Wednesday, November 10, 2010

5 simple ways to help your child avoid backpack related injuries. Banic Chiropractic Clinic

In a recent study, 84% of children reported discomfort and pain in the shoulders, lower back, upper back and neck from using a backpack. Injuries and bad habits from childhood can set one up for a lifetime of back pain. Here are 5 simple ways to help your child avoid backpack related injuries.

1. Buy the smallest pack that will fit the items to be carried and the child.

2. Backpacks should carry no more than 15% of the child’s body weight. For the average child, in the 40 to 100 lb. weight range, that is only 6 to 15 lbs. of load. A single text book weighs 4lbs.

3. The weight should be as close to the body as possible, stack the heavier items to the inside.

4. The backpack MUST be worn over both shoulders; cinch up the straps so the pack rests in the curve of the lower back, and use a waist belt if possible.

5. Putting the backpack on and taking it off are when most injuries occur. It is these same motions of lifting while bending and twisting that frequently injure adults. It is important to create healthy lifting habits while young.

a) The child should keep the pack as close to the body as possible when taking it on and off.

b) When lifting the pack, squat down and lift with the legs while keeping the back straight.

c) Putting in one shoulder while the pack is on the floor and then lifting and twisting the body simultaneously is a recipe for pain.

d) Dropping the pack back off both shoulders while arching the back is similarly risky.

Following these simple preventative strategies should help to keep your child on the path of wellness.

Wednesday, November 3, 2010

Chiropractic adjustments are healthy for kids. Watch Video

To read content regarding the benefits of chiropractic adjustments for children, search this blog with the term Kids, or visit

Wednesday, October 20, 2010

Celebrities caught with bad posture - if chronic it will be much worse than a bad picture - pain and dysfunction will result.

Forward head posture - related to headaches, neck pain, shoulder pain, carpal tunnel, respiratory weakness and bad pictures.

11 Tips to picking your perfect mattress - Banic Chiropractic Clinic Issaquah, WA

1. Newer mattresses perform better no matter what the category. Multiple studies have indicated that some 70% of individuals who have replaced their mattress for any reason find that a newer mattress is better. This does not depend on mattress type or cost.

2. Body-conforming foam, air and water were rated best. In studies that did compare mattress types, the foam mattress (Tempur), air mattress, latex mattress, or water mattress usually prevailed over spring-type or cotton mattresses in reducing pain and improving sleep and function.

3. Firm is not better. Though I have heard multiple health-care professionals recommend firm beds, studies indicate on a scale from 1(hard) to 10(soft), patients with medium-firm mattresses (5.6) had less daytime low-back pain, pain while lying in bed, and pain on rising than did patients with firm mattresses (2.3).

4. Cheap beds are related to low back pain. In a comparison that discussed bed cost, subjects recorded back and shoulder pain, sleep quality, and comfort after a month in their own beds and then in new medium-firm bedding systems. The new beds improved all areas of measure. The study found that low back pain was significantly more prominent in those sleeping on the cheapest category of new beds.

5. Test the mattress in your recommended sleep position. There are a myriad of health conditions related to sleep position, and in most of these, lying on the back is the least preferred position. In fact, in a recent study of positional sleep apnea, which makes up 53.8% of all sleep apneas, they found that sleeping on the side instead of the back could reduce waking incidents as much as a prescription CPAP machine. Most other studies on individuals with medical conditions recommend side sleeping for improved health, unless shoulder problems are prevalent. There are no recommendations for healthy asymptomatic individuals to change their preferred sleep position.

6. Apparently no flip mattresses just result in half the life to the mattress. Similarly, pillowtops are very controversial. They are blamed for early indents and lumpiness on multiple mattress types. Websites suggest getting a mattress that can be flipped, with the level of softness you find comfortable and add accessories such as a washable or memory foam mattress topper later if preferred.

7. If you weigh more, expect to spend more to get a mattress that is known for durability. Of the body-conforming type mattresses, latex is described as the most durable, but it is the most expensive. Of the spring-type, you will have to investigate not only the number of coils but also the gauge of the wire thickness that is used.

8. Your attitude is important. In an interesting hotel study, surveys were used to assess sleep quality. Guests were randomly assigned to the old bed or new mattresses of three different qualities and prices. All three of the new beds were favored to the old. The individuals most negatively affected by the old mattress were those traveling for professional reasons and those with chronic low back pain or sleep disturbances.

9. Accessories can make a difference. In the management of waking cervical pain, and to improve sleep quality and pillow comfort in the side sleeping position, rubber pillows performed better than subjects' own pillow in most instances. Subjects' own pillow performed similarly to foam and polyester pillows, and there is no evidence that the use of a foam contour pillow has advantages over the regular shaped pillows in the side-lying position. Feather pillows should not be recommended. Side sleepers will also benefit greatly from placing a pillow between the knees to reduce hip strain. Specialized pillows are made for this purpose. Back sleepers may benefit from the support of a contour pillow and may also find placing a pillow behind the knees to be comfortable.

10. Sleep trials are the only recommended way to buy a mattress. The stores are accustomed to customers spending a great deal of time on the beds to test this major investment. Visit the store, bring your sleep accessories, lie in your preferred sleep position, and take a nap. Then, pay attention to how you feel when you get up.

11. Get a great deal - According to Consumer Reports, haggling for a mattress is common and buying mattress at half off the sticker price is not unheard of. Visit consumer reports for further recommendations, or buy from one of their top-rated stores, right here in Issaquah, COSTCO.

Spine (Phila Pa 1976). 2008 Apr 1;33(7):703-8. Better backs by better beds? Bergholdt K, Fabricius RN, Bendix T.
Appl Ergon. 2008 Mar;39(2):247-54. Epub 2007 Jun 26. Grouped comparisons of sleep quality for new and personal bedding systems. Jacobson BH, Wallace TJ, Smith DB, Kolb T.
Schmerz. 1999 Jun 11;13(3):205-7. Associations between back pain, quality of sleep and quality of mattresses. Double-blind pilot study with hotel guests. Enck P, Walten T, Traue HC.
Lancet. 2003 Nov 15;362(9396):1599-604. Effect of firmness of mattress on chronic non-specific low-back pain: randomised, double-blind, controlled, multicentre trial. Kovacs FM, Abraira V, Peña A, Martín-Rodríguez JG, Sánchez-Vera M, Ferrer E, Ruano D, Guillén P, Gestoso M, Muriel A, Zamora J, Gil del Real MT, Mufraggi N.
Ergonomics. 2002 Sep 15;45(11):798-815. Physiologic responses during rest on a sleep system at varied degrees of firmness in a normal population. Lahm R, Iaizzo PA.
J Shoulder Elbow Surg. 2010 Oct;19(7):989-93. Epub 2010 Jul 24. Subacromial pressures vary with simulated sleep positions. Werner CM, Ossendorf C, Meyer DC, Blumenthal S, Gerber C.
Man Ther. 2009 Dec;14(6):671-8. Epub 2009 May 7.Pillow use: the behaviour of cervical pain, sleep quality and pillow comfort in side sleepers. Gordon SJ, Grimmer-Somers K, Trott P.
Swiss Med Wkly. 2004 Sep 18;134(37-38):543-51. The role of body position and gravity in the symptoms and treatment of various medical diseases. Martin-Du Pan RC, Benoit R, Girardier L.
Harefuah. 2009 May;148(5):304-9, 351, 350. The significance of body posture on breathing abnormalities during sleep: data analysis of 2077 obstructive sleep apnea patients] Oksenberg A, Arons E, Greenberg-Dotan S, Nasser K, Radwan H.
J Clin Sleep Med. 2010 Jun 15;6(3):238-43.Comparison of positional therapy to CPAP in patients with positional obstructive sleep apnea. Permut I, Diaz-Abad M, Chatila W, Crocetti J, Gaughan JP, D'Alonzo GE, Krachman SL.

Headaches, neck pain, shoulder pain, carpal tunnel, breathing dysfunction - 6 reasons to reduce forward head posture NOW!

The weight of the average head is 12 pounds. Every inch the head shifts forward, the work of the neck muscles is increased by an additional 12 pounds.* This shift away from normal posture causes muscles to work much harder, zaps your energy, and leads to;

Headaches – Increase in magnitude of head forward posture results in;
Increase in headache frequency
Decrease in neck range of motion
Decrease in neck muscle strength and endurance

Carpal Tunnel – Increase in magnitude of head forward posture causes;
Increase in carpal tunnel symptoms of pain, numbness, and dysfunction
Altered nerve dynamics in response to moving other joints
Decreased function in nerves that supply the arm and hand

Shoulder Pain – Increased forward head posture, and rolled forward shoulders
Decrease in shoulder and neck range of motion
Caused local changes to blood supply
Increase risk of shoulder and arm pain

Respiratory Function – Increase in magnitude of forward head posture is correlated to;
Decreased respiratory muscle strength
Decreased maximal voluntary ventilation

Neck Pain – Increase in magnitude of forward head posture is correlated to;
Increased chronic neck pain
Increased disability from neck pain


(Kapundji, Physiology of Joints; Vol. 3)

Prevention is KNOWING when you have a risk factor for disease and CORRECTING where you deviate from normal. Are you at risk for pain?

Preventative health is about managing your risk factors; all the ways you deviate from normal measures. Normal posture is the upright posture that requires the least energy to maintain. Even small shifts away from normal significantly increase the work your muscles must do as you go through your normal activities of living. Over your lifetime, this weakens the body and leads to disease.
The image above represents where the centers of body mass vertically align with gravity, note where the red line intersects the body. Deviation from normal can occur by bending to the sides or shifting forward or back. 9 steps to observing posture:

1. Have the subject close their eyes, nod the head up and down, and march in place.

2. Have the subject stop with their eyes closed, feet facing forward, as if looking to the horizon.

3. Observe the head from the front – is the face turned to the right or left?
-are the eyes level or is the head tilted toward the shoulder?
-is the chin over the center of the chest where the clavicles meet?

