Does Adjustment Speed Up Post-Surgery Recovery?


Dear readers,

This article was published earlier this year, Jan.18, 2017 from Annals of Thoracic Surgery.  This elite group was established in 1989 and the main purpose is to serve as the benchmark for risk-adjusted outcomes in cardiac surgery and is the foundation for all quality measurement and improvement activities of The Society of Thoracic Surgeons.  The aim of this study was to assess whether osteopathic manipulative treatment (OMT, similar to chiropractic adjustments) contributes to post heart surgical sternal pain relief and “improves postoperative outcomes.”  They divided them into 2 groups: control group vs manipulated group.  Here are the results:

  • VAS pain scale

    • Control group 3 vs Manipulation group 1
  • Mean Inspiration Volume (ability to breathe):

    • Control group 1400 ± 588 mL vs Manipulation group 1781 ± 633 mL.
  • Hospitalization Days
    • Control group 22 ± 6 vs Manipulation group 19 ± 5
      days.

As a results, the paper showed patients got manipulated (similar to chiropractic adjustments) have significantly reduced pain, improved function, reduced hospital stay  and associated costs, and avoidance of drugs and all the risks.

Comments from Dr. Alan Wu DC:

What a great study.  This paper supports the fact patients went thought chest operation would received tremendous benefits from manipulated/adjustments.  Adjustments should start within 5 days postoperative along with rehabilitation.  Not only it reduced pain, increased function, and it also reduced financial cost as well.   While Chiropractic has been stigmatized into musculoskeletal issue only, this is certainly not the case.  The foundation of chiropractic is based on fixing Subluxation (mis-position of the bone), restore nerve communication between the brain and body in order to achieve highest bodily functions and healing.  It is really a wonderful health care profession to keep us living optimally.  As usual, should you have any questions, feel free to reach out to us at info@ICONChiropractic.com and we will get back to you as soon as we can.

Yours in health,

Dr. Wu DC
ICON Chiropractic Center

References: 

  1. Recca V., et all. Osteopathic Manipulative Treatment Improves Heart Surgery Outcomes: A randomized Controlled Trial.  Ann Thorac Sure. 2017 Jul;104(1):145-152. doi: 10.1016/j.athoracsur.2016.09.110. Epub 2017 Jan 18
  2. Thanks To Dr. Dan Murphy DC for sharing this article.  As usual, your work and dedication to this profession is tremendous and greatly appreciated.  

Pelvis Is More Balanced After One Gonstead Adjustment?

Dear Readers,

This is a pretty nifty article published in 2015 of the Journal Physical Therapist Science.   In this paper, the author wanted to measure the impact on pelvis position and balance after ONE Gonstead adjustment. The results were significant!  Here are the details:
  1. There is a strong correlation between pelvis imbalance and joint degenerations, especially in the hip, knee, ankle and spine.
  2. Subjects were 30 female university students WITHOUT pain.
  3. Subjects were divided into pelvis adjusting group and control group (stretching group).
  4. The adjustment was consist of Gonstead theory.
  5. Varies measurements were used to asseses the outcome, which included: BackMapper, trunk inclination (TIN), trunk imbalance (TIM), the inclination of the coronal plane, pelvis position (PPO), the left and right inclination of the pelvis; ;pelvic torsion (PTO), the degree of declination of the hip bone, pelvic rotation (PRO), the declination of the pelvis on the horizontal
    plane, and the position of the scapulae (PSA).
  6. The adjusting group had significant improvement compared to the control group in all aspects.

Dr. Wu Dc’s comment:

What a great study! Here are few take away pearls from this paper.  

  1. Gonstead system rocks!  I am a proud to say I am a Gonstead exclusive chiropractor.  The precise analysis, examination and the specificity of adjustment is really the key to enhance patient’s healing and health.  This system is so great that even physical therapist profession are implemen
    ting it, what a honor!
  2. Never, I repeated, never judge your health based on how you feel.  These 30 students were asymptomatic (no pain) when they got evaluated and had pelvis imbalanced.  This is crucial because how many of us will only go to doctor when we are in pain?  “Wait and see” approach for your health is never a good idea and we should be more proactive about it. Pain is usually the last one to show and first one to go.  Before you reached the pain stage, there is usually some sort of degeneration happened already.   Make sure go see your chiropractor, acupucntirest, medical doctor and other health care professionals periodically to keep your health in top notch so you can live and function at your fullest.

