June 2012 issue Health & Wellness

• Blood Pressure Normalized in Study Group with Chiropractic
• Health Care Increasingly Out of Reach for Millions of Americans
• Infant with Colic and Reflux Improved Following Chiropractic - A Case Study
• Chiropractic Care for the Elderly Studied
• Controversy Over Chiropractic Findings in Medical Journal
• Sitting is Bad for Your Health Say Australian Chiropractors

Blood Pressure Normalized in Study Group with Chiropractic

The Journal of Upper Cervical Chiropractic Research published a study on April 24, 2012 documenting the positive effects chiropractic care has on normalizing blood pressure. This study was unique in that it looked at the effect of chiropractic on a full range of blood pressure situations and not just on the effect chiropractic has on high blood pressure.

Several previous studies have documented that chiropractic care has the effect of lowering blood pressure significantly on test subjects. The author of this study reviewed the prior studies noting that each of them showed significant improvement in patients with hypertension. One such study was done at the Hypertension Center at the University of Chicago Medical Center and published in the March 2, 2007 issue of the Journal of Human Hypertension. The study's leader, George Bakris, MD, commented, "This procedure (chiropractic) has the effect of not one, but two blood-pressure medications given in combination. And it seems to be adverse-event free. We saw no side effects and no problems."

This study looked at 42 individuals with a variety of blood pressure readings in order to compare the impact chiropractic care had on the group as a whole. In this group, there were 12 subjects with a lower blood pressure than normal, considered "hypotensive", 12 people with blood pressure in a normal range called "normotensives", 10 with slightly high blood pressure reading considered, "pre-hypertensive," and 8 who had blood pressure readings high enough to clearly fall into the categories of being stage 1 or stage 2 hypertensive.

Specific chiropractic care for correction of subluxation at the "Atlas" (top bone in the neck) was given to the group. This study reviewed data from three groups consisting of Group 1- hypotensives, Group 2- normotensives and Group 3- hypertensive, which combined the pre-hypertensive with the stage one and stage two hypertensive group.

The results for the hypotensive group with lower blood pressure showed that their average blood pressure increased to within a normal range. The study recorded that the average pre-chiropractic systolic pressure was 84.33 mmHg compared to the average post-chiropractic systolic pressure which was 98.17 mmHg. Similar improvements were seen in the diastolic pressures going from 64.83 mmHg to 73.67 mmHg after chiropractic care was initiated.

The group with normal blood pressure reading showed a slight decrease in both their systolic and diastolic reading after chiropractic care.

The biggest changes were in the groups of hypertensive and pre-hypertensive people where the systolic pressure group average was 152.61 mmHg before chiropractic, and the average after the introduction of chiropractic care fell to 132.39 mmHg. The diastolic values for this group for pre and post chiropractic care also showed improvement going from 83.83 mmHg to 77.00 mmHg.

In his conclusion, the author wrote, "These findings suggest realignment of the atlas does not simply lower ABP (arterial blood pressure) but may also be part of a systemic homeostatic mechanism not yet completely understood. The same adjustment that decreased hypertensive ABP measurements also increased hypotensive ABP measurements to more normal levels."

Health Care Increasingly Out of Reach for Millions of Americans

The above headline comes from the Atlanta Journal Constitution (AJC) on May 8, 2012 in an article by Phil Galewitz. The article starts off by noting, "Tens of millions of adults under 65 - both those with insurance and those without - saw their access to health care dramatically worsen over the past decade." This article, and several others on the same subject were based on a study published in the May, 2012 edition of Health Affairs by the Robert Woods Johnson Foundation.

On the Robert Woods Foundation website, the study authors begin by noting, "This paper’s analysis of national survey estimates found that access to health care and use of health services for adults ages 19–64, the primary targets of the Affordable Care Act, deteriorated between 2000 and 2010, particularly among those who were uninsured. More than half of uninsured U.S. adults did not see a doctor in 2010, and only slightly more than a quarter of these adults were seen by a dentist."

According to the study and the AJC article, people are making many of their health decisions based on their ability to afford the care themselves. In a May 8, 2012 article in the Orange County Register, Genevieve M. Kenney, the study’s lead author, was quoted from a prepared statement as saying, "Our study shows that access to care deteriorated for adults in virtually every state in the country, and that the uninsured experience substantially worse access to care relative to the insured in all states. This indicates that the health care safety net is not acting as an effective substitute for health insurance coverage when it comes to providing basic health care to the uninsured."

