Knee Osteoarthritis: Steroid Injections Aren’t the Answer

To Your Health
August, 2017 (Vol. 11, Issue 08)

Knee Osteoarthritis: Steroid Injections Aren’t the Answer

By Editorial Staff

Knee osteoarthritis can be painful and limit your activities, but corticosteroid injections aren’t the answer, according to new research published in the May 16, 2017 issue of the Journal of the American Medical Association.

In the study, quarterly steroid injections actually increased cartilage loss over a two-year period without providing any benefit. That’s a loss-loss situation if you ask us.

Patients suffering from knee osteoarthritis with synovitis were divided into two groups, with one group receiving the corticosteroid injections every 12 weeks for two years and a second group receiving a placebo (saline injections) at the same frequency and over the same time frame. Patients in the steroid group lost an average of 0.21 mm in cartilage thickness over the two-year period compared with only 0.10 mm, on average, in patients not receiving corticosteroids.

What’s more, patients receiving steroid injections scored only 1.2 points lower on a 0-20 pain scale (0 = no pain, 20 = extreme pain), while patients not receiving steroid treatment scored 1.9 points lower following the intervention period. In other words, patients who received no steroids reported less pain at three-month follow-ups than patients who received steroids!

Osteoarthritis is the most common form of arthritis in the world, which makes finding effective treatment options paramount. Unfortunately (and as we’ve said repeatedly with other scenarios), drugs – in this case, injections – may not be the answer. If you suffer from osteoarthritis, talk to your doctor about non-drug alternatives to manage your pain and reduce other symptoms.

Give Chronic Low Back Pain the Boot

To Your Health
August, 2017 (Vol. 11, Issue 08)

Give Chronic Low Back Pain the Boot

By Editorial Staff

Can’t seem to get rid of that low back pain? Your chiropractor can help in multiple ways. In fact, a new study suggests custom orthotics (shoe inserts) are an effective treatment option, alone or in combination with chiropractic care, for relieving pain and improving function in patients with chronic low back pain.

Researchers randomized 225 adult subjects with symptomatic LBP for three months or more into three groups for comparison.

Pain and disability were assessed at baseline and re-assessed after six weeks. The shoe orthotic group received custom-made orthotics; the “plus” group received custom orthotics plus chiropractic care (spinal manipulation, hot or cold packs and manual soft-tissue massage); and the “waitlist” group received no intervention until week six of the study, at which time they also received custom orthotics.

After six weeks, shoe orthotic and “plus” patients had experienced significant improvements in pain and function compared to patients receiving no intervention until week six (waitlist group). Comparing the orthotics-only and “plus” groups, the latter achieved greater improvements in function, but similar pain relief as the orthotics-only group.

Perhaps most notably, decreased pain and functional improvement remained significant for up to 12 months in all three groups (even the waitlist group, which received orthotics only at week six), suggesting orthotic intervention, alone or in combination with chiropractic care, can have a lasting impact on chronic LBP. As the authors stated:

low back pain - Copyright – Stock Photo / Register Mark

“It is noteworthy that for most time points after week 6, the MCID [minimal clinically important difference] data remained relatively stable, with no large decreases in the proportion of subjects who had at least 30% improvement in pain or disability compared with baseline, potentially demonstrating a lasting effect of care with the orthotic treatment.”

Talk to your chiropractor to learn more about how a comprehensive chiropractic care plan including spinal manipulation and custom orthotics can help relieve your low back pain and help minimize the chances it will return.

Source: Cambron JA, et al. Shoe orthotics for the treatment of chronic low back pain: randomized clinical trial. Arch Phys Med Rehab, 2017 (in press).

Take the Sting Out of Sciatica

To Your Health
August, 2017 (Vol. 11, Issue 08)

Take the Sting Out of Sciatica

By Editorial Staff

The sciatic nerve is the longest nerve in the body, beginning in the lower back and extending through the buttocks and down the entire leg. When the nerve is inflamed or compressed, you’ve got sciatica, characterized by mild to severe pain, burning, tingling, numbness and/or weakness.

Your chiropractor knows a great deal about sciatica, particularly because the nerve originates in the lower back, and herniated spinal discs account for the majority of sciatica cases. In fact, sciatica is a common reason for visiting a chiropractor. If you’re suffering from sciatica, your DC may perform chiropractic adjustments and related techniques to help resolve your pain.

In terms of future prevention once the pain is gone, exercise – specifically two low-level activities, walking and biking – may be suggested. Why? According to recent research, regular walking and/or biking reduces the risk of being hospitalized for sciatica by 33 percent, the same percentage risk increase attributable to obesity. While sciatica uncommonly leads to a hospital stay, it can persist if not treated properly and cause significant pain / disability.

Sciatica - Copyright – Stock Photo / Register Mark

The study did not find an association with other types of leisure-time physical activities, leading the researchers to speculate that walking / biking are specifically beneficial because they are low-level physical activities that don’t strain the low back.

Talk to your chiropractor about sciatica prevention and conservative chiropractic treatment – before you are someone you know is faced with chronic pain or even hospitalization.

Your Bones Deserve Better

To Your Health
August, 2017 (Vol. 11, Issue 08)

Your Bones Deserve Better

By Editorial Staff

Think your bones will always be strong and supportive? Think again. While the human body reaches peak bone mass by the late 20s (and up to 90 percent by age 18-20), that doesn’t mean things will stay that way, particularly if you don’t eat right, exercise and pursue other bone-friendly health behaviors.

What’s more, our bones naturally start to lose bone mass / density with age, even if you’re living a healthy lifestyle. The consequences can be staggering, starting with osteoporosis and leading to bone fractures, which can be debilitating, particularly if you’re older.

With all that said, why would you ever do anything that puts your bone health in jeopardy? You wouldn’t. But unfortunately, too many people are doing just that, and one of the culprits is insulin resistance.

When we eat, your blood sugar levels naturally rise. The pancreas responds by releasing insulin into the bloodstream, which helps deliver the sugar into the cells, where it can be used to meet the body’s energy demands. If your body doesn’t need all that sugar, insulin helps store it in your liver and then releases it to the body when it’s needed.

The problem is when we consistently have too much sugar in our blood. At a certain point, the body can become ineffective at using insulin to reduce blood sugar levels, which can lead to type 2 diabetes and related complications. This ineffectiveness is known as insulin resistance or poor sensitivity.

bone health - Copyright – Stock Photo / Register Mark

Now, back to our story. Research suggests insulin resistance can do more than contribute to diabetes; it can also reduce bone density. A large study of men and women ages 25-35 revealed that participants with the highest levels of insulin resistance had lower bone density than participants with healthy / normal insulin function. The key here is that study participants were only 25-35 – an age range at which bone density / mass should be fairly optimal and not yet influenced by age, hormones (e.g., menopause) and related factors.

Your bones deserve better. Support them and they’ll literally support you. Talk to your doctor about bone health; how you can help your bones with proper diet, weight-bearing exercise and other considerations; and why insulin resistance can be a big problem not only for your bones, but your health in general.