Chiropractics vs Back Surgery

Comparing the Risks: Spinal Manipulation versus Back Surgery 

While most people seeking medical care for back or neck pain recognize that they may have treatment options (often including chiropractic care and surgery), many do not understand the potential benefits and risks associated with those choices.

Patients who ask family, friends or coworkers for advice all too often hear secondhand stories about healthcare “miracles” or “nightmares” experienced by a friend’s uncle, a wife’s boss or a father’s golfing buddy.

The clinical facts—on the other hand—are often less accessible to the average person and tend to leave a smaller impression. However, for those who want a broader perspective on their treatment options, there are several high-quality research resources available. The American Journal of Medicine and Spine (among others) have featured information on the risks involved with surgery and spinal manipulation.

Headline:  Both Surgery and Manipulation Present Risks

Patients who are suffering with neck pain and considering both surgery and chiropractic treatment should be aware of the risks and discuss them openly with their healthcare providers.

In the case of any surgery, there may be serious complications from anesthesia, excessive bleeding, blood clots that lead to pulmonary embolism and infection. These general risks are added to the more specific risks of surgery on the spine. These may include a dural tear (the dura surrounds the spinal cord and a tear can cause leaking of cerebrospinal fluid), spinal cord injury and persistent or increased pain from an unsuccessful procedure.

Spinal manipulation may also cause dangerous complications. Spinal manipulation has been associated with disc herniation, cauda equina syndrome (pain, weakness or loss of bladder and bowel function) and vertebrobasilar accident (a tear in a major artery of the neck). These complications can be just as serious as the complications associated with surgery. 

If similarly severe complications may result from either course of treatment, how can a patient weigh the risk of each option? Managing risk isn’t just about understanding “worst-case”-type scenarios, it’s also about understanding how likely these and other complications are to occur. This is where some additional research findings can help. 

How Frequently Do Serious Complications Actually Occur?

In April 2010, the journal Spine (published by Lippincott Williams & Wilkins) included an article that summarized the incidence of adverse events in spinal surgery based on the authors’ review and analysis of the existing literature.

They found complication rates for spinal surgery ranging from 5% to 19%. Similarly, the American Journal of Medicine in 2002 published the results of a study that examined the incidence of serious adverse events for spinal manipulation. By comparison, researchers involved in that work reported complication rates ranging from one out of every 400,000 manipulations to one out of every two million.

So now we can see that the risk of a serious adverse event from spinal manipulation is extremely low relative to the risk posed by surgery. That’s one reason that the Mayo Clinic and many other reliable healthcare organizations around the world consider spinal manipulation very safe when performed by someone trained and licensed to provide this type of chiropractic care.

Whenever we talk about risk, it’s always important to remember that almost everything we do can be ‘associated’ with some type of adverse event. Driving a car, handling scissors, and even eating dinner can all lead to serious complications. The best way to handle these risks, including the risks of spinal manipulation, is to understand them and keep them in perspective.

Healthcare providers are uniquely qualified to help you do that. If you or someone you care about is interested in chiropractic care—including its potential benefits and risks — please call Dr. Wintermute at (949) 559-7999 to make an appointment.

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References
 
Dekutoski, MD, M. B., Norvell, PhD, D. C., Dettori, PhD, J. R., Fehlings, MD, PhD, FRCSC, FACS, M.G., & 

Chapman, MD, J. R. (2010). Surgeon Perceptions and Reported Complications in Spine Surgery. Spine, 35(9S).  Retrieved August 31, 2011, from http://www.medscape.com/viewarticle/721611

Staff, M. C. (n.d.). Chiropractic adjustment: Risks - MayoClinic.com. Mayo Clinic. Retrieved August 31, 2011, from http://www.mayoclinic.com/health/chiropractic-adjustment/MY01107/DSECTION=risks

Stevinson, MS, C., & Ernst, MD, PhD, E. (2002). Risks Associated With Spinal Manipulation. The American Journal of Medicine, 112(7), 566-571. Retrieved August 31, 2011, from http://www.sciencedirect.com/science/article/pii/S0002934302010689 

What is the Atlas Orthogonal (AO) Technique?

The Atlas Orthogonal chiropractic technique, often abbreviated AO, is a specialty within the field of chiropractic that focuses of the upper cervical region. Even more specifically, practitioners of the Atlas Orthogonal technique concentrate on the Atlas vertebrae – the very first bone in the neck. Their goal is to make the Atlas bone orthogonal (or exactly perpendicular) to the skull. This is where the approach gets its name.

The premise behind AO is that the first bone – the atlas – is central to the alignment of the remainder of the column. Imagine a marching band where the first member is out of position. All the other band members position themselves relative to the first member. When the first member is out of place, the entire band is out of formation. This is a crude analogy to explain the critical role played by the atlas in directing the alignment of the other vertebrae.

