The Healthy Back

Shake, Rattle and OOOps, Don’t Roll!

Vibration, Bone Density and Strength in the Elderly

If you’re getting along in years and worried about your bones and falling and breaking something you may have looked into a number of things to help keep yourself healthy.  Researchers are interested in this too, because osteoporosis, and the resulting pain and fractures, especially of the hip joints causes a lot of suffering and costs the health system a lot of money.

One surefire way of promoting bone mass and decreasing the risk of falling is physical exercise.  The problem here is that exercise not performed properly can increase the risk of falling.  Because of this, researchers and other health practitioners have sought new ways to help seniors stay on their feet and stay active. One of the strategies that’s been investigated is whole body vibration. Something that’s available in many gyms are vibration platforms.

Whole body vibration is most often delivered to the body through a vibrating platform that a person stands on.  Exercise can be performed while on the platform.  The science behind this is based on the neurophysiological theory that exercising on the platform activates muscle spindles (sensory receptors in muscles), which in turn cause a reflexive muscle contraction.  In theory, this should cause an increase in muscle strength.

This idea also theorizes that this kind of exercise will promote bone growth.  We know that the tension that muscles exert on bones causes the bones to maintain or increase their strength.  At the same time, muscle strength is highly related to bone mineral density.

Let’s look at what a recent study says about exercising on a vibration platform before you get too excited about an easy way to prevent osteoporosis and falls.  The study I’m looking at is called The Effects of Whole Body Vibration Therapy on Bone Mineral Density and leg Muscle Strength in Older Adults; A Systemic Review and Meta-analysis, by Lau RWK, Lin Rong L & Yu F et al. published in clinical Rehabilitation 2011; 25(11):975-988.

When compared to sham vibration, whole body vibration has no significant effect on hip bone mineral density unless the person exercising is 86% or more compliant in doing their exercises.

In fact the study showed that vibration platform exercise generally was no better than active exercise (the usual kind) for increasing bone density.  Interestingly, where the vibration exercise showed significant benefit was for functional tests and increased muscle strength -  things like straightening your leg to resistance, getting up out of a chair, jumping higher.  So, vibration platform exercise is beneficial for helping older people carry on doing their daily activities – staying active and flexible and strong.  It would be interesting to see a comparison study between vibration platform exercising and weight training, since weight training has been shown to be more beneficial for older people than aerobic exercising.  Apparently the stress of lifting and moving weights against resistence is good for the heart and cardiovascular system, it has more of an effect on muscle strength than other exercise and requires bending, twisting and other flexibility movements.

The review that I read about this study basically said that more and better research needs to be done on vibration platform exercise.  One of the things that I thought might be involved with the platforms was an increase in proprioceptive input, which is always a good thing for balance. This wasn’t mentioned in the study, but would be something that could be investigated.

Otherwise, the conclusions from this study is that you don’t actually need to go out and buy an expensive vibration platform, or a costly gym membership where they have vibration platforms in order to get and stays strong when you get old.  Just get moving.

When you need chiropractic adjustments Abbotsford is the place to be.  Dr. Dorothea McCallum provides General Chiropractic Care for people of all ages, Pre and Perinatal care for Moms and babies – Webster Technique Certified, Wellness Care and Coaching – Certified Chiropractic Wellness Practitioner (CCWP), Custom Corrective Orthotics.

Visit our office on-line by seeing our video on CanPages!  New Patients always welcome www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

Dr. McCallum’s office is located upstairs in the Bay SevenOaks,32900 South Fraser Way,Abbotsford,BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

FEAR AVOIDANCE BELIEFS AND PAIN AVOIDANCE IN LOW BACK PAIN part 2

Last week we began our discussion about how you think about pain and movement affects how well you heal and how well you feel.  This week, I show you how smart health providers figure out which one you are so they can help you get better faster.

The following information is from a paper in The Spine Journal 2011;11:895-903, titled Fear-avoidance beliefs and pain avoidance in low back pain – translating research into clinical practice, authored by Rainville J, Smeets RJEM, Bendix T et al.

Problematic Fear Avoidance Beliefs can be classified into 3 categories:

1. Misinformed avoiders:  Most people fall into this category, and hold the belief that certain movements and activities will cause re-injury and/or increase pain.  They then avoid these activities. In general, they do not report high distress, low self-efficacy or profound disability.  Their beliefs are based on reasoning and are likely to change with new information and new experiences.  Recommended Interventions: Educational interventions that explain the causes and process of low back pain.  These should be delivered by a recognized spine expert in a compelling format.
2. Learned Avoiders: Patients in this category do not express fear of re-injury, and do not have explicit beliefs about physical activities causing re-injury or increased pain.  They view activities as painful and avoid these activities in order to avoid pain.  Recommended Interventions: No approach has been established, but quota-based exercise has been suggested.
3. Affective Avoiders: considered the most challenging patients, they are profoundly distressed by back pain, exhibit excessive pain inhibitions during physical examination, and are strongly committed to their disabilities.  They exhibit persistent, irrational fear of physical activities due to its perceived likelihood of producing back pain.  This group would benefit from treatments that address dysfunctional cognitions and catastrophic thinking. Recommended Interventions: “exposure in vivo” technique that addressed phobias (gradually expose patient to feared physical activities); “functional restoration” treatment that integrates quota-based exercise and counseling.

