Neck Solutions Blog

February 2, 2012

Epidemiology: Spinal manipulation utilization

Filed under: Chiropractic,General Health — Administrator @ 8:04 am

Epidemiology: Spinal manipulation utilization

From: J Electromyogr Kinesiol. 2012 Jan 28. [Epub ahead of print]

The objectives of this article are to (1) describe spinal manipulation use by time, place, and person, and (2) identify predictors of the use of spinal manipulation. We conducted a systematic review of the English-language literature published from January 1, 1980 through June 30, 2011. Of 822 citations identified, 213 were deemed potentially relevant; 75 were included after further consideration. Twenty-one additional articles were identified from reference lists. The literature is heavily weighted toward North America, Europe, and Australia and thus largely precludes inferences about spinal manipulation use in other parts of the world.

In the regions covered by the literature, chiropractors, osteopaths, and physical therapists are most likely to deliver spinal manipulation, often in conjunction with other conservative therapies. Back and neck pain are the most frequent indications for receiving spinal manipulation; non-musculoskeletal conditions comprise a very small percentage of indications. Although spinal manipulation is more commonly used in adults than children, evidence suggests that spinal manipulation may be more likely used for non-musculoskeletal ailments in children than in adults. Patient satisfaction with spinal manipulation is very high.

January 31, 2012

The association of lumbar intervertebral disc degeneration on MRI in overweight and obese adults

Filed under: Disc Problems,General Health — Administrator @ 8:03 am

The association of lumbar intervertebral disc degeneration on MRI in overweight and obese adults: A population-based study.

From: Arthritis Rheum. 2012 Jan 27. doi: 10.1002/art.33462. [Epub ahead of print]

This study addressed the association of overweight and obesity to the presence, extent, and severity of lumbar disc degeneration on MRI in adults. A population-based cross-sectional study of 2,599 Southern Chinese volunteers. Radiographic and clinical assessment, including weight and height, was conducted. Sagittal T2-weighted MRIs of the lumbar spine were obtained. The presence, extent, and severity of disc degeneration as well as additional radiographic and clinical findings were assessed. Asian-modified BMI (kg/m2) categories were utilized.

There were 1,040 males and 1,559 females (mean age= 41.9 years). Disc degeneration was noted in 1,890 (72.7%) subjects. BMI was significantly higher in subjects with disc degeneration compared to subjects without degeneration. A significant increase in the number of degenerated levels, global severity of disc degeneration, and end stage disc degeneration with disc space narrowing was noted with elevated BMI, in particular in overweight and obese individuals. In the adjusted multivariate logistic regression model, there was a positive linear trend between BMI categories and the overall presence of disc degeneration for overweight and obese. End stage disc degeneration with disc space narrowing was significantly more pronounced in obese individuals.

In one of the largest studies to systematically assess lumbar disc degeneration on MRI, our study noted a significant association between the presence, increased extent, and global severity of disc degeneration in overweight and obese adults.

November 15, 2011

Fluctuation of pain by weather change in musculoskeletal disorders

Filed under: Chronic Pain,General Health — Administrator @ 5:35 am

Fluctuation of pain by weather change in musculoskeletal disorders

From: Mymensingh Med J. 2011 Oct;20(4):645-51.

In order to find out the fluctuation of pain by weather change, a descriptive cross-sectional study was conducted among 138 individuals having musculoskeletal disorders (MSDs) attending the out patient department (OPD) of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka, during March 2004 to June 2004. Data were collected by face to face interview employing a pre-tested interview schedule containing structured questions. Among 138 respondents, male were predominant (52.2%). Mean age of the respondents was 39.42±10.79 years, while the most common age group was found as ’31 to 40 years’. By occupation, majority were housewives (40.58%), followed by businessmen (29.71%), service holder (15.22%), laborer (7.97%), and students (6.52%). The primary sites of pain were back and low back (38.4%), knee (24.6%), leg (8.7%), ankle and heel (8.0%), hand and wrist (6.5%), neck (5.8%), shoulder (5.8%), and elbow (2.2%). Highest number (47.8%) patients reported aching pain, while one fifth (20.3%) of them experienced burning pain.

