Surgery or Chiropractic for Chronic Sciatica Sufferers?

Pain coming from compression or irritation of the sciatic nerve is called sciatica. Sciatica — which can include pain, tingling, numbness and muscle weakness — is really a symptom indicating an underlying problem, not a diagnosis in and of itself. This article will explore in detail the findings of a recent controlled study comparing spinal manipulation (chiropractic) and surgery for people whose sciatica did not respond to traditional medical treatment approaches.

The study discussed here was conducted by the National Spine Center in Alberta Canada and published in October of 2010 in the Journal of Manipulative and Physiological Therapeutics. The 40 study participants all had sciatica lasting over 3 months which had not responded to treatment with pain medications, lifestyle modifications, physical therapy, massage therapy or acupuncture. They had all been referred by their primary care physicians to spinal surgeons who had deemed them appropriate surgery candidates.

Instead of having all the patient proceed with surgery, they were split into two groups — one group to undergo a surgical microdiscectomy and the other group to be treated with standardized chiropractic spinal manipulation by a single chiropractor. (If not satisfied with the results they obtained from their assigned method, the patients were allowed to switch to the other treatment plan after 3 months.)

So what happened? Both groups made significant improvements over baseline scores — meaning that they saw noticeable improvements whereas previous approaches had failed. A full 60% of the study participants benefitted from chiropractic spinal manipulation to the SAME degree as if they underwent surgery. And, after 1 year there was no difference in outcome success based on the treatment method. That means that a full 60% of people referred for surgery by their primary care physicians and accepted as surgical candidates by the neurosurgeon could actually get similar results with chiropractic. That is a lot of potentially unnecessary cutting, anesthesia and ER time.
 
There is one paragraph in the results section of this study that is easy to overlook, but incredibly important. There were originally 120 candidates of which 60 met the study criteria and were asked to participate. Of these 60, 20 refused. Why? Because they had never been offered spinal manipulation as an alternative to surgery! They didnít want to participate in the study and be randomly placed in the surgery group without first trying the spinal manipulation! This is incredibly telling. Not only does it demonstrate that there is still a lot of education about chiropractic that needs to happen among the public and among primary care providers, it also demonstrates that people understand the risks and costs of surgery and want to exhaust other possibilities first.

This was the first study to ever look at people who had failed traditional medical management of sciatica. Currently most patients that fail "conservative care" are referred for a surgical evaluation. Now we know that 60% of these folks could avoid surgery and get similar long-term outcomes with chiropractic.
Please share this article with anyone considering surgery for sciatica.

Take Flexibility Training Seriously

When it comes to the Big Three of exercise - cardiovascular, strength and flexibility training - it's pretty clear which one can get overlooked. After all, while we prize cardiovascular and strength training for their role in helping us lose weight, build muscle and get fit, the benefits of flexibility training are less immediately alluring.

However, as the population ages, more of us are learning to appreciate the rewards of stretching. Staying limber can offset age-related stiffness, improve athletic performance, and optimize functional movement in daily life.

Research shows that flexibility training can develop and maintain range of motion and may help prevent and treat injury. In fact, the American College of Sports Medicine has added flexibility training to its general exercise recommendations, advising that stretching exercises for the major muscle groups be performed two to three days per week.

How can you include an effective flexibility workout in your fitness program?

Here are some guidelines:

Think in Terms of Serious Flexibility Training, Not Just Brief Stretching
Squeezing in one or two quick stretches before or after a workout is better that nothing, but this approach will yield limited results. What's more, generic stretches may not be effective for your particular body. The more time and attention you give to your flexibility training, the more benefits you'll experience. A qualified chiropractor, personal trainer, physical therapist or health professional can design a functional flexibility program specifically for you.

Consider Your Activities
Are you a golfer? Do you ski, run or play tennis? Do your daily home or work routines include bending, lifting or sitting for long periods? Functional flexibility improves the stability and mobility of the whole person in his or her specific environment. An individualized stretching program is best to improve both stability (the ability to maintain ideal body alignment during all activities) and mobility (the ability to use full, normal range of motion).