These categories of patients with problematic fear-avoidance beliefs allows health providers a way to tailor treatment plans according to the patient to improve low back outcome.

As mentioned, most patients are misinformed avoiders; These patients believe pain is harmful based on past experiences and multiple information sources.  They are generally unwilling to perform activities that (may) cause pain.  New information and experience (exercise) will reduce their fear avoidance beliefs.

Learned pain avoiders believe that pain should be avoided, and will choose to stop activities that are painful

Lastly affective avoiders have distorted beliefs about pain and spine conditions that are based on emotionally charged misinterpretation of past experiences and distortion of medical information.  They will not attempt activities that might be painful, and display profound pain inhibition for movement.  Their dysfunctional cognitions and catastrophic thinking needs to be addressed, and fears decreased through gradual exposure to feared activities.

As I heard a pain specialist once say, there is a difference between hurt and harm.  Many things may hurt, but are not harmful.  Sometimes, not moving, which does not hurt, causes the most harm.  I always advise people to move as much as possible, and most find that they feel a lot better when they do.  In fact, if reasonable movement does not improve symptoms, that is a reason to look deeper for something else going on.

Movement is life, and if you don’t keep moving, you soon won’t be able to.  If you ever hear a health provider tell you to stop moving or to rest until you feel better, I think you should probably look around for a second opinion, they could be making you worse instead of better.

CMCC Run/Walk for Chiropractic Education and Research

Dr. McCallum is again walking in the Annual CMCC Run/Walk for Chiropractic Education and Research in Toronto on April 29th.

Canadian Memorial Chiropractic College is considered the top chiropractic college in the world and is renowned for rigour and innovation.  It is a private institution and receives no government funding, but relies on membership, tuition and donations.  If you’ve been helped by Chiropractic, or know someone who has, please give generously. Just go to www.cmcc.ca/dorotheamccallum and follow the steps to donate online.

We are as close as the CanPages online. Please feel free to refer your family and friends using this link:

 www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

Dr. Dorothea McCallum is an Abbotsford back painrelief doctor who looks at so much more.  Your back is connected to every organ, cell and tissue in your body by the nervous system. Find out how chiropractic can help you live a longer, fuller life.

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

Notice:

Dr. McCallum is in Toronto this weekend for CMCC Board Meetings and the Run Walk for Chiropractic Education and Research.  See my donation plea below!

FEAR AVOIDANCE BELIEFS AND PAIN AVOIDANCE IN LOW BACK PAIN

Over the next two weeks, I’m going to be exploring  – just a little bit – about how you think about your back pain affects how well you heal and how you feel.

The following information is from a paper in The Spine Journal 2011;11:895-903, titled Fear-avoidance beliefs and pain avoidance in low back pain – translating research into clinical practice, authored by Rainville J, Smeets RJEM, Bendix T et al.

Fear avoidance beliefs (FABs) are the avoidance of movement and/or activities due to fear of pain.  This fear may be based on emotion or reason, or both. To date, most research has investigated FABs in chronic low back pain (LBP) patients, while very few studies have been conducted on fear avoidance beliefs in acute low back patients. These factors are very important for determining how disabled a person becomes and how different people handle the situations they find themselves in regarding pain.  They are particularly important because they show how beliefs can affect actual physical symptoms – how much control a person has over how they feel.

Responses to the fear of pain – note, I didn’t say to pain, but the fear of pain – run in a continuum from “confrontation” to “avoidance” as the two extremes.  A person with confrontational behaviour will attempt to return to normal activity despite the pain, and eventually will have reduced fear of pain.  A person with avoidance behaviour will avoid activity that they associate with pain, and eventually will have increased fear of pain.

The paper I cited above describes the impact of fear avoidance beliefs of the patient and the health provider on low back pain outcomes, as well as a classification system of problematic fear avoidance beliefs.  You’ll note that the health provider’s beliefs about pain are just as important as the patient’s!

Fear Avoidance Beliefs

Your health provider’s behaviour and communication methods about pain greatly influence your experience and outcome.  A good explanation of low back pain can help relieve fears and avoidance beliefs by emphasizing the mechanical basis for the pain and the body’s many resources for healing and handling pain itself.

As a health provider who tends to be more confrontational in my approach – as many chiropractors are – I need to be mindful that fear avoidance beliefs exist quite strongly throughout the general population, for many things, not just back pain.  All you have to do is watch TV for a couple of hours and count the number of ads there are for pain relief medications, or look at the addiction problems created by prescription drugs like oxicontin in the people it has been prescribed to.

It’s natural to experience an increase in fear avoidance beliefs when you experience an episode of low back pain.  This increase is usually temporary and returns to normal once your symptoms subside.  In some people, though, the FABs persist or even escalate.

In chronic low back pain cases, the consequences of fear avoidance beliefs are more significant because they are strongly associated with disability and do not often decrease as symptoms subside.

Persistent fear avoidance beliefs in chronic pain reduce the effectiveness of treatments for reducing disability.

Health Care Providers & FABs

Health care providers are typically moderate fear avoidant overall, and their fear avoidance behaviour are minimally associated with education, spine expertise, or practice experience.  Arguably, chiropractors are the least fear avoidant of the providers, since our entire schooling and education is based on movement and function and these only occur with use.

