Category: Health

Next Friday, I’ll be attending the ICAC convention to interact with fellow chiropractors and to dedicate time to continuing education. I’ll be closing the office earlier on Friday, March 22, 2019, so that I can make it on time to the presentations. Though I’m not enthused about the traffic, I’m looking forward to wealth of knowledge and the practice of lifelong learning.

What do you do to keep the things you’ve learned freshly accessible in your brain? What new things are you learning? Let me know in the comments below, or at your next appointment.

Here are some new photos of the clinic, featuring an inverter.

See you at your next appointment! Have a great day!

This Harvard article directed me to the American College of Physicians (ACP) article elucidating new guidelines for the treatment of low back pain. Indeed, the Harvard article is a summary of it, and I’d like to provide my own summary for you.

 

Before I continue, I’d like to comment that I share actual research articles here because journalism is a different form of literature than scientific writing. Thus, it takes a different method of reading to process a research article than a news article. It’s a cognitive exercise to switch between different methods of reading, and you get the added benefit of knowing exactly what the scientists say about their research versus what the journalists say that the scientists say. I think anyone, despite what you studied in school, can learn to read and understand scientific research. It just takes practice.

 

The ACP provides three recommendations. They even grade their own recommendations, e.g. strong or weak, in addition to evaluating the quality of evidence that resulted in the recommendation.

 

The first recommendation is for treatment of patients with acute or subacute low back pain. This means that the patient has been experiencing low back pain for less than twelve weeks. The ACP strongly recommends the following treatment:

 

• superficial heat
• massage
• acupuncture
• spinal manipulation (That’s chiropractic, folks.)

 

I will comment that you can seek out of a combination of these forms of care, depending on the time available to you.

 

The second recommendation pertains to patients who have chronic low back pain. This means the low back pain has been ongoing for twelve or more weeks. The ACP strongly recommends the following:

 

• exercise
• multidisciplinary rehabilitation
• acupuncture
• mindfulness-based stress reduction (I wrote a series on this.)
• tai chi
• yoga
• motor control exercise
• progressive relaxation
• electromyography biofeedback
• low-level laser therapy
• operant therapy
• cognitive behavioral therapy
• spinal manipulation (chiropractic, again)

 

I will not summarize ACP’s third recommendation because it is pharmacological in nature. As a chiropractor, I do not comment on the materia medica. I will, however, note that the ACP only weakly recommends this third, pharmacological recommendation. I think this gives quite a bit of credence to their first two, non-pharmacological recommendations. In particular, I’m honored that the organization doubly recommended chiropractic for treatment of low back pain.

 

I’d love to hear your thoughts. How would you have summarized ACP’s recommendations? Let me know in the comments, or at your next appointment.

Folks, I have a confession.

 

I’ve come to the realization that I spend more time behind a computer (typing up notes, blogging, reading up on the latest chiropractic literature, etc.) than I do delivering chiropractic adjustments. Of course, the chiropractic adjustment is quite time-efficient (in fact, its mechanism requires speed). In addition, behind-the-scenes work in front of a computer screen is necessary for operating a business in this age. So, how do we mitigate screen time’s negative effects on our health?

 

First of all, why is staring at a screen for long periods a big deal? It’s because of blue light, which is elucidated in this Harvard Health article. Blue light has the following actions:

 

• Increase attention
• Increase reaction time
• Improve mood

 

These seem quite beneficial, during waking hours, that is. Imagine that it’s time to wind down for sleep. These benefits may become counterproductive, or even detrimental, when the goal is rest. Light, especially blue light, suppresses melatonin secretion, the hormone responsible to sleep-wake cycles. Without it, our ability to regulate these cycles is impaired. While there’s research that suggests that blue light may have more ominous effects on long-term health, I choose to focus on its known effects on our activities of daily living.

 

I will summarize Harvard’s suggestions for combatting negative effects of blue light.

 

• If you must use night lights, use ones that emit red light.
• Avoid screen time two to three hours before sleep. (My commentary: I use Night Shift on my Apple devices, if I have to continue using my electronics.)
• Shift workers can use blue light-blocking glasses. (My commentary: Energy-efficient lighting has more blue light than the fluorescent bulbs of old. Ask your employer if more energy-efficient lights can be installed to aid alertness while you’re on shift, and wear blue light-blocking glasses after shift.)
• Seek out light when appropriate, i.e. when you’re awake, whenever that may be.

 

Do you think you’ll be able to implement any of these suggestions? Why or why not? Do you have any insights of your own? Let me know in the comments or at your next appointment.

 

P.S. Curious for more information about blue light or sleep in general? Head over to Tuck Sleep, for more insights on sleep health.

I wrote in the margin of my clinical pathology notes, next to discussion on fat metabolism disorders: resveratrol, 1 glass of red wine per day for women, 2 glasses per day for men. I remember it clearly, my professor remarking that it’s a shame the concentration of resveratrol is not as high in her preferred form of alcohol (tequila) and that it’s patently unfair that men are allowed more glasses of wine per day. There was a healthy dose of laughter in the auditorium after her comments, as she shifted the discussion to further dietary recommendations and lifestyle modifications for high cholesterol and high triglycerides.

 

So, when my father, an immunologist, told me about new research that alcohol confers no benefit to health, I was very surprised. (This article is published by The Lancet, that also published the studies recommending spinal manipulative therapy as a viable and preferred treatment option for low back pain.) Time published an article summarizing the study’s findings, and other experts’ commentary on those results. TL;DR? Worry not, because I will break this debate down for you.

 

Pro-moderate drinking

1. Moderate drinking offers some cardiovascular benefit, especially for women.
2. Copious data still exist that concludes that moderate drinking correlates with decreased total mortality and decreased risk of cardiovascular disease.
3. While tuberculosis may be the leading alcohol-related disease worldwide, it is very rare in the United States. Because The Lancet article researched worldwide morbidity and mortality resulting from alcohol consumption, its results may not be completely applicable to the United States.

 

Anti-moderate drinking

1. While a drink a day decreases risk for cardiovascular disease, it increases a women’s risk for breast cancer.
2. Consumption of one alcoholic drink per day afforded a 0.5% increase in risk of developing one of twenty-three alcohol-related health conditions in a year (not a huge increase).
3. Consumption of two alcoholic drinks per day afforded a 7% increase in risk of developing one of twenty-three alcohol-related health conditions in a year (uh oh).
4. Consumption of three alcoholic drinks per day afforded a 37% increase in risk of developing one of twenty-three alcohol-related health conditions in a year. (Note the exponential increase in risk, from adding just one drink.)
5. Alcohol was the seventh leading risk factor for premature death in 2016.

 

I have never recommended to a patient to start drinking in interest of cardiovascular health, and I never will. Indeed, as many experts quoted in the Time article state, the positive research on moderate drinking merely suggest that people who drink moderately may not incur adverse health effects. However, this last statement is called into question by The Lancet article. Is moderate drinking truly harmless? Or, should we steer the conversation towards other dietary recommendations and lifestyle modifications, as my professor did in clinical pathology class?

 

I’d love to hear your thoughts on this topic. Comment below, or we can discuss at your next appointment.