4. Observe the chest from the front – are the shoulders / chest turned to the right or left?
-is one shoulder higher than the other?
-is the upper body centered over the pelvis or is it shifted off of center?

5. Observe the hips from the front or back – are the hips twisted away from where the feet point?
-are the hips shifted, with more weight over one of the feet?
-does one leg look shorter? (this can only be determined by X-ray)

6. Observe the head from the side – is the ear in front of the shoulder? How far?

7. Observe the upper back from the side – is it humped? Are the shoulders rolled forward?
-is the upper body shifted forward as if more weight is on the toes?
-is the upper body shifted back in the classic teenager slump?

8. Observe the hips from the side – are they shifted forward or back over the feet?

9. Repeat steps above – Study after study, have demonstrated that an individual’s neutral resting posture is unique, repeatable, and reveals risk factors for disease.

What is wellness? Using simple proven methods to improve your health over a lifetime, and looking great is the bonus.

There are many many reasons to work to maintain great posture over your lifetime. Though a dramatic improvement in your long-term health is compelling, for many people thier motivation is looking younger and more attractive.

Tuesday, July 27, 2010

"Common" low back pain procedure is anything but. NPR

This article is striking in that it describes what should be a totally uncommon procedure. They are basically recommending that with chronic back pain of HOW LONG duration I would wonder, they can just zap the nerves with a little radio frequency and zap you are better. They are talking about obliterating the nerves which are required to send signals to your brain that problems are occurring in the body. Your brain uses this information to fine tune motion and in many other ways. In addition, muscles around the spine can become atrophied with this procedure further reducing motion control thus increasing odds of injury. And also, damage in the sensory dorsal root ganglia can cause repetitive random firing in end organs and tissues those nerves supply. As always, I will say again, please try conservative chiropractic treatment before undergoing any surgical or permanent invasive procedure.

Monday, May 31, 2010

WebMD reports: Exercise May Buffer Effects of Stress - Banic Chiropractic Blog

Exercise May Buffer Effects of Stress

[So another study that details exactly how little exercise is required to achieve a high level of function and health. Even the most reluctant exerciser should be able to manage 75 to 150 minutes a week. I'm doing it with two young kids, join me at Bally's 9:30am M,W,F without fail!]

In the study, 63 healthy older women were divided into an inactive group and an active group, based on their exercise levels over a three-day period. Many of the women were highly stressed caregivers for spouses or parents with dementia. The women in the inactive group who reported high stress levels had shorter telomeres; the active women in the high-stress group did not have shorter telomeres.

“People know stress is bad for the heart and makes you look tired and haggard and makes us more vulnerable to infections,” Puterman says. “And there is so much accumulating evidence that links stress to health, so to show that there is something we can do when we are stressed that can delay or buffer the impact is exciting.”

As far as a stress-busting exercise prescription goes, Puterman says that the CDC recommendation of 75 minutes of vigorous activity or 150 minutes of moderate activity, plus weight-bearing exercise every week for adults, will suffice.

“That is a great prescription in my mind,” he says.

Tuesday, May 25, 2010

Herbal Supplements Often Have Contaminants, Study finds

Herbal Supplements Often Have Contaminants, Study finds

[Because our general patient demographic is the health and wellness crowd, people are often surprised that as chiropractors, we do not sell vitamins and supplements at Banic Chiropractic Clinic. There are just so many issues similar to that described below with anything you eat or drink. I am even afraid of Italian olive oil after recent stories about toxic waste dumping by mafia in the Italian countryside (Trader Joes has great, cheap olive oil from California). I guess I am posting this as a warning and I can not currently make recommendations regarding which supplements are the best quality. I have to take the time to figure it out soon, as my 2 and 5 year olds take multi's and gummy omega 3.]

Half of the nation’s adult population takes vitamin supplements regularly, and about a quarter take herbal supplements at least occasionally. Annual sales are about $25 billion a year, and the growing popularity has led to an increasing number of imported supplements spiked with illegal drugs.

In 1994, Congress passed legislation that allowed supplement makers to sell products without first getting approval from the F.D.A. for their ingredients or for basic health claims. But scientific organizations have warned repeatedly since then that the F.D.A. should do more to ensure that the supplements are safe and that their health claims are substantiated.

In recent years, a vast majority of supplement suppliers have located overseas — principally in China. Nearly all of the vitamin C and many other supplements consumed in the United States are made from ingredients made in Chinese plants. Those plants are almost never inspected by the F.D.A. because the agency is not required to do so, has little money to do so and does not view the plants as particularly risky.

[There will soon be a hearing regarding greater FDA oversight of vitamin and supplement manufacture.]
Among the witnesses at the hearing will be Dr. Tod Cooperman, president of ConsumerLab .com, a company that has tested over 2,000 dietary supplements made by more than 300 manufacturers and has found that one in four have quality problems. According to Dr. Cooperman’s written testimony, the most common problems are supplements that lack adequate quantities of the indicated ingredients and those contaminated with heavy metals.

Sunday, May 9, 2010

TMJ Temporomandibular joint treatment with chiropractic manipulation and, yes, now even the dentists are trying it.

[While these first two abstracts did not surprise me, chiropractors have described great success in using jaw manipulation to re-align the temporomandibular joint, improve mouth opening and reduce pain. The third abstract, from 2008, was very interesting. In this study, dentists use jaw manipulation to restore pain free function in an individual suffering from TMJ disorder for three years. Gentle jaw manipulation is a safe and effective procedure to improve some types of TMJ dysfunction. At Banic Chiropractic Clinic, we even have massage therapists trained in intra-oral massage for the relief of TMJ pain.]

J Manipulative Physiol Ther. 1995 Sep;18(7):476-81.

The dental-chiropractic cotreatment of structural disorders of the jaw and temporomandibular joint dysfunction.
Chinappi AS Jr, Getzoff H.

OBJECTIVE: To present a case demonstrating the concept of integrated dental-orthopedic and craniochiropractic care for treating structural disorders of the jaw, neck and spine. CLINICAL FEATURES: A 33-yr-old woman sought orthodontic therapy for an overbite and severe crowding of the lower teeth. She reported a history of bilateral headaches and jaw popping. Orthodontic examination revealed degenerative changes in the right temporomandibular joint and restricted jaw opening. While in treatment, the patient began to experience severe temporomandibular joint pain and neck/lower back pain, which convinced her to accept chiropractic care. Initial chiropractic sacro-occipital technique (SOT) evaluation found Category II weight-bearing instability of the sacroiliac joint, specific thoracic and cervical vertebral subluxations, cranial sutural restrictions and temporomandibular dysfunction. Cervical X-rays revealed absence of the anterior cervical curve, characterized by parallel vertebral base lines. INTERVENTION AND OUTCOME: In addition to orthodontic treatment, the patient also received semiweekly (then bimonthly) adjustments of the spine, neck and cranial sutures. The cotreatment approach eliminated pain while improving head, jaw and tooth position. CONCLUSION: The position of the jaw and head and neck are intricately linked. The acute symptoms experienced during the initial dental treatment phase were caused by the inability of the head and neck to adapt to maxillary and mandibular changes. Chiropractic treatments enabled the body to respond positively to the dental changes. As the mandibular position improved, further improvements were indicated by physical testing and X-rays.

J Manipulative Physiol Ther. 1995 Feb;18(2):98-104.

Chiropractic manipulation of anteriorly displaced temporomandibular disc with adhesion.
Saghafi D, Curl DD.

Pacific Coast Faculty Resource Group, Whittier, CA 90609, USA.

OBJECTIVE: This AB, single-subject case study was conducted to investigate the capability of chiropractic manipulation of the temporomandibular joint (TMJ) in treating unilateral anterior displacement of the articular disc with adhesion to the articular eminence. A specific joint manipulation was designed to reduce the anteriorly displaced and adhered TMJ disc. CLINICAL FEATURES: A 21-yr-old woman suffered from a four year history of right-sided temporomandibular joint pain and clicking, with limitation of mandibular opening. The patient reported previous unsuccessful treatments for her condition. An exhaustive history, a complete review of systems and a physical examination (including, but not limited to, eyes, ears, nose, throat and motor, sensory and reflex neurological tests) were obtained. Relevant or contributory findings are extracted for this article. A clinical diagnosis of left-sided anteriorly displaced TMJ disc with adhesion to the articular eminence was made. INTERVENTION AND OUTCOME: Patient's pain level, presence of joint clicking upon mandibular opening and the amount of mandibular opening were used as outcome measures for capability of treatments. An AB, single-subject study was used where A was the baseline period and B the therapeutic intervention period. The patient was treated twice a week for a total of 19 visits. During the baseline period no treatment was given to the TMJ (3 visits) where the patient received cervical manipulation alone. During the experimental period the patient received both cervical spine manipulation and a specific manipulation to the left mandible. There were no physical therapeutic modalities applied to the jaw. The specific TMJ manipulation used requires a very low-amplitude high velocity thrust parallel to the slope of the articular eminence. The results of this study show mandibular opening distance was returned to normal in addition to the abolition of the patient's TMJ pain and clicking. During the three baseline visits mandibular opening showed no significant change, with an average of 25.3 mm (range 25-26 mm). There was also no change in the patient's TMJ pain or clicking during this baseline period. The patient's TMJ clicking was absent following the third treatment and the patient reported significant subjective pain relief as well. Temporomandibular pain was again reported during the fifth, sixth and seventh post-treatment visits due to exacerbations caused by daily activities. There was no pain reported from the beginning of the eighth post-treatment visit to the end of the study. CONCLUSION: The findings of this study show this specific manipulation of the TMJ may be appropriate for the conservative treatment of adhered anteriorly dislocated disc.