And, it’s not hard to imagine how the atlas may be out of alignment. The rather light atlas (it weighs about 2 ounces) supports the weight of the human head (which weighs about 9 to 17 pounds).

Imagine the head as a golf ball and the atlas as the top of a golf tee. The small tee is best able to support the weight of the golf ball on top when it is straight up and down.

The atlas can become misaligned as a result of chronic poor standing or sitting posture, an awkward sleeping position or improper lifting. These are all examples of gradual processes. The atlas can also be jarred out of alignment by an auto accident, bad fall, or a blow to the head.

When the atlas is out-of-alignment (non-orthogonal), the body will compensate in other ways to keep the heavy head centered over your feet. The other spinal vertebrae and the muscles in your neck, torso and lower back will alter their normal position and function in response (just like the marching band reacting to the position of the first member). Now you’ve created a situation where there may be excessive pressure on certain nerves, muscle spasms and tissue inflammation which can cause pain and dysfunction in other areas of the body.

Hopefully you are starting to see why the Atlas Orthogonalist focuses so intently on the atlas. A problem with the atlas alignment can manifest in many other distant places and cause a multitude of problems.

So how does the AO chiropractor restore the proper position of the atlas? By carefully evaluating each patient’s precise atlas position and then programming an instrument to deliver a precise percussive wave to reposition the atlas.

First, an AO-trained chiropractor will take very detailed x-rays that can map the exact position of your atlas. The tilt and rotation of your atlas are as unique to you as your own fingerprints.

Second, an instrument programmed with your exact settings will deliver a painless vibration to the affected area. There is no twisting or cracking.

Since the adjustment is custom-programmed for you it can be simultaneously very gentle and very effective. Some patients that have had traditional chiropractic will often walk away from their first AO treatment thinking that nothing has be accomplished because an AO adjustment is barely felt by the patient.

This article is just a brief introduction to the Atlas Orthogonal technique. When you visit our office, you’ll be able to get answers to all your questions. And after an exam, we’ll be able to talk with you in detail about whether you can benefit from atlas adjustment the same way that tens of thousands of your peers have.
 

Bibliography
 
(n.d.). Retrieved 8 29, 2011, from GlobalAO.com - The Official Site of the Atlas Orthogonal Program: http://globalao.com/
 
(n.d.). Retrieved 08 29, 2011, from Sweat Institute for Atlas Orthogonal Chiropractic: http://www.sweatinstitute.com/content/home.php

Find the Right Pillow for a Healthier Night's Sleep

Sleepless in America?
For more than one in three Americans, getting a good night’s sleep isn’t as easy you might think.

According to a recent poll by the National Sleep Foundation, a combination of daily stress and lifestyle choices (including night-time activities as well as eating and exercise habits) is causing more than a third of the U.S. population to get fewer hours of sleep than they need. Not surprisingly, the same proportion report that sleepiness has in some way affected their quality of life. 

The Long-Term Prescription for Quality Sleep
Many studies have focused on the time we devote (or don’t devote) to sleep.  However, a good night’s sleep is about more than just quantity. It’s also about quality. If you’re sleeping poorly, experts point out that developing a sensible routine and avoiding certain behaviors around bedtime can improve your chances of falling asleep quickly and sleeping soundly through the night. Here are a few of their suggestions:

• Go to bed at the same time each evening and wake up at the same time each morning.
• Exercise regularly but avoid increasing your heart rate within two or three hours of bedtime.
• Eat dinner early enough in the evening so that digestion doesn’t interfere with bedtime.
• Drink plenty or water but avoid drinking hot or cold liquids before or after bedtime.
• Reduce or eliminate caffeine and other stimulants in your diet.
• Sleep on your back and/or your side.
• Don’t sleep on your stomach!
•  

When it Comes to Sleep, Little Things Matter More Than You Might Think.  And They Add Up

While finding more effective ways to manage stress and making adjustments to your lifestyle can take some time, there are several “little” things you can do right away that may improve the quantity and quality of sleep you get. These things focus on your sleeping environment itself:

• Make your room is as dark as possible at bedtime.
• Reduce background noise.
• Keep your bedroom at a cool, comfortable temperature.
• Sleep on an appropriate mattress.
• Choose the right pillow.

Is Your Pillow Doing Its Job?
Let’s face it. You probably don’t give a lot of thought to the pillow you sleep on. And you probably didn’t give your pillow much thought when you purchased it either. The truth is that most people don’t. It’s not unusual for a person (or a couple) to spend thousands of dollars on a high-quality mattress but then buy pillows that don’t support the head and neck properly. That’s because — while they understand that sleeping on the wrong mattress can quickly lead to a backache — they aren’t aware that poor alignment of the neck and upper back during sleep can lead to other, more subtle problems that they may not associate with the spine.

