Author Archives: cmnacnud

About cmnacnud

Chiropractic Physician at Utah Spinal Care in Sandy, Utah.

Chiropractors and Opioid Drugs

Chiropractors are worried about opioids even though they don’t prescribe them. You see, here is the problem, musculoskeletal pain is the most common cause of severe long-term pain and disability. Chronic pain in this country is commonly treated by prescription opioids. We have more than quadrupled our death rate from overdose which parallels the prescription rate. This is not a bad drug, when used appropriately. Inappropriate use is costing tens of thousands of lives each year in this country. For that reason, all involved should be looking for alternative therapies with less risk.


Research has already found some possible effective evidence based treatments. “The American College of Physicians Clinical Practice Guideline recommends that for acute, subacute, or chronic low back pain, physicians and patients initially utilize spinal manipulation and delay pharmacologic management.”

The Bone & Joint Decade Task Force reported “Evidence suggests that manual therapy and exercise are more effective than alternative strategies for patients with neck pain.”

“For low back pain: “manipulation provides greater short-term reductions in self-reported disability and pain compared with usual medical care. 94% of the manipulation group achieved greater than 30% reduction in pain compared with 69% of usual medical care.” –Spine Journal

Chiropractic is not be the only alternative therapy that can help to solve this crisis. Addressing prescribing protocols and fully funding alternative treatments such as mental health, chiropractic, acupuncture, and massage then will improve the results of patient care and reduce the risk of addiction or death significantly.

“The rate of opioid use was lower for recipients of chiropractic services (19%) as compared to non-recipients (35%). The likelihood of filling a prescription for opioids was 55% lower in the chiropractic recipient cohort. Average annual per-person charges for opioid prescription fills were 78% lower for recipients of chiropractic services as compared to non-recipients. Average per person charges for clinical services for low back pain were also significantly lower for recipients of chiropractic services. (Avg. $1513 for chiropractic management vs. $6766 for medical management)” Link

Currently, our government is attempting to address this issue legislatively, as well as through a multitude of programs. Here in Utah this crisis is a big issue in our legislature. All legislative attempts that I’ve seen thus far focus on helping in addiction recovery and the law enforcement side of things. They are doing a great job on these items. Progress needs to be made on the treatment and prevention side of things. There are two major obstacles to overcome. The first is that medical doctors have not received education on alternative treatments. They don’t know what is safe, or effective, or where their patients can receive safe, effective, evidence based alternative care. The second obstacle is that even if referrals are given to patients, payers do not cover those treatment options. These are not obstacles that can be overcome through legislation. However legislation can encourage change. 

Educating medical doctors could be done by partnership with professional associations such as the Utah Chiropractic Physicians Association and the Utah Medical Association. Best practice guidelines should require alternative conservative care prior to opioid prescription. If the standard of care requires these things then the insurance industry will need to follow the guidelines and pay for alternative treatments.


Snow is a Pain in the Neck (Back)

Now is the time.  The weather has gone from warm to crisp to cold.  snow-shovelingSnow is covering your driveway and sidewalks.  If your body is not in condition, snow shoveling can lead to injury.

Bending and twisting when tossing a shovel of heavy snow can aggravate lower back problems.  In addition, the overall physical exertion required for snow shoveling, without proper conditioning, often results in painful injuries.  And lets be honest who does conditioning for snow shoveling.  We don’t practice it until the snow falls.

Here are some tips that you should follow in order to stay injury free this shoveling season:

  • Exercise all year round.  You may not be ready for shoveling exactly, but a well conditioned body responds better to any stress it faces.
  • Plan extra time to get anywhere, whether it be work or shopping or anything else count on some shoveling/scraping time.  If you don’t need it then you’ll be a little early, and that never hurts, but rushing the job can hurt or lead to injury.
  • Don’t shovel in your Pajamas (or shorts), wear appropriate clothing to keep your muscles warm and flexible.  Working in the cold can increase the risk of sprains or strains.
  • Stretch out. Shoveling is exercise to.  A good warm up before hand may be the difference between some sore muscles or a trip to the doctor.
  • Use a lightweight, ergonomically designed shovel to reduce back strain.  You’ll still get it done with a smaller shovel and with a lighter load each time you reduce the risk of injury.
  • Push the snow don’t throw it; walk it to the snow bank.  Avoid sudden twisting and turning motions, especially while lifting a load so far from your center.
  • Bend your knees to lift when shoveling.  Let the muscles of your legs and arms do the work, not your back.
  • Take frequent breaks.  A fatigued body is asking for an injury.
  • Feeling sore after shoveling is normal.  I know you’ve been in the snow all morning, but try putting an icepack on the affected area for 20 minutes, then take it off for a couple of hours.
  • If you do injure yourself or your soreness persists, it may be time to visit a chiropractor.  Find a local one.  If you’re in Sandy, UT or anywhere in the Salt Lake Valley come see me.  We’ll get you back to enjoying your days as quickly as possible.