PMID: 7790790 [PubMed - indexed for MEDLINE]

J Appl Oral Sci. 2009 Aug;17(4):350-3.

Joint disorder: nonreducing disc displacement with mouth opening limitation - report of a case.
Corrêa HC, Freitas AC, Da Silva AL, Coêlho TK, Castillo DB, Vinholi GH.

Department of Restorative Dentistry and Prosthodontics, Dental School, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil.

The internal derangement of the temporomandibular joint (TMJ) represents 8% of all cases of temporomandibular disorders (TMD) posing difficulties to establish an accurate diagnosis and treatment because of its low prevalence. This article presents the case of an 18-year-old Caucasian female patient who came to our Orofacial Pain and TMD Outpatient Service with complaints of intense pain on the right TMJ and limitation of mouth opening (maximum interincisal opening of 29 mm) with deviation to right, which she had been experiencing for the past 3 years. After a detailed clinical interview, a diagnosis hypothesis of nonreducing disc displacement with mouth opening limitation was established. The proposed treatment consisted of intra-joint infiltration with anesthetic in the right TMJ followed by jaw manipulation to recapture the articular disc, which was impeding the complete translation movement of the affected TMJ. After jaw manipulation, a new evaluation was done and showed the re-establishment of jaw dynamics with mouth opening and closing without deviation to the right side, clicking, opening limitation or pain. The patient was followed up at 6 months intervals. Two years after treatment, the patient was reevaluated and her mandibular range of motion without aid increased to 54 mm with no clicking, deviation to right, trismus or pain on the TMJ, indicating success of the treatment approach without recurrence of the pathology.

PMID: 19668996 [PubMed - indexed for MEDLINE]Free Article

Tuesday, May 4, 2010

Spinal Manipulation / Chiropractic cures Irritable Bowel Syndrome PubMed MedLine

Fibromyalgia Gets Worse During Menstruation
Symptoms of irritable bowel syndrome (IBS), fibromyalgia, and a painful bladder condition called interstitial cystitis (IC) seem to get worse in some women right before and during menstruation, researchers report.

[I took note of this study because the researchers describe a relationship between three syndromes characterized by pain of unknown orgins. All three syndromes can be related to a hypersensitivity to stimulus that develops in sensor nerves that tell the brain what is happening in the body. When the brain gets this misinformation from these faulty sensors it can then lead to a reaction that causes disease. Spinal manipulation has been shown to be beneficial in all these conditions with this recent study from a hospital in China providing the most exciting news of all. That chiropractic can cure Irritable Bowel Syndrome.]

Relationship between irritable bowel syndrome and unstable thoracolumbar vertebrae
Article in Chinese
Qu LX.
The Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, Jiangsu, China.
OBJECTIVE: To explore the cause and mechanism of irritable bowel syndrome, and to study the relationship between irritable bowel syndrome and unstable thoracolumbar vertebrae. METHODS: From 2004 to 2006, 82 patients with irritable bowel syndrome were treated with manipulation thoracolumbar vertebrae without any drug using. Among the patients, 24 patients were male and 58 patients were female, ranging in age from 15 to more than 61 years. RESULTS: After the treatment, 75 patients were cured and 7 patients improved. CONCLUSION: Unstable thoracolumbar vertebrae is the cause of irritable bowel syndrome. It is a simple and effective way by manipulation on thoracolumbar vertebrae to release compression and stimulation on peripheral nerve and vascular for treating this disease.
PMID: 19594048 [PubMed - indexed for MEDLINE]

J Manipulative Physiol Ther. 1990 Sep;13(7):406-11.

Mechanically induced pelvic pain and organic dysfunction in a patient without low back pain.
Browning JE.

Previous reports have identified mechanical disorders of the lumbar spine as a cause of pelvic pain and organic dysfunction (PPOD) in patients with low back pain. Less common however, are reports of mechanically induced pelvic pain and organic dysfunction in patients without accompanying low back pain. This report details the examination findings and treatment response of a patient with pelvic pain, organic dysfunction and clinical evidence of lower sacral nerve root compression (LSNRC) in whom low back pain was not an accompanying finding. Despite the absence of low back pain however, clinical evaluation revealed the characteristic findings of mechanically induced pelvic pain and organic dysfunction secondary to lower sacral nerve root irritation or compression as a result of a mechanical disorder of the low back. As in long standing cases of mechanically induced pelvic pain and organic dysfunction in which low back pain is present, this case also exhibited severe and widespread involvement of the pelvic organs. In spite of numerous failed attempts at treatment directed at the symptomatic component of the patients disorder, complete resolution of symptoms was achieved by manipulative treatment directed at the mechanical disorder of the lumbar spine.

PMID: 2212886 [PubMed - indexed for MEDLINE]

Thursday, April 29, 2010

WebMD What a Bad Lifestyle Does to Your Life Span. Practice prevention.

What a Bad Lifestyle Does to Your Life Span

[Here is the article in its entirety. Think of what you could do with 12 more healthy years of life.]

What a Bad Lifestyle Does to Your Life Span
Smoking, Drinking, Poor Diet, and Lack of Exercise Combined Greatly Increase Risk for Early Death
By Katrina Woznicki
WebMD Health NewsReviewed by Elizabeth Klodas, MD, FACCApril 26, 2010 -- People who smoke, don’t exercise, eat poorly, and drink alcohol are three times more likely to die from cardiovascular disease and nearly four times more likely to die of cancer, a new study finds.

Such people also have an overall premature death risk equivalent to being 12 years older, when compared with people who do not engage in these four behaviors, according to the study, reported in the April 26 issue of Archives of Internal Medicine.

Many studies have examined the individual effects of smoking, physical inactivity, poor diet, and drinking alcohol, and have established that they are independently associated with poorer health. However, few studies have examined the combined influence of these behaviors. This is important because people often engage in multiple poor lifestyle choices that could shorten their life span.

“To fully understand the public health impact of these behaviors, it is necessary to examine both their individual and combined impact on health outcomes,” Elisabeth Kvaavik, PhD, of the University of Oslo in Norway and her colleagues write in the study.

The researchers interviewed 4,886 randomly selected people aged 18 or older in 1984 to 1985 who lived in the United Kingdom. A health behavior score was calculated by giving one point for each unhealthy behavior: smoking; eating fruits and vegetables less than three times a day; exercising less than two hours a week; and drinking more than 14 units of alcohol per week for women, and more than 21 units per week for men.

The average age of the participants was 43.7 years at study entry, and the group was split about equally between men and women. The participants were then tracked for the next two decades. Over the course of 20 years, 1,080 participants died -- 431 from cardiovascular disease, 318 from cancer, and 331 from other causes. The researchers found that compared with participants who did not have any unhealthy behaviors, the risk of death from all causes as well as from each cause increased substantially with each additional unhealthy behavior.

When looking at the behaviors individually, the study also showed that smoking was more strongly associated to cancer and other deaths, whereas physical inactivity was more strongly associated with death from cardiovascular disease.

“Modest but achievable adjustments to lifestyle behaviors are likely to have a considerable impact at both the individual and population level,” the researchers conclude.

Wednesday, April 28, 2010

Patient Money - Caring for Hips and Knees to Avoid Artificial Joints -

Patient Money - Caring for Hips and Knees to Avoid Artificial Joints -

Although the human body has an amazing capacity to repair itself, our joints are surprisingly fragile.

When the cartilage that cushions bones wears away, it does not grow back. Thinning cartilage contributes to osteoarthritis, also known as degenerative arthritis, a painful and often debilitating condition.

Over time, arthritic joints can become so sore and inflamed that they need to be replaced with mechanical substitutes. A result: more pain, at least in the short term, and big medical bills.

Fortunately, you can act to protect your joints now, to reduce your chances of needing to replace them later.

And protect you should. The cost for a new hip or knee — the joints most commonly replaced — is $30,000 to $40,000. If you have insurance, your total out-of-pocket costs will be much less, but may still be $3,000 to $4,000. And don’t forget to factor in all those days of work you will miss before you get your new prosthetic.

Creaky joints are a growing national problem. The population is getting older, more people are overweight, and an increasing number of children and young adults are playing serious sports and getting seriously injured — all factors that contribute to osteoarthritis.

[This article contains great advice that we have discussed before. To avoid all joints aging before their time; lose weight, get fit, and use your body appropriately. This means low impact SYMMETRICAL use of your joints. Recent studies, discussed in previous blogs, have demonstrated that a short leg or poor posture can cause increased stress on one side of your body, wearing down the joints and leading to early aging and degeneration. This is true for the joints of the back just as the knees and the hips. And back pain or neck pain can be just as debilitating and neck surgery or back surgery much, much more expensive, with much higher side effects and danger than hip or knee replacements.]

Saturday, April 24, 2010

May is National Correct Posture Month: Did You See Your Chiropractor Today?

May is National Correct Posture Month: Did You Do Your Posture Exercise Today?

[This is a great article on the importance of posture in maintaining health. I particularly like that they emphasize that even doing good things, like vigorous exercise, with a poor posture results in uneven and accelerated wear on your body over time. Unfortunately, the exercises recommended in the article would be minimally effective at best in creating sustained postural improvement. In reality and according to multiple studies, chronic abnormal postures result in contracted ligaments and soft tissues and often abnormal bone growth. Correcting this condition is more like putting braces on your teeth. It requires sustained force over time. It is possible though, and its worth it.]