However, I work in a clinic that is multi-disciplinary and have watched other providers and disability programs and had to deal with the consequences of their FABs.  Health care providers with strong fear avoidance beliefs leads to patients with higher fear avoidance beliefs and more disability.  Health providers with low fear avoidance beliefs leads to patients with lower fear avoidance beliefs and  lower disability.
Next week, I’ll show you how we spot how well people will do with their care.

CMCC Run/Walk for Chiropractic Education and Research

Dr. McCallum is again walking in the Annual CMCC Run/Walk for Chiropractic Education and Research in Toronto on April 29th.

Canadian Memorial Chiropractic College is considered the top chiropractic college in the world and is renowned for rigour and innovation.  It is a private institution and receives no government funding, but relies on membership, tuition and donations.  If you’ve been helped by Chiropractic, or know someone who has, please give generously. Just go to www.cmcc.ca/dorotheamccallum and follow the steps to donate online.

We are as close as the CanPages online. Please feel free to refer your family and friends using this link:

 www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

Dr. Dorothea McCallum is an Abbotsford back painrelief doctor who looks at so much more.  Your back is connected to every organ, cell and tissue in your body by the nervous system. Find out how chiropractic can help you live a longer, fuller life.

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

Dr. McCallum is raising money for Chiropractic Education and Research on April 29th.  The 27th Backs in Motion, Run/Walk for Chiropractic Education and Research is taking place in Toronto and Dr. McCallum needs your help!

Canadian Memorial Chiropractic College is considered the top chiropractic colleges in the World and is renowned for rigour and innovation.  It is a private institution and receives no Government funding, but relies on membership, tuition and donations.  If you’ve been helped by Chiropractic, or know someone who has, please give generously.  Just go to:  www.cmcc.ca/dorotheamccallum and follow the steps to donate online.

MOVE YOUR WAY TO BETTER HEALTH

Staying active can stave off illness.  Actually this is a ridiculous thing to say because it sounds like we are predisposed to illness and only by really working at it can we ever hope to be healthy.  The truth is the exact opposite.  Our bodies are predisposed toward health, and it is only by neglect in not providing the best materials to build a good body and keeping its environment pure that we get sick.

That being said, one of the key requirements for excellent health is movement.  And now the scientists are proving what chiropractors have been saying for 117 years!!

Researchers at the University of Missouri recently persuaded a group of healthy, active young adults (I bet they were students) to stop moving around so much so they could see how inactivity affects disease risk.  Scientists have known for some time that sedentary people are at risk for developing heart disease and Type 2 diabetes.  But they haven’t fully understood why, in part because studying the effects of sedentary behavior isn’t easy.  People who are inactive may also be obese, eat poorly or face other lifestyle or metabolic issues that make it impossible to tease out the specific role that inactivity, on its own, plays in ill health.

In a recent study in Medicine & Science in Sports & Exercise, scientists created a fairly realistic version of inactivity by having volunteers cut the number of steps they took each day by at least half.

They wanted to determine whether this physical languor would affect the body’s ability to control blood sugar levels.  “It’s increasingly clear that blood sugar spikes, especially after a meal, are bad for you,” says John P. Thyfault, an associate professor of nutrition and exercise physiology at the University of Missouri, who conducted the study.  “Spikes and swings in blood sugar after meals have been linked to the development of heart disease and Type 2 diabetes.”

The scientists fitted their volunteers with sophisticated glucose monitoring devices, which checked their blood sugar levels continuously throughout the day.  They also gave the subjects pedometers and activity – measuring armbands, to track how many steps they took. Finally, they asked the volunteers to keep detailed food diaries.

Then they told them to just live normally for three days, walking and exercising as usual.

Exercise guidelines from the AHA and other groups recommend that people accumulate 10,000 steps or more a day, the equivalent of about 5 miles of walking (our genetic requirement is actually closer to 10 miles per day for optimum health, but the American Heart Association is only interested in preventing heart attacks, not optimum health.)  Few people get even close to 10,000 steps.  Repeated studies of American adults have shown that a majority take fewer than 5,000 steps per day.  The volunteers in the study were atypical in that on average they exercised 30 minutes or so most days and easily completed more than 10,000 daily steps during the first three days of the experiment.  The average was almost 13,000 steps.

During these three days, according to the data from their glucose monitors, the volunteers’ blood sugar did not spike after they ate.

That certainly changed during the second portion of the experiment, when the volunteers were told to cut back on activity so that their step counts would fall below 5,000 a day for the next three days.  The volunteers stopped exercising and at every opportunity, took the elevator, not the stairs, or had lunch delivered instead of strolling to a café.  They became, essentially, typical American adults.

Their average step counts fell to barely 4,300 during the three days and the volunteers reported that they now “exercised” on average, about three minutes per day.

Meanwhile, they ate exactly the same meals and snacks as they had in the preceding three days, so that any changes in blood sugar levels would not be a result of eating fattier or sweeter meals than before.

The changes were profound.  During the three days of inactivity, volunteers’ blood sugar levels spiked significantly after meals, with the peaks increasing by about 26 percent compared with when the volunteers were exercising and moving more.  What’s more, the peaks grew slightly with each successive day.

This change in blood sugar control after meals “occurred well before we could see any changes in fitness or adiposity,” (fat buildup), due to the reduced activity, Dr. Thyfault says.  So the blood sugar swings would seem to be a result, directly, of the volunteers not moving much.

