Spinal Injections Can be Back Breaking

Spinal injections have been shown to increase your risk of spinal fracture.

Did you know that recent research says that treatments like spinal injections can dramatically increase your risk of a cracked, or broken back? The scary part is over 9 million of these injections are given every year for spinal pain! New research has shown a 21% increased risk of a spinal fracture after every epidural steroid injection.

Lumbar epidural steroid injections are frequently given by pain management doctors for the treatment of radiculopathy or neurogenic claudication arising from compression of spinal nerves. However, there is evidence suggesting that corticosteroids can negative affect bone strength by diminishing new bone formation and increasing bone resorption.

The findings suggest that steroid injections can lead to increased bone fragility. The added exposure to glucocorticoids resulting from these injections may carry a greater risk than the medical industry previously thought.

“Of greater concern, the definable fracture risk as documented by Mandel et al. should be set against the best available evidence regarding the long-term efficacy of these interventions, which is admittedly less than robust.” - Andrew J Schoenfeld, MD

Why it Matters:

As you can imagine, spinal fractures hurt. They require further medical treatment and sometimes even result in surgery. By staying conservative with your healthcare, you can reduce your risks and get the relief you desire. Research shows spinal adjustments as one of the best forms of care to reduce your pain, increase your function and improve your overall quality of life.

Chiropractors are focused on correcting the cause of your pain. Problems with your spine can put pressure on your discs and nerves causing irritation, swelling, and a lack of spinal motion. A shot does not correct the cause of the pain, at best it only temporarily masks it. With the risks of spinal fractures, the smart decision is to get well and stay well using conservative, natural healthcare.

▪ Research has shown a 21% increased risk of spinal fractures after injections

▪ A fracture, or broken back, can cause tremendous pain and even result in surgery

▪ Natural healthcare, such as chiropractic, is recommended before moving on to riskier treatments such as spinal injections

Next Steps:

Share the science. Being well informed comes with the responsibility of sharing what you know with others who don’t. That doesn’t mean you should argue with those who are already convinced by their prejudices. It says that we encourage you to share what you know with others who are curious and can benefit from understanding the Research That Matters.

Science Source:

Spinal Manipulation Postepidural Injection for Lumbar and Cervical Radiculopathy: A Retrospective Case Series. Journal of Manipulative and Physiological Therapeutics. September 2004

Symptomatic MRI-Confirmed Lumbar Disk Herniation Patients: A Comparative Effectiveness Prospective Observational Study of 2 Age- and Sex-Matched Cohorts Treated with Either High-Velocity, Low Amplitude Spinal Manipulative Therapy or Imaging-Guided Lumbar Nerve Root Injections. Journal of Manipulative and Physiological Therapeutics. May 2013

A Retrospective Analysis of Vertebral Body Fractures Following Epidural Steroid Injections. The Journal of Bone & Joint Surgery. June 2013

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Real Results from Members of The Evidence Based Chiropractor…

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What is Foam Rolling and why does it hurt so good?

Chiropractic, foam rolling, and your body.

Foam rolling has exploded in popularity over the past few years. No longer used only by athletes and trainers, foam rolling (or myofascial release) is now used by people with all levels of fitness. The goal of foam rolling is to improve muscle function, performance, and range of motion. When a tight muscle or trigger point is released, you are able to move freely, with less pain, and improve your overall performance.

Why it Matters:

Activity, age, and injuries can cause your muscles to lose flexibility which in turn creates adhesions and pain. Foam rolling allows you to place deep compression on these areas reducing pain and adhesions while creating an improved joint range of motion. Using a foam roller during your warm-up routine may provide additional benefits beyond stretching alone. New research has discovered that foam rolling can improve flexibility more than static and dynamic stretching.

- Foam rolling is designed to release tight muscles and trigger points

- Researchers have found increased flexibility and reduced pain after foam rolling

- Proper movement patterns are thought to improve performance and reduce injury

Next Steps:

Using a foam roller on tight muscles and trigger points has been shown improve flexibility and help maintain proper movements patterns. If you have questions on whether foam rolling is right for you, just ask! We believe this type of at-home care is a great way to support the adjustments and care you receive in our office.

