze-dried strawberries were able to significantly inhibit tumor development in rats.
The research team designed a small study in humans and approached the California Strawberry Commission, which agreed to fund the study and make available the freeze-dried strawberries. The commission is a state agency funded by the strawberry industry.
Dr. Chen's team recruited 38 people in China who had mild-to-moderate dysplasia in the esophagus; 36 people completed the study. Biopsies of the esophagus were taken before and after the study. On average, patients were about 55 years old.
They were instructed to consume 30 grams of freeze-dried strawberries dissolved in a glass of water twice daily for a total of 60 grams a day for six months. Dr. Chen said the freeze-dried substance is about 10 times as concentrated as fresh strawberries, but suggested people could still benefit from eating whole strawberries on a daily basis.
Overall, the results showed 29 out of 36 participants experienced a decrease in histological grade of the precancerous lesion, or a slowing in the growth of the lesion during the study. Dr. Chen said larger, randomized placebo-controlled studies are needed to confirm the results. She said it isn't clear exactly what the anti-cancer agent in strawberries might be. But she noted that strawberries contain a variety of vitamins, minerals and other substances known as phytochemicals, which are also found in some other types of berries.

2011- Good Rules to Live By!

2011-01-12T09:09:00.000-08:00

A GUIDE FOR LIVING IN 2011

Health:

1. Drink plenty of water.
2. Eat breakfast like a king, lunch like a prince and dinner like a beggar.
3. Eat more foods that grow ON trees and plants and eat less food that is manufactured IN plants..
4. Live with the 3 E's -- Energy, Enthusiasm and Empathy.
5. Make time to pray.
6. Play more games
7. Read more books than you did in 2010 .
8. Sit in silence for at least 10 minutes each day
9. Sleep at least 7 hours.
10.Take a 10-30 minute walk daily. And while you walk, smile.

Personality:

11. Don't compare your life to others. You have no idea what their journey is all about.
12. Don't have negative thoughts on things you cannot control. Instead invest your energy in the positive present moment.
13. Don't over do. Keep your limits.
14. Don't take yourself so seriously. No one else does.
15. Don't waste your precious energy on gossip.
16. Dream more while you are awake.
17. Envy is a waste of time. You already have all you need.
18. Forget issues of the past. Don't remind your partner of his/her mistakes in the past, that will ruin your present happiness.
19. Life is too short to waste time hating anyone. Don't hate others.
20. Make peace with your past so it won't spoil the present.
21. No one is in charge of your happiness except you.
22. Realize that life is a school and you are here to learn. Problems are simply part of the curriculum that appear and fade away but the lessons you learn will last a lifetime.
23. Smile and laugh more.
24. You don't have to win every argument. Agree to disagree...

Society:

25. Call your family often.
26. Each day give something good to others.
27. Forgive everyone for everything.
28. Spend time with people over the age of 70, and under the age of 6.
29. Try to make at least three people smile each day.
30. What other people think of you is none of your business.
31. Your job won't take care of you when you are sick. Your friends will. Stay in touch.

Life:

32. Do the right thing!
33. Get rid of anything that isn't useful, beautiful, or joyful.
34. GOD heals everything.
35. However good or bad a situation is, it will change.
36. No matter how you feel, get up, dress up, and show up.
37. The best is yet to come...
38. When you awake alive in the morning, thank GOD for it.
39. Your Inner most is always happy. So, be happy.

Last but not the least:

40. Consider forwarding this guide to those you care about.

Study Finds That for Low Back Pain, Starting with Chiropractic Saves 40% on Care

2010-11-17T06:50:00.001-08:00

Study Finds That for Low Back Pain, Starting with Chiropractic Saves 40% on Care
From the ACA's "Week in Review" of 11/12/10

A new study finds that care for low back pain initiated with a doctor of chiropractic (DC) saves 40 percent on health care costs when compared with care initiated through a medical doctor (MD), the American Chiropractic Association (ACA) announced today. The study, featuring data from 85,000 Blue Cross Blue Shield beneficiaries, concludes that insurance companies that restrict access to chiropractic care for low back pain treatment may inadvertently pay more for care than they would if they removed such restrictions.

