My Blogging History

Tuesday, January 31, 2017

Chiropractic Wellness Care

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The 2012 National Health Interview Survey provides the most comprehensive information on the use of complementary health approaches in the United States. National estimates were derived via data collected from 34,525 adults aged 18 and over regarding wellness-related reasons for consumer’s utilization of supplementation, yoga, and spinal manipulation. The results of this survey were published on November 4, 2015 by the  National Center for Complementary and Integrative Health (NCCIH) and they found that:
  • ·        Over 50% reported using spinal manipulative therapy (SMT) for wellness
  • ·   While over 65% reported using spinal manipulation for treating a specific health condition


However, the most common responses from those using SMT for general wellness or disease prevention was:

Chiropractic Wellness Care
Chiropractic Care

Friday, November 18, 2016

The Dr. Oz Segment, Can Your Chiropractor Kill You? Which Aired, 11/16/16

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The Details

On Tuesday, November 15, 2016, The Dr. Oz Show filmed two segments addressing the death of Ms. Katie May. The first segment involved the family of Ms. May who believe Ms. May’s death was a result of the care she received from a chiropractor. The second segment involved Dr. Oz, Dr. Carolyn Brockington, a neurovascular surgeon, Mt. Sinai Hospital in New York (http://www.mountsinai.org/profiles/carolyn-d-brockington) and Dr. Steven Shoshany, a practicing chiropractor from New York (www.drshoshany.com).

While the consideration of any adverse outcome associated with our care is unflattering, the manner in which this situation was addressed by all three panelists was fair, constructive and informative for the public. There was no condemnation of chiropractic, and there was no statement, in this segment, that the chiropractor caused this problem. To the contrary, there was a thorough discussion of vertebral artery dissection, including its rarity in association with chiropractic care, its ability to present in seemingly healthy middle-aged persons, discussion that most dissections do not evolve into a stroke and finally that death from arterial dissection is extremely uncommon.

Three questions were posed to Dr. Shoshany in the six-and-a-half-minute segment including:
- Did cervical manipulation play a role in the circumstances of Katie May?
- How important is a patient's history in helping to understand this problem?
- What are chiropractors doing to address these situations?

Dr. Shoshany expressed condolences to the family of Ms. May and went on to explain that the best science available suggests that this was a dissection in progress that occurred during the photo-shoot involving Ms. May. He used a Bow-Hunter’s Stroke as an example of the mechanism of causation—that is the strain of maintaining a stressed position for a period yielded the injury.
He related how rare these events are in chiropractic.

The discussion moved to comments from Dr. Brockington, the neurovascular surgeon. She was asked point blank by Dr. Oz, “Do you think manipulation caused the dissection?”
- She did not say the chiropractor caused this stroke.
- She did not raise undue concern about cervical spine adjusting.

In response, she related that she, as a stroke specialist, sees strokes every day. Some of the strokes she sees have known causes and many don’t. She related that she recently saw a gentleman who developed an arterial dissection while painting. She noted that these conditions can occur in seemingly healthy persons in their 30-50s with no prior history. She reviewed an angiogram to show what a dissection looked like on imaging and to explain how it was related to blood flow and oxygenation of the brain.
She discussed that most dissections don’t lead to stroke, but cervical artery dissection did account for 1 in 5 strokes in middle-aged persons.

The conversation moved to the second question about the value of a patient history.

Dr. Shoshany related that, as a clinician, Dr. Oz appreciated that the patient history was the most valuable tool we have to work with. He related the importance of knowing about a history of stroke, aneurysm, dissection, collagen disorders, etc. Dr. Oz then walked the audience through the 5 Ds, the 3 Ns and the A associated with cervical artery dissection:
- Diplopia [a.k.a. double vision]
- Dysphagia: difficulty in swallowing
- Dysarthria: difficulty in speech articulation
- Drop Attacks: a tendency to fall without warning and without losing consciousness, or a fall of this kind
- Dizziness
- Nausea
- Numbness
- Nystagmus: an involuntary rhythmic movement of the eyes, usually from side to side, caused by some illnesses that affect the nerves and muscle behind the eyeball
- Ataxia: the inability to coordinate the movements of muscles

The advice given was that one should think of their neurologist OR visiting the emergency room rather than chiropractor when one has neck pain with these additional symptoms.

The third question about what the profession is doing about this problem allowed Dr. Shoshany to explain that the profession has been addressing this situation for decades. He also added that he has delivered more than 200,000 cervical adjustments in his 20+ years of practice in Manhattan without a single occurrence of this problem. He added that Life University, the largest single campus chiropractic program in the world, has provided an estimated 4.5 million cervical adjustments during the past 25 years without any incident of this nature. Finally, he added that among the 17 chiropractic educational programs in the United States, there has not been a single incident, to his knowledge, of this nature in the past 20 years.