This is both distressing and encouraging news.  “People immediately think, ‘So what happens if I get hurt or really busy, or for some other reason just can’t work out for awhile?”  Dr. Thyfault says.  “The answer seems to be that it shouldn’t be a big problem.” Studies in both humans and animals have found that blood sugar regulation quickly returns to normal once activity resumes.

The spikes during inactivity are natural after all, even inevitable, given that unused muscles need less fuel and so draw less sugar from the blood.

The condition becomes a serious concern, Dr. Thyfault says, only when inactivity is lingering, when it becomes the body’s default condition.  “We hypothesize that, over time, inactivity creates the physiological conditions that produce chronic disease,” like Type 2 diabetes and heart disease, regardless of a person’s weight or diet.

To avoid that fate, he says, keep moving, even if in small doses.  “When I’m really busy, I make sure to get up and walk around the office or jog in place every hour or so,” he says wear a pedometer if it will nudge you to move more.

Then, when you’re not so busy, get back into your routine and keep moving!  Remember, activities that use the large muscles of our legs use the most blood sugar and burn the most calories, so even taking the steps instead of the elevator has a HUGE benefit.

From this study, you can see how adaptable your body is, and how easy it is to go wrong in our modern society where we sit all the time.  So, get up and move around.  If your job requires you to sit a lot, stand up every time the phone rings and walk around your chair.  Your body will thank you!

CMCC Run/Walk for Chiropractic Education and Research

Dr. McCallum is again walking in the Annual CMCC Run/Walk for Chiropractic Education and Research in Toronto on April 29th.

Canadian Memorial Chiropractic College is considered the top chiropractic college in the world and is renowned for rigour and innovation.  It is a private institution and receives no government funding, but relies on membership, tuition and donations.  If you’ve been helped by Chiropractic, or know someone who has, please give generously. Just go to www.cmcc.ca/dorotheamccallum and follow the steps to donate online.

We are as close as the CanPages online. Please feel free to refer your family and friends using this link:

 www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

Dr. Dorothea McCallum is an Abbotsford back painrelief doctor who looks at so much more.  Your back is connected to every organ, cell and tissue in your body by the nervous system. Find out how chiropractic can help you live a longer, fuller life.

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

If any of

When Doing Nothing is the Best Treatment

“Don’t just do something; stand there!”

Sound clever?  It’s the kind of thing that teaching clinicians of every discipline spout off at their students. A good clinician does their best to do their best for their patient and sometimes – that’s nothing.

Here are some medical examples:

Sore throat?  Get an antibiotic.

New headache?  Get a CT scan.

Backache?  Get an X-ray.

Still got a backache?  Get an MRI.

PSA at the upper limit of “normal”?  Get a biopsy.

Blood pressure still high?  Add another medication.

Doctors tend to want to ”do something” whenever they note something amiss.  And patients, by and large, want something done when they have a symptom.  Few people like being told just to watch and wait.

Of course, every “thing” a medical doctor does also has side effects – rampant bacterial resistance from antibiotic overuse; major increases in radiation exposure from unnecessary CT scans; incontinence or impotence from prostate cancer treatments that may do nothing to prolong life; toxic drug interactions from multiple medications, particularly in the elderly.

The admonishment “don’t just do something; stand there!” reminds us that we should stop and think before we act, that there are many instances in which doing nothing is greatly preferable to doing something.

In fact, there are some doctors for whom “doing nothing” is the dominant way of thinking, who are not reflex “do-ers.”  They tend to lean to toward the status quo:  If the patient is doing fine right now, why rock the boat?

There’s a term for this in the medical literature – clinical inertia – a term with a distinctly negative connotation.  It describes the doctor who, for instance, sees a patient with cholesterol levels that are not optimum but who does not prescribe a statin.  Or the doctor who notices that a diabetic patient’s blood sugar levels are still not normal but refrains from increasing the patient’s medication.  Of course, this is not black and white:  there is a continuum of practice styles, just as there is a continuum of personalities in general.  At one end are doctors who jump on the merest hint of a borderline lab value; at the other are doctors who avoid making changes unless absolutely necessary.

An essay in the Journal of the American Medical Association called “Clinical Inertia as a Clinical Safeguard” postulated that doctors who tend toward inertia might actually benefit their patients by protecting them from overzealous medical intervention.  Keep in mind that what follows is based on U.S. information.  Here in Canada, because of our more socialized medical approach, we are often inadvertently protected from overzealousness.

The study focused on three common medical conditions – diabetes, elevated cholesterol and hypertension (high blood pressure) – for which there are established clinical guidelines for doctors to follow and “quality measures” that evaluate medical care.  For all three illnesses, “lower is better” is the dominant mantra.

Yet, while “lower is better” is probably true for large populations, that is not always the case for individual patients.  In fact, there are some clinical trials in which aggressively lowered blood sugar or blood pressure have been association with higher rates of dying. (This doesn’t surprise me because the condition is stressful on the body and the treatment just increases the stress.)

The authors weren’t saying that medical conditions shouldn’t be actively treated, but they did caution that standard clinical guidelines tend to favor overaggressive treatment in pursuit of “good numbers.”  In the stampede toward good numbers, individual patients can be harmed by the side effects of these treatments.  Clinical inertia might actually act as a safeguard for such patients.

No one wants doctors who fail to act when action is necessary. Medical emergencies are a different story altogether.  Most chronic illnesses are not emergencies, so there is room for deliberation before action.  I think many people could be saved by inertia.