About 36.2 percent respondents mentioned ‘prolonged standing’ as the main cause of pain aggravation, while almost half (48.6%) of the patients perceived that ‘application of heat’ was the key relieving factor of their pain. About two third (63%) of the respondents were sensitive to weather change; among them 56.3 percent reported that their pain increased during cold weather. Moreover, more than two third (67.4%) study-patients experienced deterioration of pain due to seasonal variation; of them 59.1 percent reported that their pain was exacerbated in winter season. Of all respondents, less than one third (30.4%) experienced aggravation of pain due to lunar change; of them majority (85.7%) experienced increased pain during dark fortnights. The study concluded that weather change might have an important role in fluctuation of pain among individuals having musculoskeletal disorders.

October 3, 2011

Face Piercing Body Art Choosing Pleasure vs. Possible Pain and Posture Instability

Filed under: Back Pain,General Health,Posture — Administrator @ 10:48 am

Face Piercing (Body Art): Choosing Pleasure vs. Possible Pain and Posture Instability

From: Front Physiol. 2011;2:64. Epub 2011 Sep 21.

Piercings (body art, i.e., with jewelry) are more and more widespread. They can induce various complications such as infections, allergies, headaches, and various skin, cartilage, or dental problems, and represent a public health problem. We draw attention to possible side effects resulting from face piercing complications observed on four young adults such as eye misalignment, decreased postural control efficiency, and non-specific chronic back pain with associated comorbidity. The authors found that the origin was pierced jewelry on the face. Removing the jewelry restored eye alignment, improved postural control, and alleviated back pain in a lasting way.

The authors suggest that pierced facial jewelry can disturb somaesthetic signals driven by the trigeminal nerve, and thus interfere with central integration processes, notably in the cerebellum and the vestibular nucleus involved in postural control and eye alignment. Facial piercings could induce sensory-motor conflict, exacerbate, or precipitate a pre-existing undetermined conflict, which leads pain and complaints. These findings are significant for health; further investigations would be of interest.

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August 11, 2011

Absence of the inferior portion of the trapezius muscle in three family members

Filed under: General Health,Posture — Administrator @ 2:48 am

Absence of the inferior portion of the trapezius muscle in three family members

From: Man Ther. 2011 Aug 6. [Epub ahead of print]

Absence of the trapezius muscle is a relatively rare occurrence but instances have been recorded in both cadaveric and in vivo clinical case reports. The two main causes that have been proposed are congenital and embryonic. The absence of trapezius may occur in isolation or in combination with other muscles such as the sternocleidomastoid or the pectoralis major muscles. Where there is co-involvement with the pectoralis major muscle in particular, the condition is often thought to be a variant of Poland’s Syndrome, which is a rare congenital anomaly characterised by unilateral chest wall hypoplasia and ipsilateral hand deformities. From an embryological viewpoint, the trapezius and sternocleidomastoid muscles are both innervated by the accessory nerve, and are derived from the mesoderm of the occipital and cervical somites. This suggests that the absence of trapezius in isolation may be an incomplete failure of the myotome compartment of either the occipital or cervical somites. Potential genetic links have also been proposed in instances where identical muscle absences have been observed in siblings and in three generations of males within a family.

Observations of absences of the whole or portions of the tripartite trapezius muscle alone have also been reported. A search of the literature identified six cases (four males, two females) revealed in cadaveric dissections. In five cases, unilateral absences of the left trapezius were reported. All parts of the trapezius muscle were absent in two cases, the upper portion in one and the inferior portion in another two cases. One case of complete bilateral absence of the trapezii was also reported. Cadaveric studies, although informative, limit any comment on a possible genetic predisposition in these individuals or any functional or symptomatic relevance as a possible consequence of the absence.

