Wellness Posts by Dr. David P. Chen

Ginger may reduce pain associated with muscle injury after exercising

support@wellness.com — Mon, 19 Jul 2010 08:47:02 Z

Wellness.com - Ginger may reduce pain associated with muscle injury after exercising by Dr. David P. Chen

For centuries, ginger root has been used as a folk remedy for a variety of ailments such as colds and upset stomachs. But now, researchers at the University of Georgia have found that daily ginger consumption also reduces muscle pain caused by exercise. Muscle pain generally is one of the most common types of pain and eccentric exercise-induced muscle pain specifically is a common type of injury related to sports and/or recreational activities.

While ginger had been shown to exert anti-inflammatory effects in rodents, its effect on experimentally-induced human muscle pain was largely unexplored. It was also believed that heating ginger, as occurs with cooking, might increase its pain-relieving effects. Two studies are directed to examine the effects of 11 days of raw and heat-treated ginger supplementation on muscle pain. The researchers recruited 74 volunteers, 34 and 40 respectively, randomly assigned them to consume capsules containing two grams of either raw or heat-treated ginger or a placebo for 11 consecutive days. On the eighth day they performed 18 extensions of the elbow flexors with a heavy weight to induce moderate muscle injury to the arm. Arm function, inflammation, pain and a biochemical involved in pain were assessed prior to and for three days after exercise.

Results showed that supplementation with both raw and heat-treated ginger attenuated muscle pain intensity 24 hours after eccentric exercise. Exercise-induced pain was reduced by 25 percent after daily supplements of raw ginger, and by 23 percent after supplementation with the heat-treated form. The study suggests that ginger may have anti-inflammatory and analgesic properties similar to that of Non-Steroidal Anti-Inflammatory drugs (NSAID's).

Reference: Black CD, Herring MP, Hurley DJ, O'Connor PJ. Ginger (Zingiber officinale) Reduces Muscle Pain Caused by Eccentric Exercise. J Pain. 2010 Apr 23; DOI: 10.1016/j.jpain.2009.12.013

Dr. David P. Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic

Evidence Supports the Use of Therapeutic Ultrasound for Joint Osteoarthritis

support@wellness.com — Thu, 10 Jun 2010 10:49:15 Z

Wellness.com - Evidence Supports the Use of Therapeutic Ultrasound for Joint Osteoarthritis by Dr. David P. Chen

A Cochrane systematic review (January 2010) and another recent clinical trial (May 2010) both provided support for therapeutic ultrasound (US) in the management of patients with osteoarthritis (OA).

The objective of the Cochrane systematic review was to compare therapeutic US with sham or no specific intervention in terms of effects on pain and function safety outcomes in patients with knee or hip OA. The authors concluded that, "In contrast to the previous version of this review, our results suggest that therapeutic ultrasound may be beneficial for patients with osteoarthritis of the knee."

The clinical study examined the short- and long-term efficacy in patients with primary hip OA with regard to pain, functional status, and quality of life (QoL). Forty-five patients with primary hip OA were enrolled into the study. The authors concluded that, "addition of therapeutic ultrasound to the traditional physical therapy showed a longitudinal positive effect on pain, functional status, and physical QoL in patients with hip osteoarthritis. The use of therapeutic ultrasound in the treatment of hip osteoarthritis should be encouraged."

References: Köybaþi M, Borman P, Kocaoðlu S, Ceceli E. The effect of additional therapeutic ultrasound in patients with primary hip osteoarthritis: a randomized placebo-controlled study. Clin Rheumatol. 2010 May 26.

Rutjes AW, Nüesch E, Sterchi R, Jüni P. Therapeutic ultrasound for osteoarthritis of the knee or hip. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD003132.

Dr. David P. Chen
Chiropractor in Laurel, Maryland
Laurel Regional Chiropractic
www.laurelregionalchiropractic.com

Study recommends conservative management of lumbar disc herniation before surgical discectomy

support@wellness.com — Fri, 07 May 2010 09:59:50 Z

Wellness.com - Study recommends conservative management of lumbar disc herniation before surgical discectomy by Dr. David P. Chen

A recent article appeared in the Spine Journal examines the cost of previous conservative care for patients that ultimately elect to have spinal surgery. The study consisted of 30,709 patients. The average cost of conservative care in the 90 days period before surgery was $3,445 each. Magnetic resonance imaging and other diagnostic procedures represented a little over half of the total pre-surgery costs. Of the treatment costs, 16% were for injections, 5.7% physical therapy, and 1.2% chiropractic care. Despite the fact that these expenses were for failed back conservative care, the authors recognize the overall benefits of conservative care and recognize that many patients are able to avoid surgery. They conclude that ¡§Although a large number of patients will ultimately require surgical intervention, given that many patients will improve with nonoperative therapy, a trial of conservative management is appropriate¡¨.