It is known that spinal function is directly related to spinal structure, as has been proven for the cervical and lumbar spinal regions.80–84 With mal-alignment in neutral posture, static and especially dynamic function from this mal-alignment dictates altered stress/strain relationships of associated spinal structures, including the bones,85–87 intervertebral discs,88–91 facet joints,92 musculotendinous tissues,93 ligamentous tissues,94 and neural elements.95–100Postural alterations are known to be associated with a plethora of human afflictions from general pain syndromes,101–109 to problems with specific joints such as the hip110–111 and the knee,112 to problems with specific spinal regions such as the flat-back syndrome,113 and cervical kyphosis,109 to local organ ailments such as uterine prolapse,114–115 gastric herniation,116 and respiratory function,117–119 to thinking,118,120 and even to morbidity and mortality.121–125 Improved posture alignment has been one of the most sought-after goals in the treatment of human ailments for ages; this continues today in all medical arenas, such as dentistry, physiotherapy, physiatry, surgery, and chiropractic.126–134Since traditional SMT has not been found to be associated with routine improvement in spinal alignment, its therapeutic effects are thought to be in reducing pain and facilitating increased spinal motion.135 Of interest, however, many monotherapies, have been found to have either limited effectiveness or complete lack of success in treating chronic low back pain. Bogduk136 has discussed that these monotherapies include analgesics, NSAIDs, muscle relaxants, antidepressants, physiotherapy, surgery, and manipulative therapy. In contrast, Gross et al.137 have reported that the multi-modal care of exercise combined with cervical manipulation provides better results than either procedure used alone. The criticism of monotherapies is taken into consideration by CBP® technique as it uses a multi-modality care regimen of SMT as well as mirror image® exercises, mirror image® adjusting and mirror image®/extension spinal traction procedures, other stretching procedures, and ergonomic counseling.

Wednesday, April 21, 2010

Prioritizing low-cost, simple health measures would save 2.5 million child lives a year - Science Daily

Prioritizing low-cost, simple health measures would save 2.5 million child lives a year

[Sorry for including this article as it has nothing to do with chiropractic, but, it is really inspiring. Researchers have determined that very low cost interventions could prevent up to 1/3 of child deaths. As a fan of World Vision and the sponsor of World Vision children, I was excited to hear about their newest initiatives, discussed in the article.]

ScienceDaily (Nov. 16, 2009) — Almost a third of the children under age five who die each year could be saved if governments rebalance health spending to ensure low-cost, simple interventions such as safe water and hygiene, bed nets and basic maternal and newborn care, aid agency World Vision said. Currently, 8.8 million children a year die before age five, most of preventable causes.....

Monday, April 19, 2010

More Kids Falling Prey to Sports Overuse Injuries - Chiropractic care cuts sport injuries - ScienceAlert

More Kids Falling Prey to Sports Overuse Injuries

[Here is the good news, chiropractic can help.]

A new Macquarie University study involving two semi-elite Australian Rules football clubs has found that chiropractic treatment can significantly reduce the risk of players succumbing to hamstring injuries and lower limb muscle strain.

The study was undertaken by sports chiropractor Wayne Hoskins as the basis for his PhD project on hamstring injuries and has just been published in the journal BMC Musculoskeletal Disorders.

"Hamstring and lower limb muscle strains are the most common injuries in the AFL," Hoskins said. "The AFL's injury survey shows no change in injury rates in the last 15 years and management of these injuries has remained a source of frustration for players, clubs, medical staff and fans alike."

"The study lasted an entire season and involved 59 players from two VFL clubs," Hoskins said. "The group which included chiropractic management had a four per cent chance of a hamstring injury and a four per cent chance of a lower limb muscle strain. The group which received the traditional management only had a 17 per cent chance of hamstring injury and a 28 per cent chance of a lower limb muscle strain."

In addition, the chiropractic group missed just four matches during the season through hamstring or lower limb muscle strains. The group not receiving chiropractic treatment missed 14 matches through hamstring injury and 21 matches through lower limb muscle strain.

The group receiving chiropractic treatment also had significant reductions in non-contact knee injuries, low back pain, and improvements in physical components of health, although this was not the goal of treatment.

[Here is the bad news, the incidence of sports injuries in children is increasing for a variety of reasons, see article. One thing that seems obvious is that coaches have to be made aware of ways to minimize injury through more balanced training, literally, of both sides of the body equally, and of how to prevent the most common injuries of their particular sport. Chiropractic can help prevent sports injuries and chiropractors can provide advice on ways to minimize risks of particular sports.]

"There are a lot of factors behind the increase in overuse injuries, but the number one thing is specialization. Kids are being forced to choose one sport and they're playing it year-round," said Dr. James Andrews, an orthopedic surgeon, president of the American Orthopaedic Society for Sports Medicine and co-chairman of the Stop Sports Injuries campaign.

According to the Stop Sports Injuries campaign, the sports with the highest risk of overuse injuries for children are: baseball, basketball, cheerleading, dancing, football, gymnastics, running, soccer, softball, swimming, tennis and volleyball. Orthopedic surgeons are now seeing two trends: a rapid increase in the number of youth sports injuries and a drop in the age of young athletes with overuse injuries.

Signs that parents should look for that might indicate an overuse injury include:

Favoring one side of the body over the other.
Appearing to be in pain when using a certain body part.
Trouble sleeping.
Stiffness in muscles or joints.

"Parents need to get involved and to listen to their kids. They also need to be knowledgeable about their child's sports and what the risks are," advised Andrews. He said parents also need to realize that a minor injury when a child is young can lead to a major one as the child grows older.

Friday, April 16, 2010

Leg length inequality can bring on joint pain and back pain- Kilgore News Herald

Leg length inequatlity can bring on joint pain - Kilgore News Herald

[Here is a succinct answer to a great question. We frequently see individuals with leg length difference so large that uneven joint degeneration can be observed. Many abnormal postures caused by unequal leg length then lead to degeneration in the spine. At Banic Chiropractic, we measure the leg length difference, provide very inexpensive custom height heel lifts and/or orthotics to correct the problem. Then we fix the posture through our unique treatment of chiropractic adjusting, postural exercise, and traction - which is like the way braces realign the teeth.]

Leg length inequality can bring on joint pain

DEAR DR. DONOHUE: I've been jogging with a group of men, all of whom are in their 50s, for a couple of years. This year, my knees have been giving me trouble. In talking with the other joggers, some say it could be that there's a difference in the length of my legs. Is this for real? How do I get them measured? What do I do if they aren't the same size? -- B.B.

ANSWER: Everyone has legs of slightly different size, just as arms are not the same length. If the difference causes no pain, you can ignore it.

However, it can cause problems. It can lead to low back pain, arthritis of the knees and hips, and hip bursitis. The unequal legs cause the generation of great pressure when the feet strike the ground, and the abnormal pressure load exists for both the longer and the shorter leg. The inequality also causes the pelvis to twist and brings on back pain. Furthermore, when standing, unequal legs distort posture, and that can produce back and joint pain.

The inequality doesn't have to be all that great. In a recently published article on knee osteoarthritis, a difference of 1 centimeter (twofifths of an inch) was linked to knee arthritis. I have to let you know that other authors define significant inequality at half an inch to four-fifths of an inch.

To measure your legs, you need an assistant. Make a mark on the top part of both legs in exactly the same place. Make another mark at the same place on the ankles. Lie down and have your assistant do the measuring with a tape measure. For a really precise measurement, X-rays of the legs provide reliable figures.

If there is a difference between your legs, you can even things out with a heel lift, a shoe lift or specially made orthotics.

Let's not go overboard with this. The causes of knee pain are many, and a better approach to your knee pain would be a consultation with your family doctor.

Wednesday, April 14, 2010

Knee Braces Ease Osteoarthritis Knee Pain WebMD - At Banic Chiropractic Clinic we use this principle to alleviate back pain.

Knee Braces Ease Osteoarthritis Pain

Knee braces basically help realign the knee; taking pressure off of damaged areas to relieve pain and restore function. Bracing is one of a number of noninvasive ways to treat knee OA and/or delay the need for joint replacement surgery.

New research presented at a media briefing Tuesday in New York City suggests that Peterson is not the only one to find relief from knee bracing. In a new study, 49 people with knee OA aged 45 to 87 who wore a knee brace had less pain, stiffness, and disability after six months of use.

Benefits of a Brace

Thirty-one percent of study participants said they took fewer over-the-counter (OTC) anti-inflammatory drugs, and 35% were taking fewer prescription anti-inflammatory drugs after six months of wearing the brace. Researchers plan to follow up on these individuals for up to two years to see who goes on to have joint replacement surgery.

But so far, so good. "The less knee misalignment the patient had, the less disability they experienced, and they saw an improvement in pain, stiffness, and function," said study researcher J. Richard Steadman, MD, founder of the Steadman Phillipon Research Institute in Vail, Colo., at the media briefing.

[The statements above are no surprise, studies have found the exact same results in the spine. Large misalignments of the spine and posture lead to predicable patterns of Osteoarthritis OA over time. The OA occurs, not only in spinal joints, but in hip and knee joints also. This is due to unequal loading through the joints as they carry the weight of the body each and every day of your life. And the greater the weight, the faster the OA will appear. At Banic Chiropractic, we use the only proven method to realign the posture, sustained mechanical traction. This method is like wearing a brace, or braces on your teeth, in that it stresses the body into a normal position and holds that position long enough to make a permanent change. After repeated times doing this, this posture is more balanced, leading to less stress on the joints of the spine and legs. My biggest pet peeve is when people tell me they BELIEVE in Chiropractic. You don't have to BELIEVE in it, there is AMPLE scientific evidence.]