Low back pain is a significant public health problem. Up to 85 percent of Americans have back pain at some point in their lives. In addition to its negative effects on employee productivity, back pain treatment accounts for about $50 billion annually in health care costs—making it one of the top 10 most costly conditions treated in the United States.

Published in the Journal of Manipulative and Physiological Therapeutics (JMPT), the new study, "Cost of Care for Common Back Pain Conditions Initiated With Chiropractic Doctor vs. Medical Doctor/Doctor of Osteopathy as First Physician: Experience of One Tennessee-Based General Health Insurer," looked at Blue Cross Blue Shield of Tennessee's intermediate and large group fully insured population over a two-year span. The insured study population had open access to MDs and DCs through self-referral, and there were no limits applied to the number of MD/DC visits allowed and no differences in co-pays.

Results show that paid costs for episodes of care initiated by a DC were almost 40 percent less than care initiated through an MD. After risk-adjusting each patient's costs, researchers still found significant savings in the chiropractic group. They estimated that allowing DC-initiated episodes of care would have led to an annual cost savings of $2.3 million for BCBS of Tennessee.

"As doctors of chiropractic, we know firsthand that our care often helps patients avoid or reduce more costly interventions such as drugs and surgery. This study supports what we see in our practices every day," said ACA President Rick McMichael, DC. "It also demonstrates the value of chiropractic care at a critical time, when our nation is attempting to reform its health care system and contain runaway costs."

Just for today....

2010-11-09T13:28:00.001-08:00

Just for today, I will allow my real personality to just be, and accept myself as I am.
Just for today, I will listen to my intuition about what I really
want in life, be OK with what I want, and not compare myself to others.
Just for today, I will adjust myself for what it is. I will face
reality. I will try to change what I can, and accept those things I cannot change.
Just for today I will release judgments of others since I do not walk in their shoes.
Just for today, I will try to live through this day only, and not
set far-reaching goals to try to overcome all my problems at once. I
know I can do something for 12 hours that would appall me if I felt that
I had to keep it up for a lifetime.
Just for today, I will try to be happy. Abraham Lincoln said, “Most
folks are about as happy as they make up their minds to be.” He was
right. I will not dwell on thoughts that depress me. I will chase them
out of my mind and replace them with happy thoughts.
Just for today, I will try to improve my mind. I will not be a
mental loafer. I will force myself to read something that requires
effort, thoughts, and concentration.
Just for today I will exercise my soul in three ways: I will do a
good deed for someone without letting them know it. (If they find out I
did it, it won’t count). I will do at least two good things that I know I
should do but have been putting off. I will not show anyone that my
feelings are hurt. They may be hurt, but today I will not show it.
Just for today, I will be agreeable. I will look as well as I can,
dress becomingly, talk softly, act courteously, and speak ill of none.
Just for today I will try to improve no one except myself.
Just for today I will have a program. I may not follow it exactly
but I will have it, thereby saving myself from two pests: hurry and
indecision.
Just for today I will have a quiet half hour to relax alone. During
this time I will reflect on my behavior and will try to get a better
perspective on my life.
Just for today I will be unafraid. I will gather the courage to do
what is right and take the responsibility for my own actions. I will
expect nothing from the world, but I will realize that as I give to the
world, the world will give to me.

New Research about Chiropractic and Health!

2010-11-07T12:26:00.001-08:00

Here are a few recent articles and research studies that show alot of promise.

PART 1 .........BLOOD PRESSURE

IN a recent BEST LIFE MAGAZINE ..ON THE TOPIC OF HYPERTENSION ...IT STATES "doctors at the university of Chicago found that chiropractic adjustment of the atlas/c-1, vertebrae relaxes the arteries at the base of the skull improving blood flow and RESULTING in an average 17 point drop in systolic blood pressure and an 8 point drop in diastolic blood pressure.

PART 2……..FROM A RECENT GOOD MEDICINE MAGAZINE "Chiro care may help fight oxidative stress in healthy people” Swedish researchers at the university of Lund found.

researchers compared people under regular CHIRO care for general wellness to pts w disease conditions such as diabetes cancer heart disease ...they found that blood levels of thiol, an antioxidant promoting DNA repair were three times higher in those pts undergoing CHIRO care for OVERALL HEALTH AND WELLNESS than in those pts with active diseases ..long term care was defined as reg CHIRO care.. longer than one year.