Previous studies have examined conservative versus surgical treatment related to several common causes of low back pain. For spinal stenosis, ¡§Among patients with lumbar spinal stenosis completing 8- to 10-year follow-up, low back pain relief, predominant symptom improvement, and satisfaction with the current state were similar in patients initially treated surgically or nonsurgically.¡¨ Another study of patients with disc herniation reported, ¡§¡Kwith moderate or severe sciatica, surgical treatment was associated with greater improvement than nonsurgical treatment at 5 years. However, patients treated surgically were as likely to be receiving disability compensation, and the relative benefit of surgery decreased over time.¡¨

Sources:
Daffner SD, Hymanson HJ, Wang JC. Cost and use of conservative management of lumbar disc herniation before surgical discectomy. Spine J. 2010 Mar 31.

http://www.chiroaccess.com/Articles/Studies-Recommend-Conservative-Care-for-Low-Back-Pain-before-Surgery.aspx?id=0000148

Dr. David P. Chen
Chiropractor in Laurel, Maryland
Laurel Regional Chiropractic

History of a Neck Injury in a Motor Vehicle Collision and Future Neck Pain

support@wellness.com — Fri, 30 Apr 2010 06:31:21 Z

Wellness.com - History of a Neck Injury in a Motor Vehicle Collision and Future Neck Pain by Dr. David P. Chen

The objective of this population-based cohort study was to investigate the association between a lifetime history of neck injury from a motor vehicle collision and the development of troublesome neck pain. The current evidence suggests that individuals with a history of neck injury in an auto collision are more likely to experience future neck pain. A cohort of 919 randomly sampled Saskatchewan adults with no or mild neck pain in September 1995 were formed. At baseline, participants were asked if they ever injured their neck in a motor vehicle collision. Six and twelve months later, we asked about the presence of troublesome neck pain (grade II-IV) on the chronic pain grade questionnaire. Multivariable Cox regression was used to estimate the association between a lifetime history of neck injury in a motor vehicle collision and the onset of troublesome neck pain while controlling for known confounders. The follow-up rate was 73.5% (676/919) at 6 months and 63.1% (580/919) at 1 year. We found a positive association between a history of neck injury in a motor vehicle collision and the onset of troublesome neck pain after controlling for bodily pain and body mass index (adjusted HRR = 2.14; 95% CI 1.12-4.10). The study suggests that a history of neck injury in a motor vehicle collision is a risk factor for developing future troublesome neck pain. The consequences of a neck injury in a motor vehicle collision can have long lasting effects and predispose individuals to experience recurrent episodes of neck pain.

Reference: Nolet PS, Côté P, Cassidy JD, Carroll LJ. The association between a lifetime history of a neck injury in a motor vehicle collision and future neck pain: a population-based cohort study. Eur Spine J. 2010 Mar 7.

Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic
www.laurelregionalchiropractic.com

Spinal manipulation is more effective for chronic low back pain

support@wellness.com — Fri, 23 Apr 2010 06:42:30 Z

Wellness.com - Spinal manipulation is more effective for chronic low back pain by Dr. David P. Chen

A randomized trial by researchers at an outpatient rehabilitation department in Italy involving 210 patients with chronic, nonspecific low back pain compared the effects of spinal manipulation, physiotherapy and back school. The participants were 210 patients (140 women and 70 men) with chronic, non-specific low back pain, average age 59. Back school and individual physiotherapy were scheduled as 15 1-hour-sessions for 3 weeks. Back school included group exercise and education/ergonomics. Individual physiotherapy included exercise, passive mobilization and soft-tissue treatment. Spinal manipulation included 4-6 20-minute sessions once-a-week.

Outcome measures were the Roland Morris Disability Questionnaire (scoring 0-24) and Pain Rating Scale (scoring 0-6), assessed at baseline, discharge, and at 3, 6, and 12months. 205 patients completed the study. At discharge, the results showed that spinal manipulation was associated with higher functional improvement and long-term pain relief than back school or individual physiotherapy, but received more further treatment at follow-ups; pain recurrences and drug intake were also reduced compared to back school or individual physiotherapy.

