(c) Michael J. Summerville

Many people think of chiropractors as merely back doctors. In reality, the chiropractic profession is built on the belief that spinal alignment affects the health of the whole body. Therefore, your chiropractor might treat your spine in order to bring about a variety of health benefits, including back health.

According to the National Center for Complementary and Alternative Medicine, about 18 million adults and 2 million children go to a chiropractor. While it's true that most visits are for common back conditions and injuries, here's an example of the chiropractic view of health in an ongoing research effort:

Researchers at the University of Chicago gave a particular type of chiropractic called NUCCA to patients taking medicine for their high blood pressure. NUCCA chiropractic specializes in adjusting only the top of the neck. They found a significant decrease in the amount of medication the patients needed after the manipulation. More studies on this connection are expected.

Chiropractic is considered to be a CAM therapy and so it takes your whole being into consideration. Is it right for you?

Photo: Kameleon007

The thought of post-Halloween back pain may conjure images of taking the costumes back up to the attic or lugging heavy bags of candy. But let's not forget the extra weight you may be carrying from having eaten those Halloween treats! With the holidays approaching, be forewarned that back pain a very common problem for overweight people. Carrying extra pounds can increase your risk for developing several back disorders.

If you are a spine surgeon or a surgical nurse specializing in spine who likes to write, About.com has an opportunity for you! As an About.com Contributing Writer, you will work with me to cover the sub-topic of spinal procedures and surgeries. You'll be responsible for producing about 15 short articles per month, and you can also write more than the minimum, if you want.

If you are interested in applying or learning more, please email your RESUME and a WRITING SAMPLE -- both IN THE BODY OF AN EMAIL -- to contributingwriters@about.com. Put the "Back and Neck Pain" in the subject line of the email. Good luck!

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Are you pregnant with low back pain? One type of low back pain that's very common during childbearing is sacral pain. Experts think that when low back pain in this area begins during pregnancy, chances are you may be experiencing it long after your baby is born. About 10% of pregnant women with low back pain continue to experience disabling pain two years after delivery.

A new study, published in Spine found that a corticosteroid injection to the lowest part of the pelvis (called the ischial spine) relieved pain for 4 weeks in 36 women who had chronic pain that had begun while they were pregnant. The women made pain drawings and filled in visual analog scales to rate the intensity, frequency and location of their pain, and the researchers measured the differences in their marks before and after the injections. The women also had a clinical exam by both a physical therapist and a doctor.

_{Source:
Torstensson, T., MSc, RPT, Lingren, A., RPT, Kristiansson, P, MD, PhD. Corticosteroid Injection Treatment to the Ischiadic Spine Reduced Pain in Women with Long-Lasting Sacral Low Back Pain with Onset During Pregnancy. Spine. 2009.}

| Sacrum | Back Pain | Visual Analog Scale - VAS |

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A new data study shows that the rate of cervical spine fusions in elderly Medicare patients rose a whopping 206% between 1992 and 2005. Over 156,000 hospital records were reviewed for demographic information.

A cervical spine fusion is a surgery that unites two adjacent spinal bones by taking out the disc material. Sometimes a bone graft is used (as well as instrumentation) in order to accomplish what doctors call a "union" between the vertebrae in question.

Interestingly, the rate of increase for the neck operations was not the same across the nation. In Idaho, there were lots of surgeries: 14% to be exact. Contrast that with Washington, DC, where the rate was .004%. The researchers also found that the condition most often warranting the surgery was cervical spondylosis with myelopathy, which is a degenerative condition that affects the spinal cord. Fifty-two percent of those who got the fusion surgery were men, 88% were white and 41% were between the ages 65 and 69.

Another study done by the same researchers found that there was a significant risk of death for elderly people who had the surgery for cervical spondylosis with myleopathy. See a short video on spinal fusion.

| Cervical Spine Fusion | Back Pain | Bone Graft |

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If you subscribe to the Back and Neck Pain newsletter you may be aware of The Daily Spine, a special feature (at the bottom) that considers the routine challenges presented or made more difficult by back pain. The Daily Spine articles provide tips for better living despite the ache in your back or neck. Here are a few samples:

• You Don't Have to Throw Your Back Out!
• Morning Stretches for Your Spine
• Aspirin for Back Pain?

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Recently, a study broke new ground in the body of knowledge around spinal cord injury rehabilitation. Previously scientists had been able to elicit limb movement in spinal cord injured people, but the movement did not involve weight bearing. This new study tested a combination of treatments that enabled paralyzed rats to use the treadmill in a nearly normal way. Study investigators say this discovery will have implications for people with spinal cord injuries.

The rats' treatments consisted of drugs, electrical stimulation and exercise. The rats were able to do a stepping like motion controlled by nerve activity (called circuits) that do not involve the use of the brain. If treatments are developed based on these findings, it could mean that regenerating nerves in the spinal cord is not necessary for patients to regain a lot of lost functionality.

