Thursday, June 21, 2012


Chiropractors and Exercise Are Better Than Drugs Says New Study
By Dr. Mercola

Chronic pain is an exceedingly common condition impacting an estimated 76.5 million Americans, one-third of whom describe their pain as severe and "disabling".i
Among them, many suffer from neck pain, which is the third most common type of pain according to the American Pain Foundation.
iiIt is estimated that 70 percent of people will experience neck pain at some point in their lives but research into effective treatments is surprisingly limited.

If you visit a conventional physician for pain, there's a very good chance you'll leave with a prescription for a medication,as nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen (Tylenol) and even opioids (OxyContin, Vicodin, etc.) are the go-to treatment for pain in the modern medical world.

However, there are better options than drugs for neck pain, not only in terms of pain relief, but also in helping to treat the underlying cause of the pain so that healing can truly occur.

New Study Shows Exercises and Chiropractic Care Beat Drugs for Neck Pain


According to a new study published in the Annals of Internal Medicine and funded by the National Institutes of Health, medication is not the best option for treating neck pain.

After following 272 neck-pain patients for 12 weeks, those who used a chiropractor or exercise were more than twice as likely to be pain free compared to those who took medication.

Specifically:
  • 32 percent who received chiropractic care became pain free
  • 30 percent of those who exercised became pain free
  • 13 percent of those treated with medication became pain free
Researchers concluded:

"For participants with acute and subacute neck pain, SMT [spinal manipulation therapy] was more effective than medication in both the short and long term. However, a few instructionl sessions of HEA [home exercise with advice] resulted in similar outcomes at most time points."

Why Exercise is Essential if You Have Neck Pain


Because exercise often leads to improved posture, range of motion and functionality of your body, it can help treat the underlying source of your pain as well as help prevent chronic neck pain from developing in the first place. Exercise helps prevent and relieve pain through a number of mechanisms including strengthening key supportive muscles and restoring flexibility. 

Not surprisingly, repetitive strain injuries have become increasingly common as so many people spend most of their work days sitting in front of computers. Computer work is associated with neck pain specifically originating from the trapezius muscle, also referred to as trapezius myalgia, and many types of neck pain can be traced back to poor posture at work or during your commute.

It's a vicious cycle as poor sitting posture leads to neck pain and once neck pain develops, it can make your posture even worse. For instance, one study showed people with chronic neck pain demonstrate a reduced ability to maintain an upright posture when distracted.iii

The same study further revealed, however, that after following a specific exercise program, people with neck pain had an improved ability to maintain a neutral cervical posture during prolonged sitting, which suggests it may help break the poor posture/neck pain cycle. Other research has similarly shown that exercise is incredibly beneficial for treating neck pain including:
  • Research in the Journal of Applied Physiology found that repetitive strain injury caused by office work can be reduced using certain strength training exercises.iv
  • A study published in the journal Arthritis & Rheumatism showed that strength training targeting the neck and shoulder muscles is the most beneficial treatment for women with chronic neck muscle pain as opposed to a general fitness routine.v

    Five Specific Exercises to Target Chronic Neck Pain


    Five specific strength exercises target the neck and shoulder muscles involved in causing chronic neck pain. Both studies mentioned above involved the same five exercises using hand weights, and detailed explanations of how to perform each exercise are provided by the National Research Centre for the Working Environment:vi
    1. Dumbbell shrug
      Stand upright with the hand weights at the side of your body. In one even motion, lift your shoulders up towards your ears and lower them again slowly. At the same time, try to relax your jaw and neck.
    2. One-arm row
      Stand with one knee on the bench and lean on the same-side hand on the front of the bench. With the free arm you pull the weight up towards your lower chest. When the weight touches your chest, lower it in a controlled motion.
    3. Upright row
      Stand upright with your arms stretched and the hand weights in front of your body. Lift the weights in a straight line as close to your body as possible, until they reach the middle of your chest and your elbows point up and out. During the whole exercise, the hand weights should be placed lower than the elbows.
    4. Reverse fly
      Lie down on a bench in a 45° forward bent angle with the hand weights hanging towards the floor. Lift the weights outward and upward until they are horizontal, and then lower the weights in one controlled motion. During the exercise, the elbows should be slightly bent.
    5. Lateral raise / shoulder abduction
      Stand upright with the hand weights at the side of your body. Lift the weights outward and upward until they are horizontal, and then lower the weights in one controlled motion. During the exercise, the elbows should be slightly bent.
    The researchers recommended performing the exercises three times per week (Mondays, Wednesdays, and Fridays) and alternating between exercises 1, 2, and 5 on one day, and exercises 1, 3, and 4 the next. When starting out, perform 2 sets of each exercise with 8-12 repetitions for each set. Increase at your own pace to 3 sets for each. Depending on the exercise and your current muscle strength, the recommended beginner's weight is between 6-12 lbs.

    As a general rule of thumb, increase the weight as soon as you can comfortably execute all three sets. As a guideline, the participants in the study roughly doubled the weight used in 10 weeks. After approximately four weeks, you can reduce the number of repetitions of the last sets in order to increase the weight.

    The Benefits of Chiropractic Care and Other Alternative Treatments for Neck Pain


    Seeing a qualified chiropractor is another wise option if you suffer from chronic pain. I am an avid believer in the chiropractic philosophy, which places a strong emphasis on your body's innate healing wisdom and far less reliance on Band-Aids like drugs and surgery. Chiropractic, osteopathic, and naturopathic physicians receive extensive training in the management of musculoskeletal disorders during their course of graduate healthcare training, which typically lasts from 4-6 years.

    Due to their comprehensive training in musculoskeletal management, numerous sources of evidence have shown that chiropractic management is much safer and often more effective than allopathic medical treatments, particularly for back and neck pain. In addition, researchers have also found that chiropractic adjustments affect our bodies on a deep cellular level.

    What that means is that chiropractic care may affect the basic physiological processes that influence oxidative stress and DNA repair, so in addition to addressing any immediate spinal misalignment that might cause pain, it can also address deeper dysfunction in your body.

    As many of you know I am an osteopathic physician. DOs, like chiropractors, also receive extensive additional training in spinal adjustments and may also be a good option for you. However, in my experience, only a small percentage of DOs are skilled in this area as they have chosen a more conventional allopathic model. So if you see a DO for this make sure they provide this service.

    Overall, the important point to remember is that there are many other options for treating chronic pain than drugs. For instance, therapeutic massage has been found to offer clinically significant improvement in function and symptoms for those with neck pain,vii while a variety of complementary and alternative medicine (CAM) treatments (including acupuncture, massage, spinal manipulation, and mobilization) were deemed to be significantly more efficacious than no treatment, placebo, physical therapy, or usual care in reducing pain immediately or at short-term after treatment for those with neck or low-back pain.viii


    References: