HealthCareTips blog

Skipping breakfast, a common habit among teenagers, associates directly with increased waist circumference and body mass index in this age group. The habit can lead to an unbalanced diet and other unhealthy behaviors, potentially making the adolescents vulnerable to weight gain.

Don’t Get Mad if a Doctor Says They Need to Screen Your Child for Abuse

Should you see a chiropractor for low back pain?

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If you’ve ever seen a doctor for back pain, you’re not alone. An estimated 85% of people experience back pain severe enough to see a doctor for at some point in their life. Yet despite how common it is, the precise cause of pain is often unclear. And a single, best treatment for most low back pain is unknown. For these reasons, doctors’ recommendations tend to vary. “Standard care” includes a balance of rest, stretching and exercise, heat, pain relievers, and time. Some doctors also suggest trying chiropractic care. The good news is that no matter what treatment is recommended, most people with a recent onset of back pain are better within a few weeks — often within a few days.

What’s the role of chiropractic care?

Some doctors refer back pain sufferers to a physical therapist right away. But many people with back pain see acupuncturists, massage therapists, or a chiropractor on their own. Experts disagree about the role of chiropractic care, and there are not many high-quality studies to consult about this approach. As a result, there are a number of questions regarding the role of chiropractic care: Should it be a routine part of initial care? Should it be reserved for people who don’t improve with other treatments? Are some people more likely to improve with chiropractic care than others?

The answers to these questions go beyond any academic debate about how good chiropractic care is. Estimates suggest that low back pain costs up to $200 billion a year in the US (including costs of care and missed work), and it’s a leading cause of disability worldwide. With the backdrop of the opioid crisis, we badly need an effective, safe, and non-opioid alternative to treat low back pain.

A recent study on chiropractic care for low back pain

A 2018 study published in JAMA Network Open is among the latest to weigh in on the pros and cons of chiropractic care for treating low back pain. Researchers enrolled 750 active-duty military personnel who complained of back pain. Half were randomly assigned to receive usual care (including medications, self-care, and physical therapy) while the other half received usual care plus up to 12 chiropractic treatments.
After six weeks of treatment, those assigned to receive chiropractic care:

reported less pain intensity
experienced less disability and more improvement in function
reported higher satisfaction with their treatment
needed less pain medicine.

While no serious side effects were reported, about 10% of those receiving chiropractic care described adverse effects (mostly stiffness in the joints or muscles). Five percent of those receiving usual care had similar complaints.

All studies have limitations

And this one is no exception. While this study suggests that chiropractic care may be helpful for low back pain, some aspects of the study make it hard to be sure. For example:

It only lasted six weeks. As mentioned, most new-onset back pain is better by then regardless of treatment. For those with more long-lasting back pain, we’ll need more than a six-week study.
The differences in improvement between those receiving chiropractic and usual care were small. It’s not clear how noticeable such a difference would be, or whether the cost of chiropractic care would be worth that small difference.
The study included a mix of people with new and longer-standing low back pain and a mix of types of pain (including pain due to a pinched nerve, muscle spasm, or other reasons). If this study had included only people with muscle spasm, or only people who were obese (rather than military recruits), the results might differ. So, it’s hard to generalize these results to everyone with back pain.
Most of the study subjects were young (average age 31) and male (77%). All were generally healthy and fit enough to pass military fitness testing.
Study subjects knew which treatment they were receiving. This creates potential for a placebo effect. Also, the added time and attention (rather than the spinal manipulation) might have contributed to the response. Then again, these factors may not matter to a person who just wants relief.
This study only included people who were willing to receive chiropractic care.
Even within the two groups, the care varied — that is, not everyone in the usual care group received the same treatment, and this can also be said for the chiropractic group.

If any of these factors had been different, the results might have been different. For example, it’s possible that if an older population of people with chronic low back pain had been studied, “usual care” might have been the better treatment.