KEYS

1- RESEARCH DONE ON HEALTHY PEOPLE

2- PTS UNDER WELLNESS CARE

3- NON SYMPT CARE

4-CARE CAUSED A CORRELATION OF INCREASED THIOL WHICH HELPS REPAIR DNA...DNA IS THE FOUNDATION FOR LIFE

5- AND THE BEST RESULTS WERE NOT FOR 3 TO 6 VISITS AS APPROVED BY THE PTS HEALTH INS BUT FOR CARE OVER A YEAR OR MORE

PART 3…..IN A RECENT MENS HEALTH MAGAZINE "instead of a flu shot try CHIRO care” vaccine shortage? no problem Recent study at Florida Atlantic university near west palm beach found that pts who underwent CHIRO adjustments had a 15% lower rate of the flu than people who didn’t get adjusted" end quote Victor Who is the author?? AUTHOR IS GORDON MCGUIRE ASSISTANT CLINICAL PROFESSOR OF PHARAMACY AT THE UNIVERSITY OF CAL SAN DIEGO SKAGGS SCHOOL OF PHARMACY

PART 4……FROM A RECENT INNOVATIONS IN WELLNESS MEDICINE MAG "for more than 65 million Americans or about 20% of the adult population they have hypertension and most take drugs like diuretics beta blockers ..calcium channel blockers but medicine should not be the front line defense esp. when safer equally effective therapies exist one of these is chiropractic in this study...presented at a recent annual meeting on the American society of hypertension ..50 pts were divided into 2 groups and treated w either an adjustment if the upper cervical or placebo therapy.. modality etc. improvement was seen in the treatment group in just 3 weeks ..after 8 weeks the systolic pressure average less than 130 while the placebo group remained unchanged .

Change your thoughts, Change your Life!

2010-11-03T15:07:00.001-07:00

Friends,
Try this Today!

For ONLY ONE DAY:

Mark a "+" on your hand and for an entire 24 hour period, BE positive.

This means...

* No negative thoughts for an entire day. NOT ONE!
* No unkind comments
* No judgment
* No opinion stated internally or externally; even if someone asks for one.
* No worry, no self defeating, disempowering thoughts
* Stay away from "the news"; both on and offline.
* Excuse yourself from gossip or others' negative based chit chat

Instead...

* Look for people to compliment
* Be as uplifting as possible; to yourself and everyone around you.
* Smile more often
* Be agreeable
* Be grateful and appreciative

Just one day.

It WILL be very difficult; you watch.

But, if you can do this for just one day, you WILL have a better day.

You will notice how pervasive negativity is and how it's been impacting your practice and your life. Why wait 'til January 1st to make some positive changes?

Flu Shot? You might do your own research first.

2010-10-29T13:34:00.000-07:00

10 Reasons Why Flu Shots Are More Dangerous Than a Flu!
Submitted by Buzz Team on Wednesday, 20 October 201073 Comments
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The verdict is out on flu shots. Many medical experts now agree it is more important to protect yourself and your family from the flu vaccine than the flu itself. Let’s take a look at the reasons behind this verdict:

1.) There is a total lack of real evidence that young children even benefit from flu shots. A systematic review of 51 studies involving 260,000 children age 6 to 23 months found no evidence that the flu vaccine is any more effective than a placebo. Also the shots are only able to protect against certain strains of the virus, which means that if you come into contact with a different strain of virus you will still get the flu.

2.) Medical journals have published thousands of articles revealing that injecting vaccines can actually lead to serious health problems including harmful immunological responses and a host of other infections. This further increases the body’s susceptibility to the diseases that the vaccine was supposed to protect against.

3.) Ever noticed how vaccinated children within days or few weeks develop runny noses, pneumonia, ear infections and bronchiolitis? The reason is the flu virus introduced in their bodies which creates these symptoms. It also indicates immuno-suppression i.e. lowering of the immunity. The flu vaccines actually do not immunize but sensitize the body against the virus.

4.) Its a known fact that Flu vaccines contain strains of the flu virus along with other ingredients. Now think about the impact such a vaccine can have over someone with a suppressed immune system? If you have a disease that is already lowering your body’s ability to fight a virus, taking the flu shot will put your body in danger of getting the full effects of the flu and make you more susceptible to pneumonia and other contagious diseases.