Dr. Oz read a statement from the American Chiropractic Association (ACA) commenting on how DCs are educated and trained in differential diagnosis based on history, examination, etc., and that they are trained to refer when necessary for further evaluation or emergency intervention.

Dr. Shoshany again emphasized the safety of chiropractic and offered the view that when you consider our safety record in light of 45 people dying every day of opioid use and abuse, chiropractic care is even safer than first thought.

The segment ended with Dr. Oz offering the following comments:
- Cervical artery dissections happen; this doesn’t mean you need to avoid going to your chiropractor.
- This doesn’t mean it was caused by the chiropractor.
- It does mean anyone with neck pain needs to fully advise their chiropractor of any other symptoms or problems they are having with the neck pain.  


The Take-Aways

1. The family of Ms. May are naturally upset about the loss of a loved one. They are entitled to their emotional grief, and even if the data doesn't support the argument, they may choose to direct it toward the chiropractic profession. 

2. The DATA cited on The Dr. Oz Show from chiropractic education about this type of issue is as follows:
- Life University, 25 years, 4.5 million cervical adjustments—no dissection related issues have been reported

- Among all 17 chiropractic educational institutions, 20 years, millions of cervical adjustments—no dissection related issues have been reported

- The 25-year window at LIFE and the 20-year window across chiropractic education should not imply something happened 26 or 21 years ago, respectively. The data isn’t available for the period before those dates.

3. The 5 Ds, 3 Ns and the A the telltale signs of a health history
- Dysphagia, dysarthria, diplopia, drop attacks and nystagmus are important symptoms that, by themselves in the presence of neck pain, strongly suggest a level of care that DOES NOT include chiropractic.

- Dizziness, nausea, numbness and ataxia are not as strongly associated by themselves with dissection and stroke, but you should look for the development of these symptoms in a constellation as a guide to increasing your index of suspicion.

- When you experience neck pain is “unlike any pain I ever had before in my life” or “the most unusual pain I have ever had” or “the worst pain I have ever had,” THINK about the possibility of a dissection in progress and handle accordingly.

4. Chiropractic care is very safe. When it is viewed in a comparative sense with pharmaceuticals or surgery for similar types of problems, it is remarkably safe. Life has risks. There are fewer risks under chiropractic care than under medical or surgical care.

5. This wasn’t discussed on The Dr. Oz Show, but it is something you should be aware of: The Coroner’s Report in the case of Ms. May noted: “Bilateral vertebral artery dissection is a rare complication of neck manipulation in one per 100,000 to one in 2 million manipulations. (South Med J. 2007 Feb; 100(2):201-3)”

* The literature cited is misquoted as follows:
- The article states “Serious complications are infrequent, with a reported incidence between one per 100,000 and one per 2 million manipulations.”
1. This does not refer exclusively to vertebral artery complications.
2. This does not refer to bilateral vertebral artery dissection.

- The literature cited did not identify an arterial dissection-unilateral or bilateral on imaging or during autopsy.

- The literature cited was the weakest class of evidence, a single case study, and neglected the opportunity to refer to two more recent case-control and case-crossover studies (Cassidy, 2008) and Kosloff (2015). He also chose not to refer to a recent meta-analysis on this subject conducted by neurosurgeons at Penn State Hershey Medical Center (Church, 2016).

Bilateral cervical artery dissection is more commonly associated with a disease of the arteries (arteriopathy) than with other causes.

Tuesday, November 15, 2016

Achieve Optimal Health and Continue Doing the Things You Love




Locate a Doctor of Chiropractic Near You
Chiropractors Near Me - 15853

www.F4CP.com/FindADoctor

Response to the Media Inquiries Regarding the Unfortunate Death of Model Katie May

According to the various media reports, Katie May, a well-known model dubbed “The Queen of Snapchat,” suffered a trauma to her neck to which she sought care from a chiropractor. According to news sources, her father has made remarks that suggest that her chiropractic care played a role in her untimely death.

Here are some facts for your consideration:

- Arterial dissection of the cervical (neck) arteries is a very rare condition occurring in 2-3 persons per 100,000 population per year. As this condition often produces neck pain and headaches, many times individuals will consult with their health care providers for advice or treatment in response to the discomfort.​​

- Whether a person consults a medical doctor or doctor of chiropractic, stroke can follow at an equal rate regardless of the type of provider. Epidemiologic studies over many years with millions of patients do not reveal any greater association of stroke for persons under chiropractic care compared with persons under medical care.