Pay Special Attention to Tight Areas
Often the shoulder, chest, hamstrings and hips are particularly tight, but you may hold tension in other areas, depending on your history of injuries and the existing imbalances in your muscle groups. Unless you tailor your flexibility training to your strengths and weaknesses, you may stretch already overstretched muscles and miss areas that need training.

Listen to Your Body
Stretching is an individual thing. Pay attention to your body's signals and don't push too far. Avoid bouncing or jerking movements to gain momentum; this approach can be dangerous.

Instead, slowly stretch your muscles to the end point of movement and hold the stretch for about 10 to 30 seconds. Older adults, pregnant women and people with injuries will need to take special precautions.

Get Creative
Varying your flexibility training can help you stick with it. You can use towels, resistance balls and other accessories to add diversity and effectiveness to your stretching.

Warm Up First
Don't forget to warm up your muscles before you begin. Walking briskly for 10 to15 minutes is a simple way to do this.

Find a Flexibility Class That Works for You
Classes that include stretching are becoming more popular and more diverse. Some combine cardiovascular and strength components with the flexibility training; others focus exclusively on stretching.

Stretch Your Mind and Body
Did you know that your emotional state may affect your flexibility? If your body is relaxed, it will be more responsive to flexibility training. Listening to music and focusing on your breath can help you relax as you stretch. You may also want to explore yoga or Pilates. In addition to stretching, classes in these disciplines may include relaxation, visualization and other mind-body techniques designed to reduce stress and increase mindfulness.

It's Not Just for Wimps
Forget the idea that stretching is just for elderly, injured or unconditioned people. Many Olympic and professional athletes rely on flexibility training for peak performance.

Do It Consistently
It doesn't help to stretch for a few weeks and then forget about it. Integrate regular stretching into your permanent fitness program. For inspiration, look to cats and dogs - they're dedicated practitioners of regular stretching and you rarely see them getting the kind of joint or muscular injuries that humans get!

Getting Started
Your chiropractor is a great resource for functional stretches specific to your needs. Be sure to ask about a customized flexibility program at your next visit.

What is Sciatica?

Many people use the term sciatica incorrectly. Sciatica is pain along the path of the sciatic nerve which extends from the lower back down each leg. Sciatica is a symptom (like itching), it is not a diagnosis (like Parkinson's disease). Sciatica can range from an occasional nuisance to excruciating pain that makes walking near impossible. There can be multiple underlying reasons for your sciatic nerve pain. A chiropractor can help find the root cause of the problem with an exam and may also order some diagnostic imaging such as an x-ray, MRI or CT scan to examine the underlying structures.

To answer the question, "what is sciatica" it is helpful to explain some of the relevant anatomical structures. The sciatic nerve is both the longest and the widest nerve in your body. It begins in the lower back as five separate nerves that extend from five different vertebrae ñ L4, L5, S1, S2, and S3. These nerves meet up to form one large bundle which runs through the buttocks and down the entire length of the leg. The sciatica nerve is responsible (directly or indirectly) for nearly all the sensation in your leg including the skin of the thigh and gluts.

Sciatica occurs when there is compression or irritation of the sciatic nerve. The pain is felt in the low back and leg, but the site of the pain isn't always the site of the underlying issue. Since the sciatica nerve is so long and travels around or through the large muscles of the buttocks, it takes an expert to determine if the pain is coming from disc compression, from muscle spasms or from something else. Again, sciatica is a symptom, not a diagnosis.

While sciatica is most often associated with pain, other symptoms may be present such as tingling, numbness, or muscle weakness. The pain can be nearly constant or intermittent. If you think you are experiencing sciatic nerve pain, keep a record of the location, duration and intensity of the pain. Your specific history plays an important role in determining the cause of the pain.

Treatment for sciatica depend on the underlying cause, so there is no one recommended course of treatment for all sciatic pain sufferers. Chiropractors use a variety of non-invasive approaches that include spinal manipulation, physical therapy, targeted stretching and active muscle release. They'll also discuss the role that nutrition and hydration play in reducing tissue inflammation and keeping discs healthy. The spine, discs, muscles and soft tissue all have a role to play in sciatica and should be evaluated and treated as a connected system.