USA Today 'Very little progress' made against serious hospital infections

Report: 'Very little progress' made against serious hospital infections

[I feel bad continuing to post about this subject but the studies just keep rolling out, this time from the US Department of Health and Human Services. This is yet another reminder that our health must be our highest priority. Small healthy choices everyday create a lifestyle of health which you will benefit from now and 30 years from now. One of the essential components of healthy living is maintaining balanced upright posture to reduce wear on your spinal discs and the joints of your entire body. Balanced posture will also reduce aberrant nerve signaling throughout your body as your brain sends strength and energy out to all the tissues of the body and receives messages in response. See your chiropractor, care for body with diet and exercise, and don't take elective surgeries lightly.]

The nation's hospitals are failing to protect patients from potentially fatal infections despite years of prevention campaigns, the government said Tuesday.

The Health and Human Services department's 2009 quality report to Congress found "very little progress" on eliminating hospital-acquired infections and called for "urgent attention" to address the shortcomings — first brought to light a decade ago.

Of five major types of serious hospital-related infections, rates of illnesses increased for three, one showed no progress, and one showed a decline. As many as 98,000 people a year die from medical errors, and preventable infections — along with medication mixups — are a significant part of the problem.

Monday, April 12, 2010

Chiropractic treatment of developmental delay syndromes, dyspraxia, dyslexia, and ADHD / ADD - Research from JMPT PubMed

[While there are a few case studies already in the literature that describe amazing results in children for syndromes such as attention deficit hyperactivity disorder, the following study has a very large sample size. After chiropractic treatments, all157 kids participating in the study were found to improve concentration and performance at school and home, control impulsivity, and to maintain focus and attention. We have also had terrific results in pediatric patients we have cared for. Please read the abstract below for more details. As a mother, I can imagine how difficult it is to watch your child struggle with a developmental delay. I have done some reading on the current medical regimen required for many of these kids and found it quite depressing. Ritalin was found to cause growth restrictions and to control symptoms only in the short-term while not providing long-term benefits. The chiropractic case studies I have read resulted in complete elimination of symptoms. Thank god my kids are healthy in this regard but based on the science I have seen, I do not think I am holding up false hope regarding Chiropractic care. See the article at the very bottom for an explanation you might share with your medical doctor. The authors of the second article are esteemed in medicine and chiropractic, personal friends, and perform their chiropractic treatments the exact same way we do.]

J Manipulative Physiol Ther. 2009 Oct;32(8):660-9.

Developmental delay syndromes: psychometric testing before and after chiropractic treatment of 157 children.
Cuthbert SC, Barras M.

Chiropractic Health Center, Pueblo, CO 81004, USA.

OBJECTIVE: This study presents a case series of 157 children with developmental delay syndromes, including the conditions such as dyspraxia, dyslexia, attention-deficit hyperactivity disorder, and learning disabilities who received chiropractic care. CLINICAL FEATURES: A consecutive sample of 157 children aged 6 to 13 years (86 boys and 71 girls) with difficulties in reading, learning, social interaction, and school performance who met these inclusion criteria were included. INTERVENTION AND OUTCOMES: Each patient received a multimodal chiropractic treatment protocol, applied kinesiology chiropractic technique. The outcome measures were a series of 8 standardized psychometric tests given to the children by a certified speech therapist pre- and posttreatment, which evaluate 20 separate areas of cognitive function, including patient- or parent-reported improvements in school performance, social interaction, and sporting activities. Individual and group data showed that at the end of treatment, the 157 children showed improvements in the 8 psychometric tests and 20 areas of cognitive function compared with their values before treatment. Their ability to concentrate, maintain focus and attention, and control impulsivity and their performance at home and school improved. CONCLUSIONS: This report suggests that a multimodal chiropractic method that assesses and treats motor dysfunction reduced symptoms and enhanced the cognitive performance in this group of children.

J Manipulative Physiol Ther 2004 (Oct); 27 (8): e14 ~ FULL TEXT

Bastecki AV, Harrison DE, Haas JW

OBJECTIVE: To discuss the case of a patient who was diagnosed with attention-deficit/hyperactivity disorder (ADHD) by a general practitioner and was treated with chiropractic care.

CLINICAL FEATURES: A 5-year-old patient was diagnosed with ADHD and treated by a pediatrician unsuccessfully with methylphenidate (Ritalin), Adderall, and Haldol for 3 years. The patient received 35 chiropractic treatments during the course of 8 weeks. A change from a 12 degrees C2-7 kyphosis to a 32 degrees C2-7 lordosis was observed after treatment. During chiropractic care, the child's facial tics resolved and his behavior vastly improved. After 27 chiropractic visits, the child's pediatrician stated that the child no longer exhibited symptoms of ADHD. The changes in structure and function may be related to the correction of cervical kyphosis.

CONCLUSION: The patient experienced significant reduction in symptoms. Additionally, the medical doctor concluded that the reduction in symptoms was significant enough to discontinue the medication. There may be a possible connection that correction of cervical kyphosis in patients with ADHD may produce a desirable clinical outcome.

From the Full-Text Article:


There exists in the current biomedical literature an ideal cervical spinal model, [17] which was used as a goal of care in this case study. It is generally known in neurosciences and anatomy that the central nervous system is the master control system of the human body. It controls and coordinates all body and cellular functions. When we look at the literature today, there has been a significant amount of information published about the mechanical forces and tension placed on the spinal structures and cord tracts in various postures. [25-36]

Breig [26] showed the changes in spinal cord biomechanics from abnormal postural positions. We propose that these changes in spinal canal and thus spinal cord position can cause such pathologic states as edema, hypoxia, blood loss, and cellular death. [28-36] It has been reported by some researchers that abnormal putamen and lenticular magnetic resonance imaging and positron-emission tomography have been observed in children with ADHD. [37, 38] The previous refrences [28-36] may give insight to these abnormal scans. The underlying cause of the mechanical and thus physiologic changes in the spinal cord, brainstem, and higher brain centers are related to the abnormal static postural positions of the skull relative to the thorax. [26]

Mechanical compression of nerves can result in microvascular permeability changes in the endoneural capillaries and lead to neural edema and changes in impulse propagation. [28-36] Additionally, it has been shown that gradual decompression of nerve roots can restore the intrinsic blood flow. [36] Because the parents reported no other major traumatic injuries to the child other than a difficult birth, we propose that the cause of the abnormal spinal configuration was a result of difficult labor. Because of the vast amount of information concerning abnormal nerve function caused by mechanical stress in neck flexion (kyphosis), [26, 39, 40-45] it stands to reason, because his neck configuration was kyphotic, that the child's nervous system was not functioning properly. Through the restoration of normal biomechanical structure and curvature, these abnormal stresses and strains were removed from the cord, which led to the improvement in function.

There exists a large amount of literature on ADHD. This literature is generally pharmacologic and behavioral in nature. Many theories of causality and subsequent treatment have been put forth. However, because chiropractors are not authorized in most states to prescribe drugs, the pharmacologic information has little bearing for chiropractors. The chiropractors who treat patients with ADHD should, however, familiarize themselves with the current diagnostic and treatment protocols used by physicians. Medication may have an effect on treatment outcomes and may be an important factor in proper management of this condition. [1-15] It should be noted that these references are nowhere near a complete review of the literature on ADHD.

It is possible that the farther we move from the Harrison ideal spinal model, [17] the greater the neurologic stress from abnormal stress and strain on the spinal cord. [26] Restoring the cervical lordosis could be the most critical aspect of any chiropractic care protocol or clinical intervention. With specific mirror image adjusting, mirror image traction, and mirror image postural exercise, cervical curve restoration is now a possible outcome. [18-21]

Several limitations of this study include: (1) a possibility that there was spontaneous remission of the ADHD symptoms and that chiropractic care had no relevance to the symptom remission; (2) the patient may have been misdiagnosed by the medical doctor; and (3) the patient's parents may not have been reporting the retrospective symptoms accurately, giving a false sense of improvement. Because this is a case report, further research is needed to determine the true effects of CBP protocol on patients suffering with ADHD.


This case study shows that spinal correction using the CBP approach may have effects much greater than relief of musculoskeletal conditions. Altered spinal biomechanics associated with abnormal posture clearly relate to significant neurological stress and malfunction. This is particularly evident when considering the effects on the brainstem and the autonomic nervous system. Thus, even in obscure cases with systemic, organic, or chemical dysfunction like ADHD, we suggest optimal spine equals optimal health.

Monday, April 5, 2010

Society for Maternal-Fetal Medicine: Statewide effort slashes number of early induced and caesarean scheduled births

Society for Maternal-Fetal Medicine: Statewide effort slashes number of early scheduled births

[I was very interested to see this statewide effort centered around one of my biggest pet peeves. I know multiple women who took great care of themselves during pregnancy but then chose to have scheduled delivery around their due date because their doctor was "going out of town" or they had relatives coming into town. These are all people that live in the Seattle area and this was just recently. I was completely aghast that the medical professionals would endorse inducing labor before the body is naturally ready. Well thankfully, I am not the only one that feels this way. In the study below, they find "Elective induction leads to more unplanned Caesarean sections in first time birth women and to increased postpartum complications for both first time and multiple birth women. Elective Caesarean section has increased maternal and neonatal risks." The entire state of Ohio has finally responded to studies like this and "successfully reduced the number of scheduled near-term births—either by cesarean delivery or induction of labor—without a medical or obstetric indication from 1 in 4 to less than 1 in 20. You are likely to know someone offered a scheduled birth. Tell them the facts or send them to me!]

Jay Iams, MD, for the Ohio Perinatal Quality Collaborative unveiled the details of a statewide effort in Ohio that successfully reduced the number of scheduled near-term births—either by cesarean delivery or induction of labor—without a medical or obstetric indication from 1 in 4 to less than 1 in 20 (P<0.05).