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June 30, 2011

A review of tinnitus symptoms beyond ‘ringing in the ears’: a call to action

Filed under: General Health,Tinnitus — Administrator @ 3:29 am

A review of tinnitus symptoms beyond ‘ringing in the ears’: a call to action

From: Curr Med Res Opin. 2011 Jun 23. [Epub ahead of print]

About 10% of the population experiences tinnitus, a common and distressing symptom characterized by the perception of sound in the absence of external stimuli. There is, however, marked heterogeneity in etiology, perception, and extent of distress among those who experience tinnitus. Reactions to tinnitus vary from simple awareness to severe irritation; some people have difficulty in hearing because of the loudness of the noise. Severe tinnitus causes many, often psychological, symptoms (e.g., tension, frustration, impaired concentration, disrupted sleep). For some, tinnitus is temporary, for others it is longstanding. Although many people adjust successfully, others are disabled by tinnitus; approximately 5% experience persistent and severe symptoms affecting their lifestyle and significantly reducing their quality of life. Because tinnitus is poorly understood and no single therapeutic approach is effective for all patients, many patients are told that ”nothing can be done” and they must ”learn to live with it.”

Tinnitus, often referred to as ‘ringing in the ears’, is highly prevalent. However, patients may also present with a number of other symptoms.

To review the broad range of symptoms of tinnitus, to evaluate their impact on patient quality of life and to explore methods of diagnosis and assessment. An electronic literature search was performed in PubMed between September and December 2010.

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April 10, 2011

A population-based study of juvenile disc degeneration and its association with overweight and obesity, low back pain, and diminished functional status

Filed under: Back Pain,Disc Problems,General Health — Administrator @ 4:59 am

A population-based study of juvenile disc degeneration and its association with overweight and obesity, low back pain, and diminished functional status.

From: J Bone Joint Surg Am. 2011 Apr;93(7):662-70.

Little is known regarding juvenile disc degeneration in individuals with normal spinal alignment. Consequently, the purpose of this study was to assess the prevalence, determinants, and clinical relevance associated with juvenile disc degeneration of the lumbar spine in individuals without spinal deformities.

A cross-sectional assessment of disc degeneration in juveniles was performed as part of a population-based study of 1989 Southern Chinese volunteers. Adolescents and young adults from thirteen to twenty years of age were defined as “juveniles.” Juvenile subjects with no spinal deformity (n = 83) were stratified into two groups, those with and those without juvenile disc degeneration. Sagittal T2-weighted magnetic resonance images (MRI) were evaluated for the presence and extent of disc degeneration as well as other spinal findings. Demographics were assessed and clinical profiles were collected with use of standardized questionnaires.

Juvenile disc degeneration was present in 35% (twenty-nine) of the juveniles without spinal deformity. Disc bulging or extrusion, high-intensity zones on MRI, and greater weight and height were significantly more prevalent in subjects with juvenile disc degeneration. Adjusted multivariate logistic regression modeling demonstrated that Asian-modified body-mass index (BMI) values in the overweight or obese range had a significant association with juvenile disc degeneration. Overweight and obese individuals had greater severity of disc degeneration than underweight and normal-weight individuals. Furthermore, individuals with juvenile disc degeneration had an increased prevalence of low back pain and/or sciatica, greater low back pain intensity, diminished social functioning, and greater physical disability than individuals without disc degeneration.

This study demonstrated that the presence of juvenile disc degeneration was strongly associated with overweight and obesity, low back pain, increased low back pain intensity, and diminished physical and social functioning. Furthermore, an elevated BMI was significantly associated with increased severity of disc degeneration. This study has public health implications regarding overweight and obesity and the development of lumbar disc disease.

November 15, 2010

Back muscle strength and spinal mobility are predictors of quality of life in middle-aged and elderly males

Filed under: Back Pain,General Health,Posture — Administrator @ 4:40 am

Back muscle strength and spinal mobility are predictors of quality of life in middle-aged and elderly males

From: Eur Spine J. 2010 Oct 31. [Epub ahead of print]

With aging of society, clarification of the relationship between quality of life and abnormal posture in the elderly may allow improvement of quality of life through any preventive methods and training. However, sagittal balance has not been studied widely and most studies have focused on postmenopausal patients with osteoporosis. In this report, we provide the first evaluation of the simultaneous effects of degenerative changes on radiograph, spinal range of motion, sagittal balance, and back muscle strength, and examine the influence of these effects on quality of life of the middle-aged and elderly male subjects.