The AJC article also reports that even those with insurance are feeling the pinch as more of the cost of private insurance is falling to the employee in the form of higher deductibles and co-payments. This increased cost is affecting the decisions that people make about seeking care. In the state of Maine, it was estimated that 109,000 people went without needed care in 2012 because of costs, while in a larger state such as Pennsylvania, the number is estimated to be at 1.1 million. In California, the number was estimated to be much higher with approximately 20 percent of adults having a health care need unmet due to costs.

Dr Gary Walsemann, president of the International Chiropractors Association, offered a possible solution to the issue by pointing out that chiropractic has been an exception to the crisis of affordable access to health care. He commented, “One of the problems with health care as it is currently being delivered is that it is a monopoly for one system of care. Almost all funding, both governmental and private, goes to support only one approach to health care. This lack of an even playing field for choice in healthcare has led to a significant cost increase in medical care, thus alienating many people from being able to afford it. Chiropractic, which works with the body's innate healing abilities, has been proven to be an effective and affordable choice. The scientific effectiveness and safety record of chiropractic speaks for itself. In many cases, even people without insurance find chiropractic well within their reach as a viable source of healthcare and wellness promotion. This example of successful cost savings, effective results and outstanding safety record should serve as an example for those discussing the future of healthcare management in both the private and public sectors.”

Infant with Colic and Reflux Improved Following Chiropractic - A Case Study

Published in the April 16, 2012 issue of the Journal of Pediatric, Maternal & Family Health is a case study documenting the improvement of colic and acid reflux in an infant who was previously not responding to medical care.

Quoting other authorities, the authors of the study offer the definition of colic as "crying and or fussing for more than three hours a day, on three or more days per week, for three weeks or more in infants less than three months of age." They also report that feeding and sleeping problems often accompany infants suffering from colic. It is estimated that colic affects between 10 to 40 percent of the infant population.

The study authors also report that according to the North American Society for Pediatric Gastroenterology and Nutrition Guidelines, gastroesophageal reflux is defined as, "...the passive passage of gastric contents in the esophagus without any implication to its etiology. The most frequent manifestation seen in infants is regurgitation or vomiting."

In this study a one-month-old male infant with reflux and colic was brought to a chiropractor for a consultation. He had been previously diagnosed with colic and reflux by his primary care physician. The infant had suffered with reflux since birth which would cause him to scream and cry after every feeding. It was noted that the infant was vomiting 12 to 18 times per day. As a result, the infant was not sleeping well. The medical doctor prescribed Zantac twice a day which had no noticeable effect on the infant boy's problems.

A chiropractic examination was performed resulting in the diagnosis of multiple vertebral subluxation being present. A subluxation is when one or more of the bones of the spine (vertebrae) move out of position and create pressure on, or irritate spinal nerves. This pressure or irritation on the nerves causes those nerves to malfunction and interfere with the signals traveling over those nerves resulting in an alteration of body function.

Chiropractic care was initiated using specific forms of chiropractic adjustments to correct the infant's vertebral subluxations. The results of this study documented that by the third visit, the volatility of the vomiting had decreased. Additionally, it was reported that the screaming and crying fits had decreased and the infant boy was able to sleep for longer periods of time. By the third week, he was eating more per feeding. By the end of the third week, the boy was vomiting only three times per day, had eliminated the colic crying symptoms, and was sleeping for six and a half hours at a time.

Chiropractic Care for the Elderly Studied

A study published on March 5, 2012 in the Journal of Manipulative and Physiological Therapeutics looked at several factors concerning how Medicare recipients received chiropractic care. Since the study is specifically based upon Medicare claims, the results are affected by how Medicare covers chiropractic.

Medicare, in the United States, covers chiropractic care specifically for the correction of vertebral subluxations. According to the Medicare.gov website, “Medicare covers manipulation of the spine if medically necessary to correct a subluxation (when one or more of the bones of your spine moves out of position) when provided by chiropractors or other qualified providers. A subluxation is a displacement or misalignment of a joint or body part.”

One of the things the study was trying to determine was if Medicare patients under chiropractic care were also receiving non-chiropractic care for the same problems while they were receiving chiropractic. The significance of this would show if chiropractic was effective, and would also show if there was a cost savings because patients did not need two types of care at the same time for the same condition.

The results of the study showed that, in the Medicare system, the most common diagnosis listed for the need for chiropractic care was one of two codes used to describe subluxation. The associated problems that were shown by code to be most prevalent were back pain, neck pain, and degenerative disc problems.