As a chiropractor I’ve seen so many people, especially older people coming in with lists that exceed two or three and can reach up to 14 and 15 different medications.  Often patients don’t know what each one is for and can’t keep straight when they are supposed to take each one.  I just remember the Doctor from Sunnybrook who taught us pharmacology saying that taking more than 3 medications at one time meant that the doctors were treating the side-effects of medications with other medications and that the patient would become so toxic that it was dangerous.  And the more medications a person was on, the more confusing the symptoms would become.

I feel fortunate to be a chiropractor.  Even if I for some reason decided to overtreat somebody for a period of time (and they went along with it) the worst that could happen is some joint hypermobility that can be resolved with rest and muscular strengthening exercises. Chiropractic is not inherently dangerous or toxic.  Since most people who go to chiropractors are undertreated because of scheduling, monetary, and other considerations, they never actually attain optimum spinal function and over treatment is almost never a danger.

As a Certified Chiropractic Wellness Practitioner I still think that the best treatment for chronic conditions like diabetes, high cholesterol and high blood pressure is prevention and life style modification.  If you already have these conditions, it’s not too late to change some of your behaviours and help your body heal and function better.  Talk to me about alternatives.

Start the New Year out right and get a check up.

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

When you need chiropractic adjustments Abbotsford is the place to be.  Dr. Dorothea McCallum provides General Chiropractic Care for people of all ages, Pre and Perinatal care for Moms and babies – Webster Technique Certified, Wellness Care and Coaching – Certified Chiropractic Wellness Practitioner (CCWP), Custom Corrective Orthotics.

Our office (inside the Bay) can be viewed on our CanPages site: www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

Happy New Year! 

HOW DOES MY BODY WORK?

An analogy will help start this explanation. The power company supplies energy to run our homes and offices. That energy travels to our homes by way of wires and cables.  Once that energy gets to our location, it allows our appliances to run the way they were designed.  If, for some reason, there is an interruption or lessening of the energy coming to us, our lights would be less bright, or perhaps our appliances would fail to operate.  The same is true of our bodies.

Let’s use a similar analogy.  Let’s say you have a dimmer switch (rheostat) installed in your dining room.  As long as the dimmer switch is set all the way up, the lights burn very brightly.  Now, let’s turn the dimmer switch as low as it can go and still see a light bit of light.  If at that time, you replace all the bulbs with the absolute best, state of the arty, light bulbs, would the bulbs be any brighter than the previous set?  Of course not!  The reason is the electrical energy travelling through the wires of your home is being stopped by the dimmer switch.  Now if you slowly start increasing the switch to allow the energy to increase, the bulbs will increase in brightness.  The light is a metaphor or analogy for how our body expresses it health.  The better the flow of energy to the vital organs and tissues of our bodies the better our bodies can perform.  Therefore, better health!

Now, let’s take this one step further.  There are 31 pairs of spinal nerves in our spinal cord.  These nerves travel from every organ, cell and tissue to the brain and then back down from the brain and exit the spinal cord at very specific areas.  For example, the nerves that control your small and large intestines, kidneys, sex organs, as well as the nerves that control your lower back and legs exit the spinal cord in the lower back region.  That is shy many patients who enter our office for lower back pain also tell us that they have constipation or diarrheal problems, or perhaps menstrual difficulties.  This is very common. Another example is a patient who has neck pain, but often complains of headaches or sinus difficulty.  That would make sense because the nerves of the neck innervate those specific areas.    When nerves are interfered with or irritated, you can expect symptoms in the areas they supply.  This is why good spinal health is so important.  It’s not just about back or neck pain – it’s about your body’s well being and function.

Think about this.  Would you expect your teeth to operate properly if you never brushed or flossed them, or never visited a dentist to clean or correct them?  Why is the spine so different? 

Well, our spine is covered by skin and muscles so we can’t see it.  If patients could see their spine to the same degree they see their teeth, many patients would be horrified by how badly they have allowed their spines to deteriorate.

In chiropractic offices the first thing you can expect is to have your spine evaluated.  This is an important step in evaluating your health level and in fact is what differentiates chiropractors from other types of physicians.

Accidents, falls, tension, stress, overuse and other factors can prevent the spine from working within its normal range of motion. This can cause minor displacements of the segments of your spine.  If this displacement irritates spinal nerves, various malfunctions can occur in your body.  These displacements are called subluxations.  Various studies have shown that subluxations can cause improper function of the organs and tissues of the body, leading to increased susceptibility to various conditions, including chronic disease.  Logically, this should make sense.  If for example, the brain cannot control the stomach or intestines because of nerve compression or interference, would it be hard to imagine the body having less ability to digest and absorb nutrients from the foods you eat?  And, if you are getting fewer nutrients would a lower level of heath be that farfetched?  Think about each organ of your body.  Let your mind ponder what would happen if each vital organ or tissue was working at only 50%.  What impact would that have on your health over the short or long term?  It is this observation that leads many people to begin giving their spine the attention it deserves.  Ask your chiropractor.  Open up your potential to a whole new level of health awareness for you, your family and friends.

 Happy New Year!

Start the year out right – get a spinal tune-up!  Just phone the office and set up a check-up.  Remember, when your spine’s in line, you feel fine!