Reference: Cecchi F, Molino-Lova R, Chiti M, Pasquini G, Paperini A, Conti AA, Macchi C. Spinal manipulation compared with back school and with individually delivered physiotherapy for the treatment of chronic low back pain: a randomized trial with one-year follow-up. Clin Rehabil 2010; 24: 26-36.

Dr. David P. Chen
Chiropractor in Laurel, Maryland
Laurel Regional Chiropractic
www.laurelregionalchiropractic.com

Neuromuscular Training for Sports Injury Prevention

support@wellness.com — Thu, 08 Apr 2010 07:53:12 Z

Wellness.com - Neuromuscular Training for Sports Injury Prevention by Dr. David P. Chen

A March 2010 systematic review conducted in Germany underscores the value of neuromuscular training in preventing sports injuries. The aim of this systematic review was to assess the effectiveness of proprioceptive/neuromuscular training in preventing sports injuries by using the best available evidence.

7 methodologically well-conducted studies were considered for this review. Pooled analysis revealed that multi-intervention training was effective in reducing the risk of lower limb injuries, acute knee injuries, and ankle sprain injuries. Balance training alone resulted in a significant risk reduction of ankle sprain injuries and a nonsignificant risk reduction for injuries overall. Exercise interventions were more effective in athletes with a history of sports injury than in those without.

They concluded that "On the basis of the results of seven high-quality studies, this review showed evidence for the effectiveness of proprioceptive/ neuromuscular training in reducing the incidence of certain types of sports injuries among adolescent and young adult athletes during pivoting sports."

Source: Hubscher M, Zech A, Pfeifer K, Hansel F, Vogt L, Banzer W. Neuromuscular training for sports injury prevention: a systematic review. Medicine and Science in Sports and Exercise 2010 (Mar);42(3):413-421.

Dr. David P. Chen
Chiropractor in Laurel, Maryland
Laurel Regional Chiropractic
www.laurelregionalchiropractic.com

Tips for Runners

support@wellness.com — Thu, 25 Mar 2010 06:52:38 Z

Wellness.com - Tips for Runners by Dr. David P. Chen

As spring is approaching and running season is here, runners from all walks of life have started training for events over the next 6 months. Whether you are training for a 5k run/walk or the big marathon, there are a few simple things you can do to help prevent injury this running season. You can protect you knees, ankles and feet by keeping the muscles around the joints in shape and flexible. Here are some tips to help:

1. Warm-up: Always warm up prior to running, especially before explosive training like hills or speed work. Cold muscles are more prone to strains. A proper warm up will increase blood flow to the major muscle groups and improve muscle recruitment and performance. Start your work out with a light jog for 5 minutes before increasing your running intensity.

2. Get your muscles in balance: Many people have muscle imbalances that predispose them, especially runners, to lower extremity injuries. Traditional exercise programs do not address these imbalances and can in fact contribute to chronic injury patterns. The goal is to find an exercise program that addresses the instability and weakness of the hip and core stabilizers. Not only will you prevent injury with these types of exercises, but you will also improve your performance by running more efficiently. A qualified physical or exercise therapist can give you an effective exercise program.

3. Stretch: Make sure you stretch after every run. There is a lot of conflicting information out there about stretching, but the truth is that flexible muscles are stronger and more efficient. Remember to always stretch after muscles are warm (so after your warm up and after you are finished with your run). Hold each stretch 30 seconds and don't bounce. You can actually increase your flexibility by being consistent with your stretching routine and stretching every day.

4. Hydrate: Your body is composed of about 60% water. When those levels are compromised your muscles do not perform or recover properly and are prone to injury. Athletes should consume 1/2 of their body weight in ounces every day. When you run, hydrate extra both before and after your run.

5. Get in alignment: Along with balancing your muscles, spinal alignment is very important in preventing sports injuries. Each and every muscle is controlled by nerves that pass through the spine. If one of those nerves is constricted one bit, the muscle it controls will not work correctly. Also, if your spinal posture is off, your running will do more harm than good and ultimately lead to a breakdown and problem with the spine, hip, knee or ankles. Being in alignment with good chiropractic care not only gets athletes out of pain but it prevents the body from breaking down. That is why Tiger Woods, Lance Armstrong and more than 80% of the distance runners in the last Olympics see chiropractors.

Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic

Too much exercise can lead to overuse injuries

support@wellness.com — Mon, 15 Mar 2010 14:43:19 Z

Wellness.com - Too much exercise can lead to overuse injuries by Dr. David P. Chen

People tend to do the same exercise routine over and over again, without varying it, without taking adequate rest, and they end up with an overuse injury.