When an Old Injury Turns Into Chronic Pain

pain_cloudThe brain is constantly changing through a process called neuroplasticity. When you have an injury it sends signals of pain to the brain. Because of injury or pain you change the way you move. This can cause changes in the sensorimotor portions of the brain. These changes can persist beyond the initial injury repair and can disrupt sensorimotor re-integration (the healing process of the nerve patterns). This may explain why you may limp even after a leg injury has healed or why you have chronic pain from an old injury that healed years ago. Because of this process joint dysfunction/subluxations can contribute to the chronicity of injuries.

Medically these conditions are called allodynia or hyperalgesia. These are when the brain is reporting the wrong feedback to the body (pain with light touch, or tingling sensation when nothing is really going on). You see your brain has a sense that you may not be aware of. Beyond your touch, taste, smell, hearing and sight you have a sense is called proprioception. It’s the ability of your body to sense where any part of it is in space even without the other senses. This sense comes from all the afferent signals that your muscle spindle fibers, Golgi tendon organs, etc… send to the brain. Vertebral subluxation is a state of altered afferent input which can lead to maladaptive central plastic changes that over time can lead to further dysfunction. In other words interference in the path of communication is like playing that game telephone, and the signal that the body sends is not what the brain gets or visa versa. This interference does affect all communication that comes through the area. So, if you have a bad knee and a bad back the brain may not know how the knee is doing even after it has healed because the back problem interfered. Because these subluxations can contribute to these conditions fixing subluxations can also contribute to resolving them.

Chiropractic care improves the health and function of the spine, so that it can accurately perceive what is going on and respond appropriately which in turn helps clear up the communication between your brain, the body and the environment. When the communication lines are open for a long enough period of time then the chronic pain patterns have a chance to resolve.

Additional Research on the topic:

Is neuroplasticity in the central nervous system the missing link to our understanding of chronic musculoskeletal disorders?

Cervical spine manipulation alters sensorimotor integration

The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control.


Tylenol Linked to Developmental Problems When Used in Pregnancy

expectingPregnant women and their doctors are always wary of using medications during the pregnancy because of the effects that it may have on the baby. Well, another drug has been linked to problems. An Association of Acetaminophen Use During Pregnancy With Behavioral Problems in Childhood. Acetaminophen is the active ingredient in Tylenol. Tylenol has been thought to be safe to take during pregnancy for aches and pains.

While 60-80% of pregnant women will experience back pain due to their pregnancy you may be wondering what is left, should they just suffer through the pain of pregnancy. There are many things that pregnant women can do to avoid or reduce pain during pregnancy. Chiropractic has been found to be a “safe and effective means of treating common musculoskeletal symptoms that affect pregnant patients.

If you’re pregnant and suffering or watching a pregnant woman suffer through her pregnancy, reach out to your local chiropractor and see what her options are. She may be much happier as soon as tonight.

Posture Does Matter

I’ve discussed posture before. I like to talk about strong vs weak posture rather than good or bad posture because weak implies that you can do something about it, where bad implies something that has just happened to you. This video uses the terms good and bad posture, but it still explains things well.

PA10:ENG Posture from Haavik Research on Vimeo.

You don’t have to wait until you or your child is in pain to solve the problems. Come in and address your weak posture before it becomes painful.

What do Symptoms Mean?

Most people don’t go to their chiropractor until they have neck pain or headaches. Those are symptoms. Symptoms don’t happen on their own. There is always a cause. Finding and treating the cause it the way to improve your health. Here is a great video on the topic from Haavik Research.

PA4:ENG Symptoms from Haavik Research on Vimeo.


What is a Chiropractor?

A chiropractor is someone who has earned a doctorate of chiropractic degree. To understand what that means, click here. A chiropractor is a physician who practices the healing arts without the use of prescription drugs or surgery (in some jurisdictions chiropractors can perform minor surgery and even have some prescription privileges). What that means is that chiropractors use natural and physical methods to help your body to heal it’s self.

The primary tool used by chiropractors, and the one most identified with chiropractic is the adjustment, manipulation, popping, cracking, or what ever you want to call it. To learn more about chiropractic adjustments and what they do click here. Chiropractors also use changes in your diet, exercise, posture and physiotherapy modalities such as ultrasound, laser, decompression, heat, and electric stimulation to help your body to heal.

Practicing healing without medication means that you cannot go to a chiropractor to get your insulin for your diabetes. That doesn’t mean that a chiropractor can’t treat you for diabetes. Chiropractors can treat people with diabetes with diet, exercise, and counseling. While these tools that a chiropractor uses will not cure diabetes or even reverse it for everyone, the vast majority of people will notice improvement in their symptoms and some studies have shown 10% or more people are able to stop their medication and are no longer classified as diabetic. This does not mean that you should stop taking your insulin right now and see your chiropractor, but by seeing your chiropractor you may be able to go back to your medical doctor and have them take you off of your prescriptions. Even if you don’t get to stop your insulin altogether you will still see improvements in your health and weight and be able to live your life more fully.

Diabetes is just one example of a condition that your chiropractor can help you with. While most people come to a chiropractor with low back pain or headaches, you can see improvement in your health with your chiropractor’s help no matter what condition or state your health is in. Even professional athletes who are in peak physical condition are able to see improvements in their performance and resilience through chiropractic care.  

A chiropractor is a doctor who is focused on improving your health no matter where you are on the spectrum of health right now. We can always be better than we are today.