Using a variety of education and intervention tools, 20 level 2 and 3 maternity hospitals—which handle about half of the state's births—shared their methods during the 14-month study. As a result, the rate of scheduled births between 36.1 and 38.6 weeks without medical necessity declined from 25% to below 5%. Inductions without medical necessity also declined from a 12-month mean of 13% to 8% (P<.0027), and fewer infants born at 36 to 38 weeks' gestation were admitted to the neonatal intensive care unit.

The Ohio Perinatal Quality Collaborative; Iams J. A statewide initiative to reduce scheduled births without appropriate indication [abstract]. Am J Obstet Gynecol. 2009;201(6 suppl):S19. Abstract 33.

J Obstet Gynaecol Can. 2009 Dec;31(12):1124-30.

Outcomes of elective labour induction and elective caesarean section in low-risk pregnancies between 37 and 41 weeks' gestation.
Dunne C, Da Silva O, Schmidt G, Natale R.

Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.

OBJECTIVE: To compare maternal and neonatal outcomes after elective induction of labour and elective Caesarean section with outcomes after spontaneous labour in women with low-risk, full-term pregnancies. METHODS: We extracted birth data from 1996 to 2005 from an obstetrical database. Singleton pregnancies with vertex presentation, anatomically normal, appropriately grown fetuses, and no medical or surgical complications were included. Outcomes after elective induction of labour and elective Caesarean section were compared with the outcomes after spontaneous labour, using chi-square and Student t tests and logistic regression. RESULTS: A total of 9686 women met the study criteria(3475 nulliparous, 6211 multiparous). The incidence of unplanned Caesarean section was higher in nulliparous women undergoing elective induction than in those with spontaneous labour (P < 0.001). Postpartum complications were more common in nulliparous and multiparous women undergoing elective induction (P < 0.001 and P < 0.01, respectively) and multiparous women undergoing elective Caesarean section, (P < 0.001). Rates of triage in NICU were higher in nulliparous women undergoing elective Caesarean section (P < 0.01), and requirements for neonatal free-flow oxygen administration were higher in nulliparous and multiparous women undergoing elective Caesarean section (P < 0.01 for each). Unplanned Caesarean section was 2.7 times more likely in nulliparous women undergoing elective induction of labour (95% CI 1.74 to 4.28, P < 0.001) and was more common among nulliparous and multiparous women undergoing induction of labour and requiring cervical ripening (P < 0. 001 and P < 0.05, respectively). CONCLUSION: Elective induction leads to more unplanned Caesarean sections in nulliparous women and to increased postpartum complications for both nulliparous and multiparous women. Elective Caesarean section has increased maternal and neonatal risks.

Thursday, April 1, 2010

Empower your patients through education!

[Thank you Ann for helping me to clarify my thoughts on interventions by medical professionals. You could say my biggest issue is the continuing paternalistic attitude that is shrouded in this new holistic movement. A couple of examples, in regard to Vitamin D supplementation, which every doctor has gotten on the bandwagon about, including mine. Here is what they should be sharing with you instead of just selling you the supplement;] Many scientists now believe we need 1,000 IU per day of vitamin D (IU = international units, a measure of vitamin potency) to avoid deficiency. For reference, a salmon serving contains about 360 IU, a glass of fortified milk about 100 IU, an egg 25 IU, and a tablespoon of cod liver oil 1300+ IU.

In comparison, full-body sunbathing for a period of time that will just make you turn pink will produce 10,000-20,000 IU of vitamin D, equivalent to 100 to 200 glasses of fortified milk. Given such copious production, relatively casual sun exposure (arms, etc) should meet vitamin-D needs.

Remember, however, that no vitamin D will be generated in short-daylight months above certain latitudes. In these periods to avoid vitamin-D deficiency - especially if you don’t like oily fish or are lactose intolerant - you will need to consume a supplement or use a UVB-emitting tanning bed. Studies have shown that individuals who use such a tanning bed in winter have serum levels of 25-hydroxyvitamin D (the marker for vitamin-D status) that is 90% higher than controls.

The importance of solar-produced vitamin D was underscored in a study that evaluated vitamin-D status in a submarine crew after two months of acute sun deprivation. Although the crew consumed a vitamin-D fortified diet, their levels of this nutrient plummeted.)

[Here is another example; I have heard frequently of women discussing a family history or personal risk of Osteoporosis with their physician. Often they are prescribed a myriad of Calcium, Magnesium, Vitamin D supplements, told to eat Calcium rich food, recommended expensive prescription medications, etc... They should be empowered to really take control of their health with advice like the following]; Nonpharmacological approaches to improve bone health and reduce osteoporosis. Schwab P, Klein RF.
PURPOSE OF REVIEW: With an aging population, osteoporosis has become a public health concern and an area of increased awareness among both patients and medical practitioners. Timely screening and pharmacologic treatment of low bone mass effectively reduces fracture risk. Nonpharmacologic interventions, however, deserve equal emphasis both in the prevention and treatment of osteoporosis. RECENT FINDINGS: Recent advances in bone biology have established that exercise in the form of short, repetitive mechanical loading leads to the greatest gains in bone strength. As demonstrated by both observational and randomized exercise intervention trials, these gains are best achieved in childhood but can be maintained in adulthood with continued regular weight-bearing exercise. In the later years, evidence supports the implementation of balance training to decrease fall risk, especially in elderly patients with low bone mass. Following an osteoporotic fracture, a multidisciplinary rehabilitation program with an emphasis on early mobilization, fall prevention, use of orthoses, and noninvasive surgical procedures is emerging as a promising approach. SUMMARY: Clinically, these findings should imply greater emphasis on high impact exercise during skeletal growth and on maintenance of weight bearing and balance training in the later years. Future research should examine the effect of these interventions on fracture prevention.

[There are many, many more examples where individuals seeking advice receive a diagnosis or magic bullet type pill/ supplement when what they could really benefit from is to be empowered by education, after all, why seek out an expert]

Chiropractic Wellness - Picking our brains: How strong is the mind-body link? New Scientist

Picking our brains: How strong is the mind-body link?

[A central tenant in chiropractic care is that the treatments influence parasympathetic and sympathetic nerves to the organs as well as the sensory and motor nerves to the musculoskeletal system. As research continues to demonstrate the influence of Chiropractic on blood pressure (decreases it), gastric motility, immune function and more, we will surely hear more and more about the influence of the Chiropractic adjustment on the vagus nerve.]

Picking our brains: How strong is the mind-body link?
01 April 2010 by Linda Geddes
Magazine issue 2754.

Could we ever learn to think ourselves well?

Many of these effects seem to be mediated by the immune system. Severe stress has been shown to reduce immune cell activity, both in the test tube and in people. There seem to be several ways in which the brain influences the immune system, from chemical mediators to direct neural control. One branch of the vagus nerve connects the brain to a key regulator of immune functioning, says Kevin Tracey of the Feinstein Institute for Medical Research in Manhasset, New York. "Signals that originate in the brain travel down the vagus nerve where they change the behaviour of immune cells in the spleen," he says (Nature, vol 420, p 853).

Tracey's team has since found that electrically stimulating the vagus nerve decreases inflammation, a state of immune system high-alert implicated in a large number of diseases, including cancer. They suspect there may be other nerve-immune links that have the effect of "turning up" inflammation.

If we can't consciously control the immune system, we might at least be able to manipulate it with drugs or perhaps via the vagus nerve.

There is a nerve that runs from the lower part of your brain (the brainstem) down to your heart. This nerve is called the vagus nerve or the pneumogastric nerve (cranial nerve X). It is the only nerve in your brain that extends down through your neck and into your abdominal region. You certainly don't want to have spinal stress anywhere in your neck. Would you believe that medical doctors use to cut the vagus nerve out of the body for treating things such as peptic ulcers? You'd think maybe they would have been doing that a long long time ago, in the dark ages of medicine, but the procedure was popular up until the mid-1990s as a treatment for peptic ulcers. The procedure was called a vagotomy and it became obsolete after was discovered that Helicobacter pylori, a microorganism that can thrive in the highly acidic environment of the stomach, was responsible for most peptic ulcers. It makes you wonder how many other surgical procedures will become obsolete as we continue to discover new things about the human body.

Wednesday, March 31, 2010

Unequal leg length tied to osteoarthritis (ample chiropractic research already links joint misalignment to pain and arthritis.) Science Daily

Unequal leg length tied to osteoarthritis, study finds

[The type of arthritis they are discussing here is the "normal" arthritis associated with aging. They are recognizing that by eliminating or improving joint misalignment's, they can eliminate or reduce osteoarthritis. Chiropractic BioPhysics as practiced at Banic Chiropractic Clinic can improve even large joint misalignment's such as head forward posture, loss of cervical curve, increased thoracic curve/ dowagers hump, and sway back or increased pelvic tilt. We can also improve asymmetry when viewing from the front such as head tilt, unlevel shoulders, and shifting of the torso relative to the pelvis. These improvements will improve your overall and long term health.]

"Most pediatricians adopt a 'wait and see' attitude for children with limb misalignment when they're growing," says Dr. Cooke. "If we can spot factors creating changes in alignment early in bone development, theoretically we could stop or slow down the progression of osteoarthritis."

The data was collected using x-ray images from more than 3,000 adults aged 50 to 79 who either had knee pain or risk factors for knee osteoarthritis as a part of the Multi Centre Osteoarthritis Study (MOST). Subjects were reassessed after a 30-month period and the researchers found that osteoarthritic changes in the knee were most significant in individuals with pronounced (more than 1 cm) leg length inequality, the shorter leg being most affected.

