A new report compares chiropractic care with medical care for older patients with low-back pain (LBP).The randomized controlled trial included 240 people (105 women and 135 men). The participants were all at least 55 years old with subacute or chronic nonradicular LBP.

The patients were divided into three groups, including two biomechanically distinct forms of spinal manipulation (SM) or minimal conservative medical care (MCMC).

Specifically, “participants were randomly allocated to 6 weeks of care including 12 visits of either high-velocity, low-amplitude (HVLA)-SM, low-velocity, variable-amplitude (LVVA)-SM, or 3 visits of MCMC

The study concludes that “biomechanically distinct forms of SM did not lead to different outcomes in older LBP patients and both SM procedures were associated with small yet clinically important changes in functional status by the end of treatment for this relatively healthy older population. Participants who received either form of SM had improvements on average in functional status ranging from 1 to 2.2 over those who received MCMC. From an evidence-based care perspective, patient preference and clinical experience should drive how clinicians and patients make the SM procedure decision for this patient population.”

JMPT – June 2009;32:330-43.

www.jmptonline.org

Investigators have found that upper cervical adjustments produce significant, measurable results in patients with non-migraine headache (tension-type headache and cervicogenic headache).As part of the analysis, patients underwent chiropractic adjustments to the atlas for correction of vertebral subluxation using National Upper Cervical Chiropractic Association (NUCCA) protocol.

Findings showed that “there was statistically significant improvement in postural measurement, X-ray measurements, and in all wellness categories from pre-treatment to post-treatment. Time series analysis of the visual analog pain scale assessments showed a significant reduction in pain intensity within two weeks of treatment for those who received only a single treatment and that the pain intensity for the single-treatment group decreased by approximately 75 percent over the study period.”

JVSR – June 4, 2009:1-11.

www.jvsr.com

A just-published case study in the Journal of Manipulative and Physiological Therapeutics adds to research demonstrating that chiropractic care may alleviate vertigo.The case follows a 46 year-old woman with benign paroxysmal positional vertigo (BPPV) characterized by severe vertigo with dizziness, nausea, and nystagmus.

The patient’s doctor of chiropractor diagnosed her with “left posterior canalolithiasis by means of the Dix-Hallpike maneuver. She was treated successfully with the Epley maneuver once and subsequently discharged without further treatment.” Her treatment did not include spinal manipulation.

JMPT – June 2009;32:387-90.

www.jmptonline.org

The study’s authors explain that “the purpose of this study was to examine heart rate variability (HRV) in the presence or the absence of pain in the lower back, while receiving one chiropractic treatment at L5 from either a manually assisted mechanical force (Activator) or a traditional diversified technique spinal manipulation.”As part of the experiment, 51 participants were randomly assigned to a control group, two treatment groups, or two sham groups.

Results revealed that “all groups decreased in value except the control group that reacted in the opposite direction, when comparing the pretests and posttests for the high-frequency component.”

The investigators conclude that “adjusting the lumbar vertebrae affected the lumbar parasympathetic nervous system output for this group of participants. Adaptation in the parasympathetic output, reflected by changes in high frequency, low frequency, and very low frequency, may be independent of type of adjustment. Therefore, the group differences found in the modulation of the HRV would seem to be related to the presence or absence of pain. The autonomic nervous system response may be specific and sensitive to its effectors organ.”

JMPT – May 2009;32:277-86.

www.jmptonline.org

According to a presentation at this year’s Digestive Disease Week 2009, even short-term use of popular acid-reducing heartburn drugs may raise the risk of hip fractures.The increased risks appeared two years after patients started taking proton pump inhibitors such as Prevacid and histamine-2 receptor antagonists, or H2RAs, such as Zantac and Tagamet. Other proton pump inhibitors include popular brands such as Nexium, Prilosec, Protonix, and Aciphex.

Dr. Douglas Corley, who led the study, explains that “the increased risk with short-term use of acid-suppressing drugs suggests that even relatively brief periods of use may be associated with increased risk of hip fractures.”

For the study, Dr. Corley and colleagues analyzed data on nearly 40,000 patients taking acid-reducing drugs, and compared them to more than 130,000 patients not taking the drugs. People aged fifty to fifty-nine who had been on proton pump inhibitors for more than two years had the biggest increase in fracture risk with taking the drugs.

Digestive Disease Week – June 2009.

www.ddw.org

According to the June issue of the International Journal of Clinical Practice, drinking large amounts of cola may lead to muscle problems.Study author Dr Moses Elisaf explains: “Evidence is increasing to suggest that excessive cola consumption can … lead to hypokalaemia, in which the blood potassium levels fall, causing an adverse effect on vital muscle functions.”

The study indicates that symptoms may range from mild weakness to profound paralysis. The case studies looked at patients whose consumption ranged from two to nine liters of cola a day.

“Although most patients recover when they stop drinking cola and take potassium supplements, cola-induced chronic hypokalaemia can make them more susceptible to potentially fatal complications, such as an irregular heartbeat” says Dr Elisaf.

IJCP – June 2009 – June 2009;63:833-35.

www.blackwellpublishing.com/ijcp