If a person’s head is supported by the pillow at a level that’s either too high or too low relative to the rest of the body, the neck and upper back can be placed under stress. Similar stress can also occur if their upper back is not supported along with the neck (so that the head tilts forward), or if the head is allowed to roll sideways when the person is sleeping on his or her back. Symptoms include snoring, insomnia and waking up with a headache, stiff neck or numbness in the arms and hands.  If you’re experiencing these sorts of symptoms, you may be sleeping on the wrong pillow.

What Makes a Pillow “Right”?

Choosing a pillow is a very personal decision. The pillow that’s right for someone else may not be right for you. Nevertheless, we’ve provided some basic guidelines that will make it easier for you to choose the right one. The right pillow:

• Supports your head at the proper height whether you’re sleeping on your side or on your back.
• Supports both your head and neck in a neutral position while you’re sleeping on your side (Make sure there is no gap between the pillow and your neck!).
• Provides adequate support for both your neck and upper back while you’re sleeping on your back.       
• Keeps your head tilted in the proper neutral position while you’re sleeping on your back.
• Prevents your head from rolling sideways while you’re sleeping on your back.
• Is easy to move on.

In general, you’re looking for a pillow that supports your neck, cushions your head and keeps your spine in alignment. It must be comfortable!

Purchasing Tips

1. Know what you like. Do you prefer a pillow that’s “bouncy” or one that can be “molded” to the shape of your head and neck? How “dense” do you like your pillow to feel?  Is it important to you that the material “breathes” and offers good insulation from heat and cold? Maybe you prefer a pillow made of synthetic or hypo-allergenic material? The more clearly you can describe your preferences, the more likely it is that a knowledgeable salesperson will be able to help you find your ideal pillow. 
    
2. Don’t skimp. Like most things, pillows can differ a great deal in the quality of their construction and materials. They also (naturally) differ a great deal in their price. Buy a better quality pillow if you can, since they’re generally made of materials that will provide better support, comfort and durability. But keep in mind that the first priorities are comfort and function. Just because a pillow is expensive doesn’t mean it’s right for you.
    

3. Take the time to “test drive” and compare. Many department stores, mattress retailers and specialty bedding shops will have sample pillows that you can try. If possible, follow the “Ten Minute Rule” and test drive pillows in your favorite sleeping positions. Remember—you and your pillow will be spending about eight hours together every night for several years, so it makes sense to choose wisely now.
    
4. Avoid buying a matched set of pillows for yourself and your partner. Keep in mind that your partner probably needs a different pillow that you do.

Get an Expert Opinion

from the Doctor

Who Understands Your Neck and Back Best

If you’re not sleeping as well as you used to, or if you’re waking up with a headache, stiff neck or numbness in your arms or hands, we invite you—and your pillow—to visit our office. As chiropractic physicians, we understand that the way you sleep affects your health — and that your health affects the way you live your life.

Call today to schedule an appointment. Sometimes a small thing (like a new pillow) can make a big difference!

AN ADJUSTMENT IN YOUR GOLF GAME

Neck and Shoulder Pain from Golfing

Chiropractic care is standard for many pro golfers and increasingly for many Senior Golfers as well. Professional golfer Lori West attributes the reason she’s playing today to chiropractic. Nearly two decades ago, she began visiting a chiropractor for pain in her shoulders and neck. According to West, the care has infinitely improved her golf game.

A Good Golf Swing

The problem is that the golf swing, in and of itself, isn’t conducive to having a healthy back. To have a good swing you create tension in your spine. (This enables you to get good distance). The tension comes from the hips stopping and the shoulders continuing to rotate. Basically, you make a coil. You’re uncoiling when you start your downswing. Since that’s an awkward movement for your back, many golfers end up with lower back problems.

Chiropractic advice and Stretches for Golfers:

     • Before your game, do some
        basic stretches.
        Stretch out hamstrings and
        groin area.
     • Put a club across your
        shoulders and lean left
        and right.
     • Get in a position of where
        you would be in a swing
        and bend left and right.
     • Grab a club behind your
        back and raise it up,
        stretching your
        shoulder muscles.
     • Grab the club backwards –
        so if you normally swing
        right-handed, you’d grab it
        like you’d be swinging
        left-handed — and take 10 practice swings that way. You’re
        stretching different muscles and it will help you loosen up
        considerably.
     • Do neck stretches. Stiff neck muscles inhibit the rest of the body
        from turning freely.

Flexibility and Golf

Anything that helps your flexibility eventually helps with your game. As you get older, your swing naturally shortens since the muscles aren’t as supple. During the winter, work on stretching the muscles of the arms, shoulders and back. Flexibility is very important for older golfers.

Improved Balance for Golf
Also, you have to have good balance if you want to hit the golf ball consistently. A healthy spine is paramount to proper balance and posture. Improve your balance and you’ll improve your consistency. In needed, orthotic stabilizers for your shoes can help improve balance so your swing is better.

Chiropractors care for your body as a whole, not just the back. So if your golf game is feeling out of sync, chiropractic may be just the very adjustment that your body and game needs!

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