 

Yours in health,
Dr. Wu DC
ICON Chiropractic Center

 

Reference:

Correlations among pelvic positions and differences in lower extremity joint angles during walking in female university student.  J Phys Ther Sci. 2015 Jun;27(6):1941-4. doi: 10.1589/jpts.27.1941. Epub 2015 Jun 30.

Can Chiropractic Care Naturally Enhance Your Immunity?

Chiropractic and Immunity

In this study, seventy-six asymptomatic subjects were randomized to receive an upper thoracic (upper mid-back) spinal manipulation (chiropractic adjustments) with cavitation (sounds) or without cavitation, or were included in a control group. All subjects had their blood drawn before, 20 minutes and two hours after the intervention. Production of IL-2 in mononuclear cell (key element of immune system) cultures was activated with staphylococcal protein A (SPA). Induced secretion of IL-2 increased significantly in manipulation with and without cavitation.

The paper concludes that in vitro T lymphocyte (immune) response to a SPA stimulus became enhanced after spinal manipulation. Therefore, this effect may be independent of joint cavitation/audible. This finding suggests manipulation may influence IL-2 immune-regulated biological responses.

Dr. Wu DC’s comment:

We all know how wonderful chiropractic adjustments can be for sore neck, lower back pain and joint issues.  But do you know chiropractic adjustments can also enhance your immune system as well?   In this study, researches evaluate effects of upper mid back spinal manipulation (chiropractic adjustment) on the production of interleukin 2 (IL-2) – a key element of innate immune system signal response to foreign body infections such as bacteria, viruses and parasites.  IL-2 also play a major role with T-cell-dependent immune response system which helps you to fight off these nasty and gnarly microbial infection.  Pretty cool stuff, isn’t it?

Teodorczyk-Injeyan JA, Injeyan HS, McGregor M, et al.
Enhancement of in vitro interleukin-2 production in normal subjects following  a single spinal manipulative treatment.
Chiropractic & Osteopathy 2008;16:5.

Curvy Back, less lower back pain?

Lumbosacral sagittal alignment in association to intervertebral disc diseases.

This is a nice study to know.   In this study, authors were studying the relationship between the lumbar lordosis (lower back curve), intervertebral disc pathologies (disc herniation and

/or degeneration) and pain.  Here are the fact

  1. 2 different groups of 50 subjects with lower back pain.
  2. First group is lower back pain with disc pathology and second group is lower back
    pain without disc pathology.
  3. Took MRI of each group and calculated the lumbar lordosis (lower back curve).
  4. People with disc pathologies has straighter lower back curve than without disc pathology.
  5. Authors concluded that “patients with intervertebral disc lesions seem to have more straightened lumbosacral profiles, but it has not been proven which comes first: disc degeneration or changes in sagittal alignment.”

Dr. Wu DC comment:

If you have been to my office then you would known I am very keen on spinal curvatures.  Curves work as suspensions and they are there to protect and preserve your spine.  Too much or too little curves could potentially speed up degeneration (aging) process.  This study has stated the relationship between these two but weren’t sure which one comes first.  Chiropractic has long been known to correct misalignment of spine (we called it subluxation) which can potentially change curvatures of spine. My take is, does not matter which one comes first, loss curve or degeneration of disc, it is important to get your spine check periodically before you hit either one of these.  Prevention always triumph treatment.

Dr. Wu DC

Published online 2014 Dec 17. doi:  10.4184/asj.2014.8.6.813

Text Neck and Blood Flow to the Brain.

