Science In Brief

Chiropractic Litterature Review

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In The News

- This one isn't exactly hot off the presses, but it's worth noting. Of course, we've known for a while that smoking is a definite risk factor for back pain and disc disease. A new study presented this March at the 2013 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), looked at low back/radicular leg pain in patients who actually quit smoking compared to those who didn't. The study covered 6779 subjects. Here's what they found. 

Overall, 8.9 percent of patients over age of 55 smoked compared with 23.9 percent of those age 55 and younger.

Twenty-five percent of patients over age 55 had quit smoking prior to the study, as had 26.1 percent of those younger than age 55.

Mean improvement in reported pain over the course of treatment was significantly different in non-smokers and current smokers in both age groups.

Current smokers in both age groups reported greater pain than those who had never smoked.

Those who quit smoking during the course of care reported greater pain improvement than those who continued to smoke.

As a group, those who continued smoking during treatment had no clinically significant improvement in reported pain, regardless of age.

Worth remembering if you are faced with a non responding case. Sometimes everything we do for the patient isn't sufficient to overcome what they are doing to themselves.

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In the News- Most of us are familiar with the potential benefits of using olive oil in the diet. Fresh olive oil, a natural source of beneficial polyphenols, appears to reduce risk of heart disease, metabolic syndrome, cancer, high blood pressure, blood clots and more. So what's the problem?

A recent article from Live Science.com cites sources from the USDA and UC Davis, indicating that the beneficial polyphenol compounds simply aren't present in most commercially available olive oils. And it's the polyphenols, not the oil itself, that confers health benefits.

Several factors appear to be responsible:

            Shelf Life- Poyphenols decline with age. Maximum shelf life is 2 years but that's   much too long.
            Harvest methods- Rough handling of fruit exposes polyphenols to the elements.
            Older Trees- Polyphenol content is significantly higher in fruit from older trees.
            Over Processing- "Extra virgin" oil is pressed only once and is best.
            Cooking and Storage Methods- Exposure to light, air, or any use of heat (including cooking) will reduce polyphenol content.
            Dilution of Olive Oils with Canola and other products.

Solutions?

  • Look for harvest dates (many bottlers only give "sell by" dates which are   typically 2 years after harvest). Try to use within a few months of harvest.
  • US growers are now producing high quality oils which may be fresher than European products.
  • Use only oils in dark or opaque bottles to prevent light damage. Store oils in a cool dark place at home. 
  • Avoid cooking with high heat...instead drizzle oils on salads etc for maximum benefit. 
  • Learn how good quality oil tastes and smells. Many describe the smell as "fruity" or like green olives. The taste of good quality oils is commonly described as "peppery".

The USDA may eventually require assays of oil quality and content to be printed on the bottle. For now, maybe the above steps will be helpful in advising your patients.

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In the News- Just ran across this interesting article from the Journal of Arthritis Care Research. A full review will follow shortly. Researchers at Wake Forest Baptist Medical Center studied the effect of moderate physical activity (defined as easy jogging or brisk walking) on fibromyalgia (FM) patients. They followed 170 subjects over 36 weeks. Participants who exercised, even if they didn\'t participate in physical activity for the full 36 weeks of the study, showed significant improvement in pain, exhaustion and other outcome measures.

Even more importantly, increased physical activity was NOT associated with any worsening of pain. This is significant because so many FM patients tend to avoid physical exercise for fear it will increase their symptoms. This study shows that isn\'t the case. Patients who exercise feel better...not worse!

Editor’s Comments: Get your patients moving. They don\'t need a gym membership... just a pair of shoes.

Editor: Mark R Payne DC

Link to Abstract: http://www.ncbi.nlm.nih.gov/pubmed/23401486

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In the News-

If you treat young athletes in your practice, you'll be interested in the results of a new study of young baseball athletes. The study, sponsored by the American Orthopedic Society for Sports Medicine, followed 750 young pitchers ( ages 9-18) for three years. His conclusion? Despite the introduction of pitching limits in youth baseball, young pitchers are now being injured in ever increasing numbers. And the culprit, doesn't appear to be the coaches or the leagues, instead blame seems to lie with the parents and the young athletes themselves.

The study concludes that a significant number of young pitchers routinely exceed the safe pitching limits in a several ways. Approximately 40 percent play in leagues which don't monitor pitch counts/limits. More than half pitched on consecutive days. Nearly one in five will pitch multiple games on a single day, and up to a third will pitch for more than one team. Finally, as many as 13 percent of these young hurlers are pitching more than eight months out of the year. (Young athletes who pitch 8 months or more annually are five times as likely to require surgery.) Taken together, the hypercompetitive environment, is driving many young athletes toward injury.

The author suggest a simple series of "Rules of Ones" to avoid overuse injury. One game per day. One day of rest after any pitching. One position only during any pitched game. One Team at a time. One season of some other organized sport. And finally, One week off for any complaint of arm soreness or fatigue.

To which I will add one more. There's only One person responsible for keeping the young pitcher healthy....The Parent.

To the best of my knowledge the study hasn't been officially published yet, at least I am not able to find it. However, you can find the full text by searching here.

The full text document should come up at the top of your search list.

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In the News-  May 2013  The Journal of Alzheimers Disease reported in a recent issue that cinnamon may play an important role in preventing Alzheimer's Disease (AD). Two compounds found in cinnamon, cinnanaldehyde and epicatechin, have been found to prevent the development of, and possibly even promote the dissociation of,  neurofibrillary tangles (Tau) in the brain. Tangles of the filamentous tau fibers are considered the hallmark finding of AD. 

It is believed that both cinnamaldehyde and epicatechin protect tau fibers from oxidative damage and resultant abnormalities of structure and function.

Editor’s Comments: Alzheimer’s disease is the 6th leading cause of death in the U.S, affecting 1 out of 8 seniors. Annual costs of AD exceed $200 Billion. In my case, it’s really personal. As the parent of a Down’s Syndrome child, virtually 100 percent of which will develop AD by their early fifties, any beacon of hope is received with gratitude. This looks promising, but it’s very early. As always, more research is needed.

Editor: Mark R Payne DC

Link to Abstract: http://www.ncbi.nlm.nih.gov/pubmed/23531502

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