The most important thing to take away from this article is that sciatica (sciatic nerve pain) is a symptom of an underlying condition. You'll only start to get better once the underlying condition is identified and this is done through a combination of an exam, history and recommended diagnostic imaging.

COLD OR FLU? WHICH IS IT?

During the winter months, the phone rings constantly with people who have “the flu”. Except…they don’t. Do you know the difference between having a cold and having the flu?

The common cold (and boy is it common) develops gradually over several days and can start with a scratchy throat, sneezing and sniffles leading to congestion. Any fever present is mild (in adults). Coughing is generally hacking and can be moist due to congestion.

On the other hand, influenza often starts rather suddenly with fever (usually greater than 101 degrees F and lasting 3-4 days), headache and all over body aches (myalgia).  People with the flu are often exhausted or fatigued. Coughing is usually dry and hacking and can last days or weeks after all other flu symptoms have passed.

Influenza or “the flu” is more of a systemic illness, meaning it affects your entire body, whereas a cold generally just affects the upper body. You can sometimes get a stuffy nose, sneezing and sore throat with the flu, but it’s much more common with colds. The flu is more serious because it can lead to other problems, like pneumonia in susceptible adults and young children.

Influenza is caused by a virus. In general, viral illnesses will run their course without a trip to the doctor. Antibiotics don't work against viruses, so all your doctor can recommend to help you are pain medications, cough suppressants or an anti-pyretic (fever reducers). All of these are available without a prescription from your local drug store to help you deal with flu symptoms.

If you are suffering from cold or flu symptoms, you should also schedule a visit to your chiropractor. Chiropractic care doesn’t treat the virus directly, but rather boosts your body’s ability to fight the invaders. That’s why regular chiropractic care can reduce the frequency with which you get sick. When your body’s immune system is in peak condition, it can fight off minor intruders with ease.

All ABout Vitamin A

You may have heard from your grandma that eating carrots can improve you vision. That may not be exactly true, but carrots do contain something called provitamin A carotenoids. These are pigments in some plants that can be converted by the body into vitamin A, and vitamin A is important to your vision.
 
Vitamin A is also helpful to bone growth and your immune system. As with other vitamins, there are different forms of vitamin A. One of the forms that is most usable to the body is called retinol, which is found in liver, eggs, and milk. One of the most common provitamin A carotenoids that the body converts easily to retinol is beta carotene. Beta carotene is found in yellow and orange fruits and vegetables including carrots, sweet potatoes, spinach, and cantaloupe. Vitamin A is also one of the vitamins often used to fortify breakfast cereals.

Vitamin A is fat soluble, which means that the body stores it, mostly in the liver. That also means that it is possible to build up toxic levels of Vitamin A. This rarely happens from food sources because as the body builds up supplies of vitamin A it will slow down the conversion of beta carotene. When people do get vitamin A toxicity, it is usually from taking too much in supplemental or pill form. Toxic levels of vitamin A can cause liver problems, central nervous system problems, deterioration of bone density, and birth defects.

True deficiency of vitamin A is rare in the US, but common in countries where malnourishment is widespread. As mentioned earlier, vitamin A is important to the immune system and vision. This is because the body uses vitamin A to make various internal tissues, such as those lining the eye, lungs, and intestinal tract. When these linings are weakened by vitamin A deficiency, it is easier for harmful bacteria to penetrate them and thus, people with vitamin A deficiency are more prone to infections, illness, blindness, and respiratory problems.

Aside from the malnourished, other people who may be prone to vitamin A deficiency include those who consume large amounts of alcohol and those with certain metabolic disorders that affect how fat and other nutrients are absorbed by the body.

Some recent and ongoing studies involving vitamin A and beta carotene include investigations as to whether high amounts of vitamin A contribute to osteoporosis, and whether beta carotene can lower the risk of some forms of cancer.

As of this writing the Recommended Daily Intake for Vitamin A was 2,310 IU for females and 3,000 IU for males. For a current list of recommendations and list of foods that contain Vitamin A from the National Institutes for Health visit http://ods.od.nih.gov/factsheets/vitamina/