The subjects were 100 Japanese males who underwent a basic health checkup. Lumbar lateral radiograph, sagittal balance and spinal mobility determined and back muscle strength were measured. The thoracic/lumbar angle ratio was used as an index of sagittal balance. SF-36 physical component summary scores showed a significant negative correlation with age, osteophyte score and thoracic/lumbar angle ratio, and a significant positive correlation with lumbar lordosis angle, thoracic spinal range of motion, and back muscle strength. Multiple regression analysis indicated that thoracic spinal range of motion and back muscle strength were significantly associated with SF-36 physical component summary.

In conclusion, quality of life of the middle-aged and elderly male subjects was related to sagittal balance, lumbar lordosis angle, spinal range of motion, and back muscle strength. Exercise including muscle strength and spinal range of motion may be able to influence these primary factors related to quality of life. Back muscle strength and thoracic range of motion impact on improvement of quality of life in the middle-aged and the elderly

July 31, 2010

Prevalence of neck pain in subjects with metabolic syndrome – a cross-sectional population-based study

Filed under: General Health,Neck Pain — Administrator @ 5:51 am

Prevalence of neck pain in subjects with metabolic syndrome – a cross-sectional population-based study.

From: BMC Musculoskelet Disord. 2010 Jul 30;11(1):171.

Metabolic syndrome has become increasingly common worldwide. Metabolic syndrome is a cluster of risk factors defined by high fasting glucose and triglycerides, low HDL cholesterol, high blood pressure, and abdominal obesity that increases the risk for cardiovascular diseases, type 2 diabetes mellitus, and all-cause mortality. The prevalence of metabolic syndrome in the US population is approximately 35%. In Eastern Finland the corresponding prevalence has been found to be 37%. Neck pain is also a common symptom among the middle-aged population. In a large Finnish population-based study, 24% of men and 37% of women aged at least 30 years had suffered from neck pain during the preceding month.

There are few studies in which the prevalence of pain has been assessed in subjects with metabolic syndrome. In one study females with chronic pain from fibromyalgia were at an increased risk of metabolic syndrome. Another study found that subjects with metabolic syndrome were more likely to have problems with pain symptoms. It has been suggested that stress is related to both metabolic syndrome and neck pain. Low physical activity has been found to be associated with metabolic syndrome and musculoskeletal pain. Some studies have found an association between obesity and neck pain. Because visceral obesity is one of the main features of metabolic syndrome, it could be proposed that metabolic syndrome is also related to neck pain. It has been speculated that both metabolic syndrome and persistent chronic pain syndromes are related to hypothalamus-pituitary-adrenal stress axis dysfunction. Therefore, it could be expected that the prevalence of neck pain is elevated in subjects with metabolic syndrome. Thus, if there were common features in the background of these disorders, the authors hypothesized that neck pain is more prevalent among subjects with metabolic syndrome than among those without metabolic syndrome. In this study the authors aimed to analyse the prevalence of neck pain in subjects with metabolic syndrome.

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May 19, 2010

The prevalence of headache may be related with the latitude: a possible role of Vitamin D insufficiency?

Filed under: General Health,Headaches — Administrator @ 2:31 am

The prevalence of headache may be related with the latitude: a possible role of Vitamin D insufficiency?

From: J Headache Pain. 2010 May 13. [Epub ahead of print]

According to recent observations, there is worldwide vitamin D insufficiency in various populations. A number of observations suggest a link between low serum levels of vitamin D and higher incidence of chronic pain. A few case reports have shown a beneficial effect of vitamin D therapy in patients with headache disorders. Serum vitamin D level shows a strong correlation with the latitude. Here, we review the literature to delineate a relation of prevalence rate of headaches with the latitude. The authors noted a significant relation between the prevalence of both tension-type headache and migraine with the latitude. There was a tendency for headache prevalence to increase with increasing latitude. The relation was more obvious for the lifetime prevalence for both migraine and tension-type headache. One year prevalence for migraine was also higher at higher latitude.

There were limited studies on the seasonal variation of headache disorders. However, available data indicate increased frequency of headache attacks in autumn-winter and least attacks in summer. This profile of headache matches with the seasonal variations of serum vitamin D levels. The presence of vitamin D receptor, 1alpha-hydroxylase and vitamin D-binding protein in the hypothalamus further suggest a role of vitamin D deficiency in the generation of head pain.

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