Regimens: How Much Exercise Will Prevent Weight Gain? Now you know courtesy of the New York Times

Regimens: How Much Exercise Will Prevent Weight Gain?

[Here is the article in its entirety. It is inspiring yet challenging to avoid the mid-life weight gain. I am still losing my after baby weight, unfortunately, my daughter is turning two in a week. I guess I am going to need to get up above 7 hours per week of exercise.]

Losing weight is difficult, and keeping it off may be even harder. So Harvard researchers set out to determine exactly how much physical activity women need in midlife to avoid gaining weight as they age.

The researchers found that an hour of moderate activity a day — including such recreational activities as brisk walking, leisurely bicycling, ballroom dancing and playing with children — prevented women of normal weight from gaining more than five pounds over any three-year period. Half that amount of vigorous activity, like running, jogging or fast biking, will do the trick as well, they said.

Women who got the same amount of exercise but were heavier to start with were not able to avoid gaining weight, however. Neither were women of normal weight who got less than seven hours a week of moderate activity, according to the study, published in the March 24 issue of The Journal of the American Medical Association.

The average weight gain over the course of the 15-year study, which followed 34,079 healthy women with an average age of 54 at the beginning, was just over five pounds. The researchers did not take diet into account.

“It’s so hard to lose weight and maintain the loss, so whatever weight you are, you should try to stay that weight — that is a success,” said the paper’s lead author, Dr. I-Min Lee, an associate professor of epidemiology at Harvard School of Public Health.

But any amount of exercise is beneficial, she emphasized. “People shouldn’t just throw up their hands and say, ‘Sixty minutes? I can’t do that,’ and give up. Health is more than weight.”

Wednesday, March 24, 2010

Breast fed and formula fed babies not getting enough vitamin D - CNN reports on Pediatrics journal and Center for Disease Control studies

Babies not getting enough vitamin D

[Here I was patting myself on the back for my all natural approach to mothering, and now I find out the 9 of 10 breast fed babies are Vitamin D deficient. That is totally shocking to me. I truly believed that breastfeeding would ensure my child had all the nutrients they need. Well, now you know, supplement or sun is required for babies.]

Very few infants who consumed breast milk alone - between 5 percent and 13 percent - met the current or former recommendation for vitamin D intake. Among the formula-fed infants, 81 percent to 98 percent met the former recommendation, but just 20 percent to 37 percent of the same infants would have met the current recommendation.

Most babies did not receive vitamin D supplements. No more than 13 percent of the breast-fed infants were given supplements, and fewer than 4 percent of the formula-fed babies received them.

The results - especially concerning formula-fed babies- are eye-opening, says Carrie Drazba, M.D., a pediatrician at Rush University Medical Center, in Chicago. "I don't think a lot of us realized that formula-fed babies are not meeting their vitamin D requirements," she says.

Although the most obvious health problem associated with vitamin D deficiency in babies is rickets, or soft bones, pediatricians are increasingly mindful of respiratory infections and chronic diseases (such as type 1 diabetes) that have been linked to inadequate intake of the vitamin in that age group, Drazba says.

A pair of studies published last year, for instance, found that children with low levels of vitamin D were more likely to have several risk factors that contribute to heart disease, including high blood pressure, high blood glucose, and low HDL (or good cholesterol).

"We're finding out that there are other risks associated with vitamin D deficiency besides rickets," says Drazba. "A lot of cells in our body have receptors for vitamin D."

Sunday, March 21, 2010

Chiropractic decreases back pain in pregnancy, 94% had clinically important pain relief in 4.5 days. J Midwifery Womens Health. 2006

[Our pampering combination of full spine chiropractic care and therapeutic massage has made those last months of pregnancy bearable for so many women, including myself. The great thing is that it is natural. I was afraid to even take a single Ibuprofen while pregnant and breastfeeding, leaving Chiropractic the safe and sensible alternative.]

J Midwifery Womens Health. 2006 Jan-Feb;51(1):e7-10.

Chiropractic spinal manipulation for low back pain of pregnancy: a retrospective case series.
Lisi AJ.

University of Bridgeport College of Chiropractic.

Low back pain is a common complaint in pregnancy, with a reported prevalence of 57% to 69% and incidence of 61%. Although such pain can result in significant disability, it has been shown that as few as 32% of women report symptoms to their prenatal provider, and only 25% of providers recommend treatment. Chiropractors sometimes manage low back pain in pregnant women; however, scarce data exist regarding such treatment. This retrospective case series was undertaken to describe the results of a group of pregnant women with low back pain who underwent chiropractic treatment including spinal manipulation. Seventeen cases met all inclusion criteria. The overall group average Numerical Rating Scale pain score decreased from 5.9 (range 2-10) at initial presentation to 1.5 (range 0-5) at termination of care. Sixteen of 17 (94.1%) cases demonstrated clinically important improvement. The average time to initial clinically important pain relief was 4.5 (range 0-13) days after initial presentation, and the average number of visits undergone up to that point was 1.8 (range 1-5). No adverse effects were reported in any of the 17 cases. The results suggest that chiropractic treatment was safe in these cases and support the hypothesis that it may be effective for reducing pain intensity.

Thursday, March 18, 2010

Spinal manipulations (chiropractic) significantly benefit sciatica with disc herniation and acute low back pain. Spine Journal

[Spine Journal is a very prestigious medical journal. They performed this study to determine the efficacy and safety of spinal manipulation (chiropractic) in caring for patients with evidence of disc protrusion accompanied by sciatica and low back pain. The researchers found that spinal manipulation (chiropractic adjustments) increased the number of pain free days, reduced radiating symptoms - pain into the leg, and reduced overall pain. There were no adverse effects of the treatment. Anyone suffering from the debilitating effects of sciatica and disc herniation should consider a course of conservative chiropractic treatment before discussing surgical options. See WebMD post on deaths from elective surgery associated with medical errors.]

Spine J. 2006 Mar-Apr;6(2):131-7. Epub 2006 Feb 3.

Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations.
Santilli V, Beghi E, Finucci S.

Direttore Cattedra Medicina Fisica e Riabilitativa, Università di Roma La Sapienza, P.le Aldo Moro 5, Roma, Rome, 00185, Italy.

BACKGROUND CONTEXT: Acute back pain and sciatica are major sources of disability. Many medical interventions are available, including manipulations, with conflicting results. PURPOSE: To assess the short- and long-term effects of spinal manipulations on acute back pain and sciatica with disc protrusion. STUDY DESIGN/SETTING: Randomized double-blind trial comparing active and simulated manipulations in rehabilitation medical centers in Rome and suburbs. PATIENT SAMPLE: 102 ambulatory patients with at least moderate pain on a visual analog scale for local pain (VAS1) and/or radiating pain (VAS2). OUTCOME MEASURES: Pain-free patients at end of treatment; treatment failure (proportion of patients stopping the assigned treatment for lack of effect on pain); number of days with no, mild, moderate, or severe pain; quality of life; number of days on nonsteroidal anti-inflammatory drugs; number of drug prescriptions; VAS1 and VAS2 scores; quality of life and psychosocial findings; and reduction of disc protrusion on magnetic resonance imaging. METHODS: Manipulations or simulated manipulations were done 5 days per week by experienced chiropractors, with a number of sessions which depended on pain relief or up to a maximum of 20, using a rapid thrust technique. Patients were assessed at admission and at 15, 30, 45, 90, and 180 days. At each visit, all indicators of pain relief were used. RESULTS: A total of 64 men and 38 women aged 19-63 years were randomized to manipulations (53) or simulated manipulations (49). Manipulations appeared more effective on the basis of the percentage of pain-free cases (local pain 28 vs. 6%; p<.005; radiating pain 55 vs. 20%; p<.0001), number of days with pain (23.6 vs. 27.4; p<.005), and number of days with moderate or severe pain (13.9 vs. 17.9; p<.05). Patients receiving manipulations had lower mean VAS1 (p<.0001) and VAS2 scores (p<.001). A significant interaction was found between therapeutic arm and time. There were no significant differences in quality of life and psychosocial scores. There were only two treatment failures (manipulation 1; simulated manipulation 1) and no adverse events. CONCLUSIONS: Active manipulations have more effect than simulated manipulations on pain relief for acute back pain and sciatica with disc protrusion.

PMID: 16517383 [PubMed - indexed for MEDLINE]

Tuesday, March 16, 2010

WebMD reports on back pain and neck pain risks for kids.

[Heavy back packs, texting, and in my opinion, playing video games and lack of education about proper posture and body mechanics are all wreaking havoc on children's backs. We see more and more pediatric cases with symptoms that would be more typical in an adult. Please, take the time to learn proper sitting and standing posture and teach them to your children. When standing, the ear should be over the shoulder, shoulder over hip, and hip aligned with knee and ankle. When sitting, slumping and slouching forward with your shoulders curved in and your head jutting out are horrible for your body. When poor postures are held over long periods of time, eventually the body maintains that position leaving the child on the road to having a "bad back".]

Texting may be preferred over phone jabbering by many young people, but too much text messaging may increase the risk of neck or shoulder pain, a new study shows. "What we’ve seen so far is very similar to what we see with office workers who’ve spent most of their time at a computer," Gold says. "The way the body is positioned for texting -- stationary shoulders and back with rapidly moving fingers -- is similar to the position for typing on a computer. They used body maps for the students to indicate areas of discomfort. The students were asked how many text messages they sent per day.
The researchers say they found an association, only in male participants, between shoulder discomfort and the number of messages punched out.

Texting Can Be a Pain in the Neck, Shoulders

A new study shows heavy backpacks place significant strain on children's spines and may lead to back pain.

