Main Street Chiropractic

Hi I'm Dr. Carl Zaycosky, and this is my way of sharing the resources, insight, and experience I've gained in my years as a chiropractor. I hope they help you chart a course toward whole body health.

Back Pain Guidelines Part 3

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One point of contention I have with the guidelines are the recommendations as to when to employ exercises for someone experiencing acute low back pain. Exercise is recommended as a treatment approach for chronic (lasting more than 12 weeks) pain. I don’t dispute that exercise alone may not have measurable benefit in the acute, early stage of injury; it has proven benefit when used in conjunction with spinal manipulation. There is a study which indicates spinal manipulation has better outcomes when used with exercise when compared with spinal manipulation as the sole treatment method.

I want to add my own opinion at this juncture. It’s important to remember each person’s back pain is a little different than someone else’s. Meaning what may not work for one individual may work for another. I often think what a savings our national healthcare budget would have if each person could be directed initially to the back pain treatment approach that would be the most effective for them. Since that isn’t possible. Recommendations from a reputable source (The American College of Physicians) that have made an extensive review of the medical literature is the best alternative currently available. This approach is called best practice methods and is a model that is being implemented throughout healthcare.

 

You local chiropractor,

Dr. Z.

Carl Zaycosky, DC
Main Street Chiropractic

For part 2: click here

For part 1: click here

 

 

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Back Pain Guidelines Part 2

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The American Academy of Physicians came up with these guidelines by reviewing over 150 studies covering the treatment of low back pain (LBP). To me the most surprising finding wasn’t what worked but what didn’t. The research does not show any benefit in using non-steroidal anti-inflammatory drugs (NSAIDS) in the treatment of LBP lasting less than 12 weeks. This time frame is considered by most to be the acute stage of an injury. NSAIDS are medicines like aspirin, Motrin, Advil and Aleve. You can also add acetaminophen (Tylenol) to this list of unhelpful approaches in treating acute LBP even though Tylenol is not an NSAID.
The first line in the treatment of LBP is spinal manipulation, CHIROPRACTIC CARE (emphasis added). Also in this group of first line choices are massage, acupuncture and heat. Though be careful of heat application in the first days of a back injury. I’ve blogged in the past about the wonders of ice therapy and still hold that opinion. http://drzmainstchiro.com/dr-carl-zaycoskys-blog/entry/ice-vs-heat-how-to-properly-care-for-your-injury-part-1-inflammation-and-congestion-1.html
The study points out that there is a circumstance where NSAIDS use has proven to be reasonable. That is when the above mentioned treatment options don’t work. This is clear . Given the potential side effects and the minimal benefit in helping low back pain NSAIDS are not the first choice.
Low back pain is a common aliment and only a few years ago these recommendations may have seemed outrageous; not that people weren’t using chiropractic care for treatment of their back pain. But discouraging the use of medication as a first step in treatment is a big change in the American Academy of Phycisians guidelines.


There is still more to this so stay tuned.
Dr. Z.
Main Street Chiropractic

Back Pain Guidlines Part 1: click here

Back Pain Guidlines Part 3: click here

 

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Back Pain Guidelines Part 1

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“times they is a changin’” specifically in how back pain is treated by health professionals. The word came out earlier this year with the release of updated guidelines from The American Academy of Physicians regarding treatment of back pain. I’m going to cover these recommendations in the next few blogs, but before I get to that, SPOILER ALERT: chiropractic treatment comes out smelling like a rose in these guidelines.
Healthcare is consistently changing as new approaches are discovered and found to be effective, subsequently being employed with patients. Likewise treatment approaches that seemed to be helpful are discarded once the science has proven them to be ineffective or not as effective as they were once thought to be.
The treatment of back pain is a prime example of how treatment approaches change over time. When I started practice the medical model of care at least for severe low back pain, was two weeks of bed rest. Keep in mind too this rest often times occurred in a hospital, “times they is a changin’” image under today’s health care norms of same day surgery and home based care, spending two weeks in a hospital to rest.
My point is not to ridicule past practices. I’m sure the healthcare providers then were using methods they thought best for their patients. Believe me I was employing methods of chiropractic practice in 1984 I wouldn’t dream of using today. And, I bet 50 years from now the providers will look back and shake their about what was being done to patients in the teens.
I’ll get to the specifics next time.

Your Local Chiropractor
Dr. Z.
Main Street Chiropractic

For part 2: click here

For part 3: click here

 

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The SI Joint: Part 1

I’m going to get a little technical on these next few blogs. But I think you’ll find this to be good stuff. I’m going to address a cause of low back pain that is at times overlooked by health care providers (including me). That is the sacroiliac joint commonly referred to as the SI joint.

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Here’s a brief anatomy lesson. Your pelvis is made up of three bones, starting at your side with the illium going to the center where the sacrum sits and another ilium on the far side. Or, as I tell people a hip bone, the tailbone and another hip bone. Where the tailbone meets the hip bone is called the sacroiliac joint. I find it curious that patients consistently refer to their SI joint as their hip joint. The hip joint is by definition the ball and socket type joint that the top of your leg fits into which lies at the lower part of the ilium.

The movement of the SI is important to understand in knowing why it can cause back pain. Slightly cup your hands. Place the palm of one hand on the back surface of the other cupped hand. Now glide the surface of your hands back and forth toward the wrists in a smooth movement over the top of each other. This is the type of efficient movement that takes place at your SI joint when everything is working correctly. When it’s not this can cause problems. More on that next time. 

Your local chiropractor,

Dr. Z

Main St. Chiropractic

For part 2, click here.

For part 3, click here.

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Ice vs. Heat: How to Properly Care for Your Injury Part 1

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Do I put ice or heat on it? This is definitely one of the top three questions I’ve gotten in my years of practice. Someone hurts their back lifting, say stacking fire wood, and though the body part and/or mechanism of injury may be different, the reaction is the same. They are aware that they should do something, but there is this ongoing cold/heat debate and, rightfully, confusion.  The following couple blogs will help you better understand the body’s response to injury and help clear up this debate.

It’s important to ask yourself: what is actually going on inside of me that cold or heat may or may not help? The body responds to a muscle injury by producing an inflammatory response. Inflammation is a term mentioned frequently in regards to health. The inflammation I’m discussing has to do with the reaction by the muscle to injury and the body’s automatic response to try to heal/correct itself. There is a well-studied process to how inflammation works in its response to a recent muscle injury. Basically, the body is responding by directing cells to the injured area that help in the healing process. One of the phases of this process is called congestion. Whether it’s traffic congestion on a crowded city street or an injured neck muscle, too much “stuff” is trying to get into an area that isn’t big enough. On the street if there isn’t some control of the vehicles there are obvious problems. The same for your muscles and the problem is called swelling.

We’ll talk about the control mechanism for your body’s congestion next time.

Your local Chiropractor,

Dr. Z

at Main St. Chiropractic

For part 2: click here

For part 3: click here

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