Science Source:

Acute Effects of Foam Rolling, Static Stretching, and Dynamic Stretching During Warm-ups on Muscular Flexibility and Strength in Young Adults. Journal of Sports Rehabilitation 2017

Differences in pressure pain threshold among men and women after foam rolling. Journal of Bodywork and Movement Therapies 2017

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How to Reduce Crossfit Injuries

If you’re into Crossfit, you know how addictive it can become. That mix of high-intensity interval training and competition can help drive your motivation and commitment and lead you to achieve amazing changes to your body. That consistency becomes the key to your success - to getting the results you're after, but what do you do when you're injured?

Preventing Crossfit Injuries 

Injuries often occur when your body doesn’t have the correct balance of strength and flexibility. Muscles tears, sprain and strains, and even painful arthritic changes can flare up for a number of reasons, such as attempting to lift too much weight at once or not having enough flexibility to support that weight through a full range of motion. How can you reduce your likelihood of injury? Researchers have discovered that a combination of proper warm up/cool down, a full range of motion and progressive intensity training can help reduce injuries when strength training.  

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• Take a few minutes to stretch before and after your workout.

• Increase the weight you lift slowly and focus on quality reps vs. max weight.

• Use good posture and ergonomics during your workouts - don’t “cheat” and increase your risk of injury.

 

One of the most effective ways to improve your spinal mobility and flexibility is through Chiropractic care. Adjustments to your spine and extremities have been shown to increase their range of motion and may help you find that perfect balance of strength and flexibility.

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Short-term effect of spinal manipulation on pain perception, spinal mobility, and full height recovery in male subjects with degenerative disk disease: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation 2014. Progressive resistance strength training and the related injuries in older adults: the susceptibility of the shoulder. Aging Clinical and Experimental Research 2014.

The Most Overlooked Source of Back Pain: Fatty Infiltration of the Multifidus

Your back hurts, and no one can figure out why. It can be incredibly frustrating when you've had x-rays, MRI's and more doctors visits than you care to remember.

Well, there is a very common source of back pain that is often overlooked. It's impossible to see on X-rays and often overlooked on MRI.

What is the most overlooked source of back pain?

Fatty infiltration of the multifidus. If you have a patient that has an MRI, first of all, take a look at those pictures. Don't just look at the report. Furthermore, take a good look at those axial slices when you go down to L4-L5-S1. You will see the multifidus in what I call it the channels or gutters directly posterior to the lamina. The multifidus there should look like a beautiful marble sized steak and then on the outside should be superficial fat, which is white. If you cannot tell the difference between what is the fat and what is the muscle tissue- then you have fatty infiltration of the multifidus.

This is very important because very few docs are talking to their patients about that right now. But if there is deconditioning and fatty infiltration of the musculature, it is going to result in needed more than one or two adjustments to get where they want to be. They are genuinely deconditioned, so it helps you set better expectations for your patients.

The pain occurs in this area because essentially they are unstable. Normal movement patterns will place a tremendous amount of stress and strain on the facets, discs, and all other supporting structures when the muscles are deconditioned. Those other structures aren't designed to handle the extra load and will often fail- thus resulting in pain.

This is also relevant information to know if that patient is exploring a surgical intervention such as a laminectomy or decompression. How well do you think that's going to hold together? Probably not very well.

One more questions, do you think spinal injections are miraculously going to take care of 50 years of degenerative change? I don't think so!

So, I would encourage you to be different, be better. A lot of physicians are not looking at those axial pictures, and if you are, you probably haven't checked out the integrity of the multifidus lately. I would encourage you to do so for next patient that comes in that has an MRI. Look at those actual pictures. Take a look at multifidus and see what you think about the integrity of the muscle and set a better expectation for the recovery of your patient. Your practice is where they should be if they have this challenge. Establishing proper motion with adjustments, gapping the facets, getting movement into the disc and improving the multifidus through exercise and rehab is typically a great start to a successful plan of care.

Looking for Neck and Back Pain Relief? Try adding Chiropractic!

If you visited a medical doctor for low back pain, you definitely want to consider adding chiropractic.

In 2012, Spine Journal released a research study where they found 73 percent of people who added chiropractic care to medical care had their pain much better or even completely gone. If you had medical care alone, you only had a 17 percent chance to get those same results.

Chiropractors are trained to work on your muscles (soft tissue), your spinal alignment and range of motion motion to help reduce pressure on the nerves that exit your spine. Also, chiropractic adjustments have been shown to decrease pain by stimulating your central nervous system and brain, without having to resort to taking dangerous drugs.

So if you're struggling with back pain and maybe you've gone to a medical doctor definitely consider adding chiropractic care. It is going to drastically increase the likelihood that you get the results you desire.