The Office reopens for regular hours on January 3, 2012.  If you reach the answering machine, please leave a message – it’s a lot easier for us to call you back!

Dr. Dorothea

Our office (inside the Bay) can be viewed on our CanPages site: www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

If you’re looking for a holistic chiropractor Abbotsford is the place to look!  Dr. Dorothea McCallum has been practicing drug free, surgery free, hands on chiropractic for over 20 years. Dr. Dorothea McCallum provides General Chiropractic Care for people of all ages, Pre and Perinatal care for Moms and babies – Webster Technique Certified, Wellness Care and Coaching – Certified Chiropractic Wellness Practitioner (CCWP) and Custom Corrective Orthotics.

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

Merry Christmas!  Hope everyone has a wonderful holiday.  When you focus on the Reason for the  Season you can leave your stress behind and rejoice in the greatest gift given to all humankind.  Blessings to everyone on Jesus’ Birthday.

The History of Chiropractic

From the beginning of history, man has always been searching for the Fountain of Youth.  In medicine, people have been searching for the magic bullet, a drug that would literally take care of all our health needs.  Unfortunately, as we all know that magic bullet does not exist.  The question then follows, what can be done to help our health needs throughout our lives.

Dorland’s Medical Dictionary describes health as a state of wellness, not merely the absence of disease or infirmity.  Another way of looking at this is that the absence of pain does not give us a good indication of the patient’s health level.

“The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease.”

 Thomas Edison

Health is an ongoing process; one that evolves as we age.  If you look around at our society, you can see a rampant crisis of health problems.  People are looking for answers and in many cases are not getting them. It’s my opinion that the main cause of these issues is that prevention of disease and illness is scoffed at by society.  If someone feels well -no problem – nothing to worry about.  We are now realizing that health maintenance is the key to good health.  Rather than wait for the health crisis, let’s attempt to prevent the crisis from occurring.

Chiropractic health care focuses primarily on the examination and treatment of the spine and pelvis to determine if some part of the body’s structure is malfunctioning.  And, if so, what can be done to correct the structure to return the body to the best possible physiologically sound state?

Think back how many times you’ve received treatment for an illness and after feeling a bit better, you stopped treatment.  But is feeling well the same as being well?  Short-term treatment may only help to temporarily alleviate symptoms, a part of the condition, but never really address the cause of the problem.  There can be long term consequences to symptoms relief only – the condition can return, or can develop into something even more serious. 

Chiropractic can be used in several ways.  As prevention, chiropractic helps keep your spine and nervous system working at optimum so disease and injury are less likely to occur.  As treatment, chiropractic addresses the cause of your condition and restores normal function.  As rehabilitation, chiropractic assists your body in attaining optimum function after an injury and as maintenance chiropractic helps you retain all the good healing and function you’ve achieved through your care.

CHRISTMAS IS COMING!

Need to find the Perfect Present for someone special?  Give the gift of health!  Gift Certificates are available in the office. 

Holiday Hours are:

Christmas Eve, Dec 24 – Open til Noon

Closed from Noon Saturday, December 24 until Tuesday, January 3, 2012.  Book your New Year Adjustment for the first week in January and start the year right!

When you need chiropractic adjustments Abbotsford is the place to be.  Dr. Dorothea McCallum provides General Chiropractic Care for people of all ages, Pre and Perinatal care for Moms and babies – Webster Technique Certified, Wellness Care and Coaching – Certified Chiropractic Wellness Practitioner (CCWP), Custom Corrective Orthotics.

 Our office (inside the Bay) can be viewed on our CanPages site: www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

The following is an exerpt from a scientic journal about disc herniations. I have had a lot of patients come into the office with future, current and past disc herniations.  It’ s no fun having this problem, and nobody has all the answers regarding the best way to predict or care for the patient who has it.  There is some interesting information here.  I’ve copied parts of the paper and will try to unpack it in regular people’s terms so you can understand a bit better.  Some of the information is quite surprising, as you ‘ll see. I’ve italized my comments to distinguish them from the body of a quote.

Diagnostic accuracy of the clinical examination in identifying the level of herniation in patients with sciatica

Hancock M, Koes B, Ostelo R et al.

Spine 2011; 36(11): E712-719.

Patients with sciatica complaints (this is pain down the back of your leg ) are examined by means of a variety of test procedures to determine if the symptoms are caused by a disc herniation as well as which level is involved.(sciatica is not always caused by disc herniation – sometimes it is a tight piriformis muscle, sometimes inflammation in the area of the  nerve, etc) The general tests (e.g., Straight Leg Raise [SLR] and Valsalva’s Maneuver) provide information about whether a disc herniation is present, but they do not provide information about which disc level is involved. Tests that do provide disc-level specific information include dermatome (dermatomes are patterns of nerve distribution  on the skin that map out and correspond to particular spinal levels – so you can trace the sore spot from an extremity like your toe all the way back to the level of the spine where the nerve comes from), muscle strength and deep tendon reflex testing. 

When the clinical picture (a clinical picture is determined by the history of the complaint, and test results from nerve, muscle, strength, etc tests) points to a disc herniation, patients are commonly evaluated by magnetic resonance imaging (MRI) to confirm the presence and level of involvement. However, if the level of herniation that is seen on MRI does not correlate with the clinical examination findings, the patient may not be expected to improve following a disc-specific intervention (e.g., discectomy). 