The study did show that 89.1 percent of the people who went to a chiropractor for a specific problem under Medicare only saw a chiropractor for this condition. In other words, only slightly over 10 percent also went to an MD or other health practitioner for the same problem they were going to the chiropractor for. The researchers state that this indicates that most chiropractic care is not rendered in conjunction with medical care. They stated, “This suggests that there is likely very little referral to chiropractic from other nonchiropractic providers and vice versa, indicating that co-management simply does not occur.”

Dr. Coralee Van Egmond, special projects director for the International Chiropractors Association, summed up these interesting findings by saying, “Chiropractic is demonstrated by this research as being highly clinically effective for this growing patient population. Chiropractic has a special significance for the aging population because it aides significantly in maintaining mobility, and mobility is life for our elderly patients, and serves to help maintain clarity of mind since chiropractic is a drugless science. The research record continues to show chiropractic’s unique cost-effective contribution to the health and well-being of all ages.”

Controversy Over Chiropractic Findings in Medical Journal

In the May 1, 2012 issue of the Annuls of Internal Medicine from the American College of Physicians is a letter from researchers defending their work against criticism from medical doctors and other researchers who are not happy with the results of the original study. The original study, published in the same journal on January 3, 2012, showed that patients suffering from acute neck pain did better with chiropractic adjustments and showed a statistically significant advantage over medication after 8, 12, 26, and 52 week follow ups.

The authors of the original study responded in the journal by saying, “Our study was a pragmatic trial designed to assess the comparative effectiveness of three commonly used management options for neck pain. The design was chosen to represent as closely as possible what happens in the real-world clinical setting in which treatment is tailored to individual patients.”

Some of the letters criticizing the positive chiropractic study tried to question the safety of chiropractic, to which the authors responded, “We disagree with Mr. Chapman about the documented risk for significant adverse outcomes related to cervical spine manipulation. The best available evidence about the relationship between spinal manipulation and vertebral artery dissection comes from several large case–control studies. These studies show that, although there is an association between visits to chiropractors and the subsequent development of vertebral vascular stroke, this type of stroke is extremely rare. Of importance, the risk is no greater than if patients seek care from their family medical physicians, who are very unlikely to apply spinal manipulation.”

Dr. Robert Braile, a chiropractor for over 30 years and past president of the International Chiropractors Association and current president of the Georgia Council of Chiropractic responded by adding, “It is interesting to note that there are still some pockets of medical prejudice against a science and practice that have clearly stood the test of time both scientifically and clinically with millions of patients.” Dr. Braile continued, “The bottom line has to be the welfare of the patients, and research such as this, plus many other studies shows the benefits of chiropractic over medications for people suffering from many health issues.”

Sitting is Bad for Your Health Say Australian Chiropractors

Above is the headline of an article that appeared on the Australian health website “nzDoctor.co.nz” on May 9, 2012. The article is a release by the Australian Chiropractic Association that warns against sitting for long lengths of time.

The article notes that, “Increased computer use at work and home means that over half of your day is spent sitting and that our sitting habits can have significant impact on our overall health.” With this in mind, the New Zealand Chiropractors' Association (NZCA) has joined forces with the Chiropractors Association of Australia (CAA) to promote the “Sit Right” campaign for the month of May.

“We know that the body will adapt to cater to what you do most often, so as your body adapts to constant sitting it makes you less skilled at basic functions like standing, walking, running and jumping,” stated Dr. Hayden Thomas, chiropractor and spokesperson for the New Zealand Chiropractors Association. Dr. Hayden continues, “Sitting all day can result in muscle stiffness, poor balance and mobility, as well as pain in your lower back, neck and hip. Research has shown that excessive sitting can be lethal. The aim of this campaign initiated by our colleagues in Australia is to highlight the problems associated with bad posture. Many people don't realize that when you sit for extended periods in the wrong position this posture can stay with you even when you stand or walk around”

To help people participate with this campaign, the Chiropractors' Association of Australia has developed a Sit Right Widget as a simple tool to prompt computer users to take a break if they have been sitting on the computer for a while. The widget, when installed on a computer, reminds the user to get up and take a break at regular intervals. The default setting is to prompt for a break every hour, although users can change these settings to 20 or 40 minute intervals.

The Sit Right widget is available online at: http://whatsyourposture.com.au/sit-right/about-the-sit-right-widget/.