- In February 2016, a team of neurosurgeons at the University of Pennsylvania Hershey Medical Center published research concluding, “There is no convincing evidence to support a causal link between chiropractic manipulation and cervical artery dissection (CAD).”

- Chiropractic manipulation has shown to be safe, effective treatment for neck, mid back and lower back pain. A comprehensive review of scientific evidence noted that there is as much evidence supporting chiropractic care as for other treatments such as prescription and non-prescription drugs and surgery.


The doctors at Life in Motion Chiropractic and Wellness recognize that this is a sensitive subject and we are presenting this information to you with the utmost respect for Ms. May and her family.

Thursday, November 3, 2016

Got Pain?



TRY CHIROPRACTIC FIRST!
Here’s why:

Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: results of a pragmatic randomized comparative effectiveness study.

Conclusion: The results of this trial suggest that chiropractic manipulative therapy (CMT) in conjunction with standard medical care (SMC) offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard care, for men and women between 18 and 35 years of age with acute low back pain (LBP).

The Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain.

Conclusion: This is the first reported randomized controlled trial comparing full clinical practice guidelines-based treatment, including spinal manipulative therapy administered by chiropractors, to family physician-directed usual care (UC) in the treatment of patients with acute mechanical low back pain (AM-LBP). Compared to family physician-directed UC, full clinical practice guidelines-based treatment including chiropractic spinal manipulative therapy is associated with significantly greater improvement in condition-specific functioning.

Pain, disability, and satisfaction outcomes and predictors of outcomes: A practice-based study of chronic low back pain patients attending primary care and chiropractic physicians.

Conclusion: Chiropractic care compared favorably to medical care with respect to long-term pain and disability outcomes. Further study is required to explore the advantage seen for chiropractic care in patients with leg pain below the knee and in the area of patient satisfaction. Identification of patient and treatment characteristics associated with better or worse outcomes may foster changes in physicians' practice activities that better serve these patients' needs.

Primary care professional for spinal health and well being.
Primary Spine Practitioner


Tuesday, November 1, 2016

Back-to-School Backpacks: F4CP Alerts Parents About Weight Overloads, Impact Upon Posture and Health

HASBROUCK HEIGHTS, NJ – August 02, 2016 – According to a study published in the Journal of Pediatric Orthopedics, students bearing excessive weight in their backpacks can develop long-lasting back pain, among a multitude of serious health conditions including neck pain, tingling and numbness of the arms and shoulders, headaches, muscle spasms and postural decline. As the back-to-school season quickly approaches, the Foundation for Chiropractic Progress (F4CP), the leading voice of the chiropractic profession, calls attention to the safety concerns associated with carrying heavy backpacks and validates the significant impact of postural habits on overall health.

Over time, the heavy weight of a backpack can cause an unnatural alignment of the spine as students are forced to offset the pressure by arching the back or bending forward at the hips,” states Sherry McAllister, DC, executive vice president, F4CP, who notes that the weight of a backpack should be no more than five to 10 percent of an individual’s body weight. She continues, “To help combat backpack-related postural stress, students should consider bags that offer multiple compartments and tightened, padded straps worn on both shoulders to help appropriately position and distribute weight.”

In addition to the added stress that backpacks place on the spine, students who are prone to slouching, rounding the shoulders, or protruding the head forward may experience further pain from sitting at a desk for prolonged periods of time. Doctors of chiropractic (DCs) – who receive a minimum of seven years of higher level education – specialize in spinal health and wellness and are specifically trained to provide hands-on care that helps to naturally align and strengthen the spine, as well as counsel patients about nutrition, exercise and proper body positioning tips.

Addressing postural habits is especially important while children and adolescents are still growing, as they are more inclined to implement strong body mechanics at an early age, essentially avoiding the impact of improper alignment later on in life. The slogan to remember for good posture is practice makes permanent, so practice good posture,” shares Dr. McAllister. “To prevent backpack-related pain or discomfort, I recommend consulting a doctor of chiropractic to learn more about how to reduce the risk of injury and back pain, and to improve overall spinal configuration, muscle support and health.”

For additional information regarding the importance of backpack safety and the value of chiropractic care, please view the F4CP’s public service announcement here.

About Foundation for Chiropractic Progress    

A not-for-profit organization, the Foundation for Chiropractic Progress (F4CP) informs and educates the general public about the value of chiropractic care. Visit www.f4cp.com or call 866-901-F4CP (3427). Social media: FacebookTwitterLinkedInPinterestYouTube.