_Sources:

1. Grégoire Courtine, Yury Gerasimenko, Rubia van den Brand, Aileen Yew, Pavel Musienko, Hui Zhong, Bingbing Song, Yan Ao, Ronaldo M Ichiyama, Igor Lavrov, Roland R Roy, Michael V Sofroniew & V Reggie Edgerton. Transformation of nonfunctional spinal circuits into functional states after the loss of brain input. Nature Neuroscience, 2009; DOI: 10.1038/nn.2401

2. University of California - Los Angeles (2009, September 21). Scientists Make Paralyzed Rats Walk Again After Spinal-cord Injury. ScienceDaily. Retrieved September 22, 2009, from http://www.sciencedaily.com­ /releases/2009/09/090920204455.htm

| Complete SCI | Incomplete SCI | Newly Diagnosed SCI-For Friends and Family | Exercising with Spinal Cord Injury |

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While you may see a lot of bickering on the news reports about health care reform, there is some bipartisan work going on that could benefit people living with chronic pain, provided the bill passes. In June the National Pain Care Act of 2009, introduced by Sens. Chris Dodd (D-CT) and Orin Hatch (R-UT), and supported by the American Pain Foundation, was unanimously adopted by the Committee on Health, Education, Labor, and Pensions as one of the amendments to the healthcare reform bill.

What's sad, though, is that while Republicans have spent much time working up about 160 amendments to be included in health care reform for America, according to most news reports at least, more likely than not, none of them are planning on voting for it, no matter what. You may remember Sen. Chuck Grassley (R-IA) from the Finance committee stating flat out that he just would not vote for a health care reform bill - even though he is a key author on the bill they plan to unveil this week. But I digress.

In the House the bill was H.R. 756; in the Senate it's S. 660. I blogged about it when the Pain Care Act was passed by the House, back in March.

Standing up for your rights is tough when you have pain because it's so isolating and draining. But September is Pain Awareness Month and there is strength in numbers, so let's look at a few ways you might be able to advocate for yourself and others while we wait for the Pain Care Act to (hopefully) become law. The American Pain Foundation has ideas:

• Raise Awareness
• Sign a Petition
• Find a Local Event


AND

• Learn More About Chronic Pain at About.com's Pain Site

| House Passes National Pain Care Act 2009 | Back Pain | Pain Management |

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For people who feel that health reform is going to be too expensive, another couple of billion just got added to the federal budget. Every little bit helps.

On September 2, pharma giant Pfizer issued a press release detailing a settlement with the Department of Justice for the marketing strategies they used for selling Bextra and a number of other drugs off-label without the FDA's approval. Bextra was a cox-2 inhibitor (type of NSAID) used for pain management, including back pain. Pfizer voluntarily took Bextra off the market in 2005 after it became evident that the drug's side effects included serious and even fatal cardiovascular problems. As mentioned above, the Pfizer-DOJ agreement was not limited to Bextra. Lyrica, a painkiller used for fibromyalgia and about 9 other drugs had been marketed inappropriately to the public.

| Vioxx Timeline | Back Pain | NSAIDs and Back Pain |

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Did you see the tributes to Senator Kennedy this past weekend? Boy, he and his family had their share of health issues! It was a serious back injury with subsequent chronic pain that would plague him for the rest of his life that provided the catalyst for his efforts to secure affordable health care for all Americans.

In 1964, Senator Kennedy was in a plane crash while on his way to a state convention. He sustained very serious injuries - a "broken back", some broken ribs and a collapsed lung. His broken back consisted of several crushed vertebrae, or spinal fractures. (By the way, his brother President John F. Kennedy had spinal fusion in 1954, when he was a senator. During his recovery, he took time off from the Senate and worked on Profiles in Courage.)

Ted Kennedy's treatment consisted of laying immobile on a special contraption designed to minimize pressure sores. Remember, this was 1964. Today, he would have likely had either a vertebroplasty or kyphoplasty. According to Newsweek, the six months Senator Kennedy was immobile was a fertile time during which he became really serious about his role as a legislator. His extended stay in the hospital also allowed him to reflect on how health care is available for those who can afford it, but not the poor. But what if someone of lesser means had the same injury? How would their treatment go? According to Masslive.com:

"I knew the care was expensive, but I didn't have to worry about that," Kennedy wrote. "But quality care shouldn't depend on your financial resources, or the type of job you have, or the medical condition you face. Every American should be able to get the same treatment that U.S. senators are entitled to."

Hmm, where have I heard that recently? We will soon see if the Senator's life's work and dream will reach fruition. I certainly hope so.

| Vertebroplasty | Back Pain | Spinal Fracture |

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