Most overuse injuries can be blamed on four factors: 1. Inadequate recovery (when your body doesn't fully recover from one run to the next). 2. Biomechanical irregularities (such as overpronation and leg-length discrepancy). 3. Muscular imbalances caused by running itself (tight hamstrings and weak quadriceps, for example). 4. Improper or worn-out footwear. Cross-training can't help you with your footwear choices, but it can address the other three factors. If you're a beginning runner who hasn't yet developed strength and flexibility imbalances, you can get big benefits from endurance cross-training. Your ankles, knees, and lower back aren't used to the repetitive impact of running, so you can use walking, elliptical machines, and other low-impact conditioning tools to improve endurance without beating up your most vulnerable joints, muscles, and connective tissues. You can gradually mix in some running once you've established a base of fitness.

So the bottom line is that, if you're feeling pain while doing an exercise, the form might be wrong or you might be injured. Some runners just run, without doing any cross-training, and they may do the same thing every week. Strength training or weight lifting routine will help those runners to focus on their weaknesses. Also, by varying routines and taking time to recover can help with injury prevention.

Dr. David Chen
Chiropractor in Laurel, Maryland
Laurel Regional Chiropractic
www.laurelregionalchiropractic.com

Study shows that Cold Laser Therapy helps Chronic Neck Pain Sufferers

support@wellness.com — Tue, 02 Mar 2010 15:15:14 Z

Wellness.com - Study shows that Cold Laser Therapy helps Chronic Neck Pain Sufferers by Dr. David P. Chen

A new Australian study appeared in the journal Lancet shows that using cold laser therapy to treat chronic neck pain can be very effective.

Low-level laser therapy, also known as LLLT involves using a laser's light to stimulate tissue repair and ease pain. Lead researcher Roberta Chow of the Brain and Mind Research Institute at Australia's University of Sydney carried out an overview of 16 randomized trials that put this increasingly popular procedure to the test. 820 patients were enrolled in the trials and divided into two groups: one that received either the therapy or other one that received a dummy treatment.

In five trials, the researchers found that patients given LLLT were around four times more likely to have reduced pain compared with a placebo. In the 11 other trials, for which there was a detailed analysis of pain symptoms, LLLT patients reported reductions of chronic pain by around 20 points on a scale of 100 points. The pain reduction continued for up to 22 weeks.

LLLT compares favorably with other drugs and remedies for effectiveness and its side-effects are mild, says the study. The researchers further suggested that low level laser therapy be used in combination with an exercise program for neck pain as well.

Original article: Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM. "Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials." Lancet. 2009 Dec 5;374(9705):1897-908.

Dr. David P. Chen
Chiropractor in Laurel, Maryland
Laurel Regional Chiropractic
http://www.laurelregionalchiropractic.com/

Effects of resistance training and chiropractic treatment in women with fibromyalgia

support@wellness.com — Fri, 19 Feb 2010 07:45:46 Z

Wellness.com - Effects of resistance training and chiropractic treatment in women with fibromyalgia by Dr. David P. Chen

A recent study has found that resistance training is more helpful for women with fibromyalgia if it is combined with chiropractic treatment.

The randomized controlled study aimed to evaluate resistance training and resistance training combined with chiropractic treatment on the impact and functionality of fibromyalgia in women. 21 women with fibromyalgia, who had an average age of 48 years, took part in the study. They were randomly assigned to either resistance training or resistance training combined with chiropractic treatment, with 10 women in the first group and 11 in the second. Both groups completed 16 weeks of resistance training consisting of 10 exercises performed two times per week. The group assigned to receive both resistance training and chiropractic treatment also received chiropractic treatment two times per week.

The results showed that both groups increased upper and lower body strength and there were similar improvements in fibromyalgia impact in both groups as well as the strength domains of the functionality assessment. However, only the group receiving resistance training combined with chiropractic treatment significantly improved in the pre- to post-functional domains of flexibility, balance and coordination, and endurance.

One factor in the beneficial effects of the chiropractic treatment may have been that many chiropractors perform some myofascial release as part of their treatments. Myofascial pain is a common problem with fibromyalgia and it can cause exercise to be more painful and less effective.

Original article by: Panton LB, Figueroa A, Kingsley JD, Hornbuckle L, Wilson J, John NS, Abood D, Mathis R, Vantassel J, McMillan V. Effects of Resistance Training and Chiropractic Treatment in Women with Fibromyalgia. J Altern Complement Med. 2009 Mar;15(3):321-8.

Dr. David P. Chen
Chiropractor in Laurel, Maryland
Laurel Regional Chiropractic
http://www.laurelregionalchiropractic.com/