5.) The Flu vaccines contain mercury, a heavy metal known to be hazardous for human health. The amount of mercury contained in a multi-dose flu shot is much higher than the maximum allowable daily exposure limit. Mercury toxicity can cause memory loss, depression, ADD, oral health problems, digestive imbalances, respiratory problems, cardiovascular diseases and many more such serious health ailments.

And what about the elderly? Can the flu vaccine help them?

6.) There is mounting evidence that flu shots can cause Alzheimer’s disease. One report shows that people who received the flu vaccine each year for 3 to 5 years had a 10-fold greater chance of developing Alzheimer’s disease than people who did not have any flu shots. Also with age the immune system weakens, thus lowering your ability to fight off infections. Introducing the flu virus in the bodies of elderly could have dangerous consequences.

Can we trust the authorities who are promoting the wide-spread use of flu vaccines?

7.) The Center for Disease Control appoints a 15-member Advisory Committee on Immunization Practices (ACIP). This committee is responsible for deciding who should be vaccinated each year. Almost all the ACIP have a financial interest in immunizations. It’s all about the money and may have very little to do with your health and well being. The very people pushing these vaccines stand to make billions of dollars. This itself creates a doubt on how effective these flu vaccines really are?

8.) Research shows that over-use of the flu-vaccine and drugs like Tamiflu and Relenza can actually alter flu viruses and cause them to mutate into a more deadly strain. Couple this with drug resistant strains and you have virtually no benefits with much risk.

9.) There is enough evidence that shows that the ingredients present in the flu vaccinations can actually cause serious neurological disorders. In the 1976 swine flu outbreak, many who got the flu shots developed permanent nerve damage. Flu vaccines can contain many harmful materials including detergent, mercury, formaldehyde, and strains of live flu virus. Is this what you want to put in YOUR body?

10.) Trying to guess what strain to vaccinate against each season has proved to be no more effective than a guessing game. This has been very true in recent years with the H1N1 strain. Moreover getting multi-shots will only prove more dangerous as different strains of viruses and harmful ingredients are introduced into your body.

Flu shots are indeed more dangerous than you could think, and it is best to rely on natural ways to protect against the flu rather than getting yourself vaccinated.

Isn’t it interesting that the main stream public health officials never promote the various proven ways to avoid the flu other than through vaccination? How about spending some of the billions of advertising dollars teaching us natural ways to boost our immune systems and avoid the flu without harmful and sometimes deadly vaccinations.

Help Us Spread This Article!

Some videos on the topic you should watch… We got a kick out of the one below!

This one is more educational…

References:

http://www.articlecity.com/articles/health/article_366.shtml

http://www.shirleys-wellness-cafe.com/flu.htm

http://chetday.com/noflushots.htm

http://www.vaclib.org/basic/fluindex.htm

http://www.politicolnews.com/n1h1-vaccine-dangerous/?

http://www.infowars.com/australia-bans-flu-vaccines-in-children-after-vomiting-fevers-seizures/?

http://www.i-sis.org.uk/fastTrackSwineFluVaccineUnderFire.php?

http://www.angelfire.com/az/sthurston/flu_shots_and_flu_vaccines.html

http://w3.newsmax.com/blaylock/1.cfm

http://www.lewrockwell.com/sardi/sardi119.html

http://vaccineinfo.net/immunization/vaccine/influenza/flu_vaccine_warning.shtml

http://healthscents4u.com/FluVaccineIngredients.aspx

http://tribes.tribe.net/2012the-end-times/thread/4759aed8-4e07-417a-b131-c13bec69dfcf

http://www.rense.com/general86/dngers.htm

http://theintelhub.com/2010/09/01/cdc-ignores-dangers-needles-for-everyon/

Flu SHot Gift Cards!!!

2010-08-25T06:53:00.000-07:00

Walgreens announces flu shot gift card; give the "gift" of a vaccine (opinion)
Wednesday, August 18, 2010
by Mike Adams, the Health Ranger
Editor of NaturalNews.com (See all articles...)

(NaturalNews) Summer isn't even over yet and the big push for the mass vaccination of the entire population is already under way. The CDC started the push by recently urging vaccine shots for everyone -- including infants, pregnant women and immune-compromised people. Adding to the vaccination hoopla, Walgreens has announced something quite bizarre: A flu shot gift card.

