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 October
2005
Your cars
heater can heat one side of the neck more than the other because
air from the vents towards the windows are cooled against
the outside glass while those in the middle of the car are not. This
can cause the side of your neck closer to the outside glass (for the
driver this would be the left side) to be colder than the side towards
the center of the car. This can cause the neck muscles on the cold side
to be tightened more than the warm side, again causing subluxation,
spasm & pain. So keep the scarf on and the collar up while driving
also. A major study recently published in the Journal of Occupational and Environmental Medicine (2004;46:847-855) was the result of 4 years of research. The authors examined 1.4 million records of patients in California who had used the services of a managed care network of health insurance. All the cases studied were identified as having neuromusculoskeletal (NMS) complaints, which is the bailey wick of chiropractic. Of this large group, 175,000 were chiropractic patients, 332,000 were medical patients who also had insurance coverage for chiropractic care, and 888,000 were medical patients who had no chiropractic coverage. What the researcher discovered is quite interesting. They said that their findings indicated that "patients use chiropractic care as a direct substitute for medical care." They went on to elaborate that "the addition of a chiropractic benefit would be that it is the equivalent of expanding the network of available providers for care of NMS conditions. Patients with back pain, neck pain, and related complaints can choose either chiropractic care or medical care, and this expanded choice does not seem to result in more patients seeking care." In other words, giving people a choice does not cost more, and of those who had the choice, nearly? chose chiropractic care for their aches and pains. The study is very clear that including chiropractic care as an insured benefit does not increase the overall rates of complaints, nor does it cause a duplication of services. "Patients appear to be directly substituting chiropractic care for medical care," the authors wrote. This is where we begin to run afoul to medicine. MD’s really don’t like to lose people to us, even if we can do a better job, safer and quicker than they can. It all comes down to dollars and cents. There’s not a lot of altruism here. But the people who pay the bills will ultimately have the say. A few more studies like this one and perhaps more people will have better and freer choices as to where to take their physical troubles.
These experiences can be frightening, and people do not soon forget just how much pain they suffered during this time or just how paralyzed and afraid they were. Unfortunately, this fear frequently leads to a delay in recovery. Not only does the fear delay recovery but quite often poor advice from a well-meaning but ill-informed physician can cause a protracted and unsatisfying recovery as well. Patients often spend too many days in bed and take too much time off work. They develop an attitude that their back is somehow made of glass and that the slightest wrong move will cause a setback. Physicians tell these people to avoid lifting and sports, and even encourage sometimes unrealistic things like changing occupations and stopping activities that have nothing to do with low back rehabilitation. The experience with pain combined with some frightening expert advice often instills groundless fears that hamper proper recovery. The big problem with bouts of back pain is the all-too-common progression into states of chronic or recurrent pain. Recurrency occurs when a person experiences numerous acute episodes, whereas the term chronic implies long term, low grade pain and disability. In order to discover just how important activity is to getting over back pain, researchers in Seattle set out find a large group of people who had been in pain for eight to ten weeks and who had significantly reduced their activities as a result. They randomly assigned the 240 patients they found who fit these criteria into two groups, one for increased activity and one who would just keep doing what their doctors told them, so-called "usual care." The activity group had a 90 minute psychology session in which they discussed back pain related fears, the benefits of getting their former lives back in terms of sport, recreation and activity, and how to set treatment goals. This group then had a couple of sessions with physiotherapists who taught stretching, work hardening and other appropriate exercises. Finally this group had another short psychotherapy session to deal with recurrences and the pains of healing and getting moving again. These people were quite typical of lower back pain sufferers; 60% were female and all were middle-aged. As a group, they all had reported moderate to severe reductions in normal activity because of back pain. The results compiled at the end of one year and two years were significant. Please remember that these people had no real treatment--just increased levels of appropriate activity. The activity group experienced a 33% improvement in disability scores, but only a modest advantage in their pain levels. The basic lesson here is that fear of activity often causes prolonged recovery and increases the chance of simple back pain becoming chronic and long term. This notion of less rest and more activity has been around awhile, but sadly most treating medical practitioners are not getting the message. Research has shown that bed rest beyond three days usually makes the problem worse. Not so long ago, it was common to find a person with acute back pain taking to their bed for six weeks, and sometimes on a striker board to boot. These unfortunate souls, while receiving what was considered to be the convention treatment of the day, were never the same again. It is false notions such as these that so frustrates not only active therapists like chiropractors, but also insurance companies and workers’ compensation boards. The cost of chronic care and its resultant disability skyrockets when compared to active and appropriate acute care. So if you
have back pain, don’t be afraid of it. Get up and get moving!
References
for this article are as follows:
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Be Careful When You are 1/3 Naked!