I bolded the last sentence because this is very important and shows how surgery can fail.  Even though you have the right level and the disc is bulged and/or herniated the clinical symptoms might indicate a different level. If you have these kinds of conflcting signs and you operate, the patient will not be helped!  It just shows that the body is more complicated that we understand and it points to the fact that we don’t really know very much!  Obviously, from this, the pain is not always generated from the herniated disc!

Even though it is extremely important to have a good correlation between clinical examination findings and MRI findings before proceeding to surgery, little is known about the accuracy of commonly used tests in predicting the level of disc herniation. 

Think about the last part of the above sentence – personally, it gives me pause, and would certainly make me think more than twice before letting anyone operate on me.  I’d like better accuracy!

The objective of this this study was (in patients with sciatica and confirmed lumbar disc herniation) to investigate the diagnostic accuracy of:

• individual neurologic tests,
• combinations of tests, and
• a clinician’s overall impression in identifying the specific level of a suspected disc herniation.

The study’s secondary objective was to determine if the diagnostic accuracy was influenced by whether the herniation was central or lateral.

• Patients (n = 283) were on average 42 years-of-age and 66% were males.
• The mean sciatica pain level was 65 on a 100 point visual analogue scale (VAS).
• Symptom duration was an average of 9 weeks.
• The most common level of disc herniation was L5/S1, which occurred in 59.6% of the patients.
• The L4/L5 level was next most common, affecting 44.6% of the patients.
• Only 4.6% had L3/L4 involvement.
• Overall, there was a great deal of variation in the frequency of positive findings between the tests.
• There was a very high correlation between side of herniation and the side of sciatica with only five patients having pain on the opposite side.

Dermatomal pain location was the most accurate of the neurological tests in identifying the level of disc herniation. However, none of the tests were considered to be very accurate, with all of the respective AUC values being below 0.75. (Area under the curve – an indication of a test’s ability to discriminate, that is, to correctly classify those who have a particular condition from those who do not have the condition. A perfect test would have an AUC of 1, whereas a worthless test that could not discriminate at all would have an AUC of 0.5. Generally, a test that has excellent accuracy would be 0.90 or above, good 0.80-0.90, fair 0.70-0.80 and poor 0.60-0.70.) Patient reports of pain in the L5 and S1 dermatomes were the best tests to identify L4/L5 and L5/S1 herniations, respectively. 

Examination by a neurologist was more accurate at identifying the level of disc herniation than any of the individual tests,  (make sure you get a neurologist to evaluate you – not an orthopedic surgeon!)

When several index tests were combined, diagnostic accuracy was slightly superior to dermatomal pain location, the most accurate index test, but was inferior to the rating of a neurologist. 

The authors concluded that their study did not provide evidence to support the accuracy of any of the individual neurological examination tests in identifying the level of disc herniation in the lower three discs that are demonstrated on MRI. On the other hand, a neurologist utilizing a group of tests was moderately accurate in identifying the level of disc herniation. 

When the findings of several positive index tests were combined, accuracy increased slightly. 

Dermatomal pain location was the most accurate single clinical test in identifying the level of disc herniation. Thus, clinicians should pay particular attention to this finding when present in patients with suspected lumbar disc herniation.

CHRISTMAS IS COMING!

Need to find the Perfect Present for someone special?  Give the gift of health!  Gift Certificates are available in the office. 

Holiday Hours are:

Christmas Eve, Dec 24 – Open til Noon

Closed from Noon Saturday, December 24 until Tuesday, January 3, 2012.  Book your New Year Adjustment for the first week in January and start the year right!

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

When you need chiropractic adjustments Abbotsford is the place to be.  Dr. Dorothea McCallum provides General Chiropractic Care for people of all ages, Pre and Perinatal care for Moms and babies – Webster Technique Certified, Wellness Care and Coaching – Certified Chiropractic Wellness Practitioner (CCWP), Custom Corrective Orthotics

Our office (inside the Bay) can be viewed on our CanPages site: www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

Chiropractic: Common Misperceptions   Part 2

Last week we looked at some of the common misperceptions about chiropractic – here’s some more.

Chiropractors are not “real” doctors

This statement is true if you believe that only medical doctors are doctors.  We certainly aren’t medical doctors and have chosen not to be.  When I decided to enter chiropractic school, I chose to enter a healing art that concentrated on the spine and everything attached to that spine.  I chose a field of study that looked for the structural causes of health conditions and how a patient’s condition could be corrected rather than entering a field of medicine, which in many cases, chose to cover up symptoms through the use of medication.

When you think about it, since the spine includes the spinal cord, which is an integral part of the central nervous system, intimately connected to the brain and instrumental in controlling every organ, cell and tissue in the body, chiropractic is so much more than just the safest, most effective treatment for a sore back or a headache. 

Chiropractors are not allowed to use drugs or perform surgery.

While this statement is true legally, I refer to the last question for an answer.  When chiropractors enter chiropractic school, they choose to enter a healing art that does not use medication or surgery as its treatment choice.  So, it’s not a matter of no allowed to; it’s a matter of don’t want to.

Why do I have to keep coming, the pain is gone!

This goes back to the concept of threshold level of pain.  With treatment, your pain level is soon reduced or gone.  In many cases, if treatment is stopped at that time, the bulk of the condition is still looming behind the scenes, so to speak, below the water line (threshold level of pain). Once normal activity is resumed and normal daily stresses occur, the pain will re-appear.  That is why I re-examine patients from time to time to determine where they are in care, and to have a better indication as to what is needed.