Bottom line

This new study lends support for chiropractic care to treat low back pain. But it’s important to recognize the limitations of this trial, and keep in mind that treatment side effects were more common among those receiving chiropractic care. In addition, chiropractic treatments aren’t free (although, fortunately, insurance coverage for chiropractic care is becoming more common).

This won’t be — and shouldn’t be — the last study of chiropractic care for low back pain. But until we know more, I’ll continue to offer it as one of many treatment options.

The post Should you see a chiropractor for low back pain? appeared first on Harvard Health Blog.

You Are Not Your Thoughts

Listen closely because what I’m about to share with you may help release years of unnecessary stress, confusion, and emotional exhaustion. Simply put: You are not your thoughts. Please repeat that to yourself three more times, as it can be an important realization on your path to emotional peace. Yes, the brain is a powerful thing and when we focus on our goals, we can make them happen. But… it’s not our thoughts themselves that bring things to fruition, it’s our actions.

The premise that we are our thoughts and that somehow just thinking (or even obsessing!) about something will draw that energy to us and magically make it happen is just that: magical.

If our thoughts, alone, were that powerful, then the world would have ended many a century ago (think about how long doomsayers have been predicting the end of time). Our population would probably be at most a quarter of what it is today (think about all the worries that plague the minds of most parents). And almost all of us would be dead or dying at this very moment due to concerning thoughts, which include deadly diseases, accidents, and, well, the fear of death itself.

Although Freud proposed that thoughts are innately related to who we are, the more modern system cognitive behavioral therapists follow is that thoughts are merely thoughts — not indicators that paint a picture of who we are. In fact, thoughts are often in direct opposition to the thinker. People who suffer from OCD (obsessive-compulsive disorder) and anxiety often ruminate about the darkest of fears, as they have been shown to actually be more conscientious than the average person and, thus, obsess about whatever horrid thoughts come to the surface because they are so horrified that they are having them.

In her piece, “Bizarre Thoughts and Me: Confessions of an OCD Therapist,” psychotherapist Stacey Kuhl Wochner shares this: “I am a therapist who treats Obsessive-Compulsive Disorder (OCD) and I have bizarre thoughts. Here is my big revelation. We all have them. It’s not just you. And I do not have OCD.” She then shares a long list of many bizarre thoughts that she had recorded in just a few weeks’ time. Here is a sampling: “I had a thought that I didn’t want to leave fibromyalgia in the search box of my phone, lest I get it; I had a thought about punching my husband in the face in bed… and I wasn’t even mad at him; I had a thought that I should tear up the paper with my parents address on it before throwing it away to keep them safe.”

Wochner states that there are still common misperceptions about thinking that include how thoughts are meaningful links to the inner being of the thinker, and how our thoughts are sometimes considered bad omens for the future. In other words, we’re all taking our thoughts too seriously — and need to learn how to let the negative ones float on by. An answer, by the way, to the misperception that thoughts can be considered bad omens, it’s imperative to remember that statistically, bad things are going to happen whether we think about them or not. On the other side of the coin, it’s also important to note here that our more positive thoughts can not only help us realize our goals but may be good for our health as well.

A New York Times article by Jane E. Brody titled “A Positive Outlook May Be Good for Your Health,” notes that in a study about participant’s views on aging, positive thoughts “can enhance belief in one’s abilities, decrease perceived stress and foster healthful behaviors.” Researchers have also found that positive emotions can boost the immune system, counter depression, lower blood pressure, and decrease heart disease. In this way, when our thoughts are focused on the positive, they can be seen as magical! But, just because some dark thoughts may intrude along the way, whatever healthy behaviors that may have stemmed from your more solution-based thought processes will continue to benefit you.

It’s all about being aware that the intrusive, scary thoughts are merely unsubstantial puffs of nothingness that we should learn to blow off, and that our intentional, positive thoughts can help shape our behaviors in productive ways. In conclusion, you are not your thoughts; you are the sum of so much more, including your intent and, more importantly, action.