Decreased Vertebral Artery Hemodynamics in Patients with Loss of Cervical Lordosis

Med. Sci Monit, 2016; 22:495-500

Key points:

  1. The authors wanted to determine the relationship between vertebral artery (blood vessels in the neck) and cervical lordosis (neck curve).
  2. Loss of cervical lordosis (neck curve) causes disrupted biomechanics, triggering a degenerative process in the cervical spine.
  3. The loss of cervical lordosis (neck curve) is associated with neck, upper thoracic, and shoulder pain, tension and cervicogenic headaches, and POORER HEALTH-RELATED QUALITY of the life outcomes.
  4. The evaluation parameters included lumen diameter (LD: size of blood vessel), peak systolic velocity (PS: blood going into vessel), and end-diastolic velocity (ED: blood going out of vessels), and flow volume (FV).
  5. The results of the study revealed that vertebral artery parameters, including LD, FV and PS, were significantly different between groups, with patients with LOSS OF CRVICAL LORDOSIS SHOWING LOWER VALUES in comparison to controls.
  6. Axial load (weight of head) is shifted from posterior to anterior (back to forward) is lost, and the increased compressive forces triggers and accelerates the degenerative process.

Dr. Wu DC’s Comment:

  • Spine is a very delicate structure especially at the neck region because of nerves and blood vessels.
  • When you put your head forward to read phone or tablet, you are slowly changing the curvature of your neck.
  • “Text Neck”, is no longer a catchphrase but an actual medical diagnosis.
  • You are changing the function and health of your body when you change the position of your head, such as this article stated, reduced blood flow to the brain.
  • Posture is extremely important to the health; good posture can lead to better health.

 

Incidence of Spontaneous Resorption of Lumbar Disc Herniation

Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis

Ming Zhong, MD, Jin Tao Liu, MD, Hong Jiang, MD, phD, Wen MO, PhD, Peng-Fei Yu, MD, Xiao Chun Li, MD, and Rui Rui Xue, MD
Pain Physician 2017; 20:E45-E52

Key points:

1. Studies of acute Lumbar Disc Herniation (LDH) have found that 2 and 5 years after diagnosis there was little difference between patients who underwent surgery and those who did not.
2. Since 1990 magnetic resonance imaging (MRI) and computed tomography (CT) have provide evidence that conservative treatment allows resorption of the herniated disc.
3. …the overall incidence of spontaneous resorption after LDH was 66.66% ….
4. Spontaneous regression of disc herniation at repeat epidurography has been described since 1945.
5. IN 1990, an article was published in Spine in which Saal et al first identified the phenomenon of spontaneous resorption as observed by MRI and CT. This phenomenon showed us that LDH could be treated conservatively.
6. Overall incidence of LDH reabsorption was around 66.66%. In japan, the resorption rate was 62.58%, which is close to the average level.
7. In the United Kingdom, the incidence was much higher, at 82.94%.

Dr. Wu DC comment:

• This is a really good review article for people who are suffering from the lumbar disc herniation (LDH). LDH can cause debilitating discomforts such as leg weakness, nerve pain shoots down the leg to even affected organs functions. However, LDH could also be incidental finding which means it is completely asymptotic and benign.
• The conventional treatment for LDH is usually operation/surgery, but as this article stated, the surgical outcome is not much different from conservative treatment.
• The conservative treatments in this paper includes: bed rest, oral steroids, NASIDS, massage, physical therapy; and may I add the specific chiropractic adjustment to the list as multiple other studies have shown.
• It is also interesting to see the age demographic in this article, as it ranges from 20s to 80s. In other words, the body is always attempting to heal itself as long as we provide a good environment to allow it to do so, in regardless to the age.
• I have always remembered what my professor told us in the class: if you have a hammer in your hand, everything looks like a nail. If you have a symptomatic disc herniation, depends on whom you talk to first, could very well decided ending up on the operation table or not. Surgery or conservative treatment, the decision is yours, but I know which one I am going to choose first.

Have any questions about disc herniation? drop a line to us or schedule an appointment at www.ICONchiropractic.com or call (408)796-7300.

ICON Chiropractic