Available for $29.99 at your nearest Walgreens retailer, this gift card is, as Walgreens explains on their website, "a way to help more Americans stay well throughout the upcoming flu season by giving the gift of a flu shot."

See a full-size picture of this flu shot gift card right here: http://www.naturalnews.com/images/W...

Of course, if you gave your friends the gift of vitamin D supplements, they wouldn't need a flu shot or a jab in the arm with a sharp needle. Vitamin D has been proven again and again to work better than vaccines at preventing influenza (http://www.naturalnews.com/027385_V...), yet it remains all but ignored by the conventional medical establishment which just happens to be dominated by the financial interests of vaccine manufacturers (pharma companies).

Swine flu again?
As Walgreens admits on its own website (http://news.walgreens.com/article_d...), this year's seasonal flu shot only protects against last year's viruses. In particular, this year's flu shot contains DNA fragments from H1N1 swine flu -- yep, the very same virus that fizzled out last year after the WHO hilariously declared a stage six global pandemic. This whole charade turned out to be engineered by WHO advisors who had financial ties to the vaccine companies (http://www.naturalnews.com/029441_v...).

Now they're trying to jab you again with the same viral fragments. But this year they're playing mind games with the public by packaging these flu shots as "gifts." Walgreens must think this is clever, but it's actually a bit of a farce.

Usually a gift is something you actually want; something that's uplifting or health enhancing in some way. Vaccines, on the other hand, have been widely linked to convulsions and neurological disorders. Just recently, Australia actually banned its seasonal flu vaccine for children after dozens of children went into convulsions from receiving the flu shot.

Why do flu shots cause convulsions? Because flu shots contain neurological inflammation agents designed to elicit an immune response for building antibodies. The problem is that these chemicals can also cause neurological damage leading to symptoms you just can't ignore... such as convulsions. Some teens have even been paralyzed by flu shots. Western doctors routinely ignore this evidence and simply declare vaccines to be "safe for everyone!" even when they clearly aren't.

So anyone who buys a flu shot gift card and hands it to a child or teenager might actually be giving the gift of convulsions. Happy Birthday, Bobby! Here, have some convulsions and go get yourself jabbed in the arm with a sharp needle...

Sending the wrong message
In my opinion, buying a Walgreens flu shot gift card sends a powerful, two-part message. First, it announces that you're a complete idiot when it comes to health, and you're a total sucker for the corporate-controlled interventionist health care system that excels at convincing you to buy dangerous drugs you don't even need.

Secondly, it says that you probably hate the person you're giving it to. What kind of person buys a vaccine shot as a gift anyway? Does it include a Hallmark card that says "Every time I think of you, I wince in pain and can't stop convulsing. Enjoy this vaccine so that you can have the same experience."

Or another card, "I couldn't decide what to get you for Christmas, so I thought I'd get you vaccinated instead. Merry Christmas!"

Can you imagine some little kid receiving this gift from his parents? He was hoping for an X-Box or a dirt bike, but instead he gets an envelope with a red card in it. "What's this?" he asks his parents. "Oh, Bobby, it's a VACCINE gift card! To protect your health!" Bobby replies, "How does it work?" And his parents answer, "Well, using this vaccine gift card, you can get jabbed in the arm with chemicals and live viruses, and it won't even cost you a penny!"

"I feel really loved," answers Bobby. "No one has ever given me the gift of a vaccine shot! When can we go to Walgreens and cash in?"

What's next? Chemo Cards!
I got to thinking about this: If flu shot gift cards are so popular, why not just expand this into all the toxic chemicals of modern medicine? Perhaps hospitals should roll out Chemotherapy Gift Cards so you can "give the gift of chemo!"

Is your loved one just a little too healthy? Does their brain work too well? Is their liver annoyingly operating at one hundred percent? Give the gift of chemotherapy and you'll destroy their kidney, liver and brain function (after which they'll gladly accept your flu shot vaccine gift cards next year).

The chemo card can act like a coffee punch card, too: After ten rounds of chemotherapy, the eleventh is on the house! (If you're still alive, anyway...)