I came to you for a few months, was satisfied with the results and decided to stop care.  Now a few months later or more, my pain has returned.  I really don’t want to get started all over again and I don’t want to have to come in over a long time.

This happens from time to time.  Please understand something. I recommend the treatment that YOUR condition requires.  The best thing I can tell you is that IF it has been a long time since treatment ended, let’s say 6 months to a year, there‘s a good chance at least a brief examination is needed to determine if the condition is the same or different than before.  In many cases, the same amount of treatment is NOT needed.  If you make it clear what your goals are, I will customize your treatment to give you what you need. I will however, recommend what your condition needs, not necessarily what you want to hear.  It’s then up to you to decide what you want.  Please don’t be intimidated by me or my recommendations.  As corny as it sounds, I want to help you to the degree you want help.  It’s your body and health after all!!

Something else you need to know is this.  Back conditions nearly always recur.  When we look at the current research it appears more and more that back pain is almost always a cumulative injury (unless you’re in a bad accident, fall from a plane, or are literally hit by a bus) and because we are creatures of habit, we keep doing the same things over and over and over.  While our symptoms wax and wane, the underlying condition doesn’t go away.  This means that once our back is injured, it can heal, but it is not cured.  I think people get frustrated and are disappointed because they expect a 100% cure, when there isn’t one.  As a chiropractor my job is facilitate your healing to its optimum level and help you maintain it, so you can remain symptom free, or at least have better control over your episodes, rather than having them control you.

CHRISTMAS IS COMING!

Need to find the Perfect Present for someone special?  Give the gift of health!  Gift Certificates are available in the office. 

Holiday Hours are:

Christmas Eve, Dec 24 – Open til Noon

Closed from Noon Saturday, December 24 until Tuesday, January 3, 2012.  Book your New Year Adjustment for the first week in January and start the year right!

 Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

At McCallum Chiropractic we are always looking to enhance your health through easy, effective choices.  Choose Chiropractic.

Our office (inside the Bay) can be viewed on our CanPages site: www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

Chiropractic: Common Misperceptions Part 1

Why do I have to go so frequently for treatment?  Is it really necessary?

The best way to answer this is to use an analogy.  If you have an infection and visited your MD, there is a chance he would prescribe an antibiotic to fight the infection.  That prescription might need to be taken twice a day for 14 days.  In that 14 day period you received 28 treatments. It doesn’t seem like it because you only had one actual visit to the office.

In chiropractic, the treatment is given in the office, not at home and not out of a bottle.   So, if you were to receive treatment three times a week for nine weeks, while it may seem like a lot of treatment, you were actually treated one time less than in the medical analogy given above.

At my office, I tailor your treatment plan to you and your condition so you have optimum results – for you.  Sometimes, if the problem has been there for a long time, it can take a longer time to treat.  If you have concerns about the treatment plan designed for you, please let me know so I can explain and talk about other possible treatment options.

It seems like once you start going to a chiropractor you have to go forever!

In actuality, many patients CHOOSE to receive chiropractic throughout their lives, because they see the improvements in their lifestyle and health.  Let’s face it, our society is geared towards fast food, fast cars and immediate gratification. It’s no wonder that people also want fast food healthcare. Let’s give you another analogy that may help.  Diabetics and those with allergies sometimes need medication every day or every week of their life!!!  Nobody criticizes them or their doctor for treating their condition on an ongoing basis.  In fact, we’d think they were foolish if they stopped.

In some cases patients with significant structural problems need structural support for long periods of time and perhaps the rest of their life. While these types of problems are not an everyday occurrence in my office, they do happen. Also, as you’ll see in Part 2, sometimes, even the problem you think is a small, new problem, may have a more serious root cause and require more care than you anticipate.

Most people who come to my office for care for longer periods of time simply like the way they feel and choose to utilize chiropractic treatment more thoroughly than others.

Chiropractic is not accepted by the medical profession.  My doctor doesn’t want me to utilize chiropractic.

While this situation was very common when I first started practicing over 20 years ago, there are occasionally patients who tell me this even today.  It is unfortunate that this occurs.  I personally don’t believe that any doctor has all the answers.  That is why I refer to most other types of doctors when the need arises.  In most cases, the medical doctor who has this attitude may still carry the prejudices of years past or has a total misunderstanding of what chiropractic treatment consists of and what our goals of treatment are.  I have found that if this ever occurs, a telephone call can help alleviate any concerns your medical doctor has with treatment. In some cases, after discussing the patient’s additional health issues with the medical doctor, I may alter my approach of treatment because of a patient’s health history. A smart doctor is one who listens to their patient and to the other health professionals the patient may have seen.

Next week, we’ll continue with some of the commonly held misconceptions about Chiropractic.  If you have any questions, please let me know.  I’d be happy to answer them for you.

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

When you need chiropractic adjustments Abbotsford is the place to be.  Dr. Dorothea McCallum provides General Chiropractic Care for people of all ages, Pre and Perinatal care for Moms and babies – Webster Technique Certified, Wellness Care and Coaching – Certified Chiropractic Wellness Practitioner (CCWP), Custom Corrective Orthotics.

Visit our office on-line by seeing our video on CanPages!  New Patients always welcome www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html