While this idea may seem outlandish today, it's actually not that far-fetched. Flu shot gift cards are already packaging western chemical medicines as "gifts." And we just reported a story about how pharma drug pushers want fast food restaurants to hand out statin drugs for free to customers (http://www.naturalnews.com/029467_s...). It seems that the idea of repackaging interventionist chemical medicines as gifts is pervasive.

It's too bad we can't figure out a way to give the gift of common sense to people. If they had any common sense about health and nutrition, they wouldn't need flu shot gift cards in the first place.

Is your Car like Big Pharma???

2010-08-02T06:40:00.001-07:00

What would happen if you had to buy your car from a company that operated in the same way as the pharmaceutical industries?

Cost

-Your car would cost $4.5 million, a 30,000 percent markup over cost.

-The same car would be available in

Canada

Mexico

for less than $5,000.

Dealing with Competition

-Meanwhile, automakers would be lobbying Congress to outlaw bicycles and airplanes, just as the drug companies try to do with herbs and nutritional supplements.

-All auto imports would be banned. If you drove a Toyota down from

Canada

, you would be arrested.

-Car dealers would be bribed with money, free vacations, free food, and free cars by automobile sales representatives to push certain cars.

Safety

-Cars with no seatbelts, airbags, crumple zones, or other safety systems would be declared perfectly safe by the FDA, which would instead focus on the dangers of bicycles.

-Driver's ed programs would be cancelled nationwide, and people would be encouraged to buy new cars rather than repair damaged ones or avoid accidents in the first place.

-Safety tests showing that cars were dangerous would be buried, and scientists who produced such results would be prevented from ever conducting car safety tests ever again.

-After being sued by customers injured in the cars with no safety systems, automakers would further lobby Congress to pass laws protecting car companies against class-action lawsuits.

-Any federally mandated warnings about car safety problems would be printed in small type on a tiny label hidden under the driver's seat.

-Driving certain cars would cause side effects like loss of sex drive or full-body muscle pain.

Advertising

-Car companies would heavily promote new models each year, which would be no different from the ones they were selling 30 years ago.

-Car companies would invent reasons for you to buy a dozen or more cars.

-Automobile advertising would be filled with pictures of happy, healthy, energetic drivers, but the cars would break down constantly, fail to perform as promised, and quickly stop working.

-Cars would be sold to you with extra features like a sunroof, air conditioning, or a navigational system, but when the car arrived none of these features would be included, just as drug companies exaggerate the "multiple health benefits" of their products.

The Principles of Chiropractic

2010-07-19T08:15:00.001-07:00

The Principles of Health and Chiropractic

What is a principle? A principle is a fundamental law or code of conduct. I think of the Golden Rule as a principle that we can use to guide and enrich our lives. The Golden Rule encourages us to treat others, as we ourselves would like to be treated. I know if the Golden Rule guided all my words and actions then my world would be enriched. Chiropractic has principles too. To the extent that we are successful in translating these to the patient, they will naturally experience greater levels of health and fulfillment. I have written down the basic principles of Chiropractic that are the most important to your health and that of your family.

1-There is a powerful healer within all of us. Its mission is to keep our bodies healthy and needs very little assistance from us. We call this the Innate Intelligence of the body. Innate simply means inborn or indwelling. It is the Life that is within you and is even now beating your heart without your effort. It is present in every cell.

2-This Innate Wisdom of your body uses the nervous system as a pathway from the brain to the cells of the body. Through the nervous system, Innate Intelligence coordinates and controls every cell and every function in the body.

3-Interference to the nervous system interferes with the mission of Innate Intelligence, which is to keep your body healthy and in the proper balance.

4-Spinal misalignments (subluxations) put pressure on the nervous system and interfere with this Intelligence and its ability to carry out its mission, which is maintaining health.

5-Interference to the nervous system (subluxation) is often silent or without symptoms until the final stages of the disease process, therefore, spinal care should begin long before symptoms arise.

6-Correction of the subluxation restores our body’s ability to heal and function as intended.

7-Spinal misalignments or subluxations are a natural consequence of physical, chemical and emotional stressors in the environment, which occurs on a daily basis. Subluxations should be kept to a minimum throughout the life of the individual.

8-For optimal health, spinal care should begin as soon after birth as possible and be maintained throughout the life of the individual.