Researchers say it's the first study to use magnetic resonance imaging (MRI) scans to document compression of the spinal discs and spinal curvature caused by a typical school backpack load on children.

"Backpack loads are responsible for a significant amount of back pain in children, which in part, may be due to changes in lumbar disc height or curvature," write researchers Timothy B. Neuschwander, MD, of the University of California, San Diego, in Spine.

"Over 92% of children in the United States carry backpacks that are typically loaded with 10% to 22% body weight," write the researchers. "Thirty-seven percent of children aged 11 to 14 years report back pain, the majority of whom attribute the pain to wearing a school backpack."

In the study, researchers used an upright MRI scanner to image the spines of eight children, average age of 11, while standing first with an empty backpack and then backpack loads representing 10%, 20%, and 30% of the children's body weight (9, 18, and 26 pounds, respectively).

The results showed two key spinal measurements changed as the weight of the backpack increased. Heavier weights caused compression of the discs that act as a cushion between the bones of the spine.

Researchers say that disc compression was especially great in the lower spine at heavier backpack weights.

Heavier backpack loads were also associated with increased curvature of the lower spine. Half of the children had a significant spinal curve even with the 18-pound backpack. Most of the children had to adjust their posture to adapt to the heaviest, 26-pound backpack load.

The amount of back pain reported by the children also increased as backpack load increased. At the heaviest load, the average pain score was nearly 5 out of 10 for the children.

Researchers say the results show heavy backpacks cause compression of the spinal discs and increased spinal curvature that are related to the back pain reported by children.

In the study, children wore the backpacks with the straps over both shoulders, but researchers say the spinal curvature could be even worse if the backpack were carried over one shoulder as many children do.

Monday, March 15, 2010

Back pain accounts for 1/3 of work place injuries. Can A Vibrating Mouse Prevent Computer-related Injuries?

[Don't wait for your body to break down, learn how to stop it. We offer a course on workplace ergonomics and have provided public speaking on ergonomics and workplace safety at many eastside businesses.]

Back injuries also account for one-third of all workplace injuries. A decade ago most of these were associated with heavy lifting. Today they are mostly caused by people sitting for longer periods of time -- often in front of a computer.

The younger onset of computer use makes the current rate of compensatory damage claims the canary in the coal mine. There is typically a 10- to 15-year latency before injuries start to develop, Hedge has found. In the early 1990s he showed that the average age of workers reporting carpal tunnel syndrome was late 30s to early 40s; last year, he found the average age of onset had dropped to the mid-20s and even younger for some people.

Can A Vibrating Mouse Prevent Computer-related Injuries?

Do you need a mechanic or a chiropractor? - Danbury News Times

[I love how this doctor writes about chiropractic, and he is being interviewed by a registered nurse.]

What I want you to do is put your arm in a sling and come back and see me in two weeks. What do you think will happen with the shoulder?" asked Danbury chiropractic physician Dr. Ronald G. Manoni.

I imagined my arm in a sling, immobilized for weeks and answered, "You'd get a frozen shoulder."

"You'd get a frozen shoulder," he affirmed. "Atrophy of the musculature. So what happens to the spine is you get these small muscles that atrophy... You get joints that get locked or semi-locked, that can't move.

"You take a perfectly healthy joint and immobilize it, and you get destruction of the joint. Patients come to me and say, "I bent over wrong, I did this, I did that, and I say, "Look, if someone is walking up the stairs and has a heart attack, you wouldn't say the stairs caused it, would you?

"It was cumulative factors. It was hereditary, he smoked, drank alcohol, didn't exercise, was overweight... So the same process happens on an ongoing basis with the spine through injuries, improper bending, lifting, prolonged posture.

"It's cumulative. All those things combined, just as in heart disease, can cause a problem in spinal functioning and the overall health of a person."

Manoni referred to the National Safety Council's estimate of 1,500 spinal traumas from falls that a child has by the time he is 10 years old.

He said chiropractic can be very effective in relieving asthma symptoms. "If you have a diminishment of function in the nerves going to the bronchioles, they don't function as well, but by relieving the irritation on the nerve root, asthmatics can get relief."

"That's an interesting thing," I mused. "So little by little we get out of alignment?"

"The out of alignment," he sighed. "You're not the front end of a car. It's a neurological dysfunction. It's cumulative -- there are falls, prolonged postures, abnormal stresses and strains.

"You know, our bodies were not meant to sit at desks all day and that only a couple of generations ago we were an agrarian culture.

"Add that to the approximately 500 chemicals a day we're exposed to today, the toxins we have in our foods, in our environment, and it all causes our bodies not to function as well or causes disease in many instances."

"My understanding was that chiropractors realign the spine and the bones that have shifted," I persisted.

Manoni patiently explained there are 24 joints in our spines through which nerves pass from the spinal cord to just about every part of our bodies.

He described subluxation, defined as an incomplete or partial dislocation, as a blocked nerve root or blocked functioning in any joint. "If you have this in your wrist, you call it carpal tunnel syndrome; in your shoulder, maybe a bursitis...

"But if it's in your spine, it affects so much more because it affects both the sympathetic and parasympathetic nervous system."

The sympathetic nervous system is active during stress or danger. It is involved in regulating pulse and blood pressure, dilating pupils, and changing muscle tone.

The parasympathetic nervous system controls involuntary, unconscious functions like slowing the heart rate, constricting pupils, relaxing the bowels.

"For example, if there was a subluxation of a joint in the lower back," Manoni continued, "some people would get sciatica from that. But those same nerve roots in your lower back go to your leg, and they also go to your organs of digestion and your urinary tract, so these can be affected, too."

"What's the goal of an adjustment?" I asked, having finally given up on getting an alignment.

"Ah, yes, adjustment...," he smiled with approval. "By adjusting with your hands and improving the function of the spinal joints, you improve the function of the nervous system."

Chiropractic is a holistic approach that enhances the function of the entire body, and Manoni equated this to taking supplements: "Are vitamins good for just one organ or for your whole body? You're eating nutritionally well, why? Because you want your pancreas to be healthy?

"No, because you want your entire body to be healthy. So having a properly functioning nervous system, taking care of where the nerves emanate from the spine, enhances the function of the whole human being."

For more information go to or call 203-792-9582.

Linda Napier is a registered nurse and independent patient advocate who lives in Southbury. She is the author of the book "Tender Medicine." You can contact her at

Do you need a mechanic or a chiropractor? - Danbury News Times

Shocking statistics on hospital errors - Natural health care and wellness should be the first choice.

Errors made by doctors, nurses and other medical caregivers cause 44,000 to 98,000 deaths a year. Hospital infections, many considered preventable, take another 100,000 lives. And mistakes involving medications injure 1.3 million patients annually in the U.S., according to the Food and Drug Administration.
[Do these numbers shock you?]
New Focus on Averting Errors: Hospital Culture -

Wednesday, March 10, 2010

Developing standards to document effect on organ function of spinal cord injury - Chiropractic philosophy in a nutshell

[This article is so amazing. It really drives home how traditional medicine has been missing the forest for the trees. Published just last year, the best scientists from around the world said, wait a second. In spinal cord injury we are documenting loss of motor function (weakness), loss of sensory function (pain, tingling)but we have not been looking at the expected effects on organs. That is strange because bidirectional nerves at all levels of the spinal column carry nerve signals from the spinal cord, through the bones of the spine, into large groups and out to the organs. What I'm saying is, why can chiropractic help with sciatica but some don't believe it can help with blood pressure, digestive problems, etc.. If there is strain or inflammation at the level of the spinal cord or nerve root, how can only the motor and sensory nerves be affected while the nerves to the organs just float through unaffected? That's right, they can't!Hopefully these scientists will complete this interesting research, basically chiropractic philosophy, over the next decade and further the profession of chiropractic even more.]

Spinal Cord (2009) 47, 36–43; doi:10.1038/sc.2008.121; published online 28 October 2008

International standards to document remaining autonomic function after spinal cord injury
M S Alexander1, F Biering-Sorensen2, D Bodner3, N L Brackett4, D Cardenas4, S Charlifue5, G Creasey6, V Dietz7, J Ditunno8, W Donovan11, S L Elliott9, I Estores10, D E Graves11, B Green12, A Gousse4, A B Jackson1, M Kennelly13, A-K Karlsson14, A Krassioukov9, K Krogh15, T Linsenmeyer16, R Marino8, C J Mathias17, I Perkash6, A W Sheel9, G Shilero18, B Schurch7, J Sonksen19, S Stiens20, J Wecht18, L A Wuermser21 and J-J Wyndaele22

1University of Alabama, Birmingham, AL, USA
2Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
3Case Western Reserve University, Cleveland, OH, USA
4University of Miami, Miami, FL, USA
5Craig Hospital, Englewood, CO, USA
6Stanford University, Palo Alto, CA, USA
7University Hospital Balgrist, Zurich, Switzerland
8Thomas Jefferson University, Philadelphia, PA, USA
9International Collaboration On Repair Discoveries (ICORD), University of British Columbia and Vancouver Coastal Health, Vancouver, British Columbia, Canada
10James A Haley VA Hospital, Tampa, FL, USA
11Baylor College of Medicine, Houston, TX, USA
12Shepherd Center, Atlanta, GA, USA
13McKay Urology, Carolinas Healthcare, Charlotte, NC, USA
14Sahlgrenska University Hospital, Gothenburg, Sweden
15Aarhus University Hospital, Aarhus, Denmark
16Kessler Institute for Rehabilitation, West Orange, NJ, USA
17Imperial College, St Mary's Hospital, London, UK
18James J Peters Veterans Affairs Medical Center, Bronx, NY, USA
19Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
20Veterans Affairs Puget Sound Health Care, Seattle, WA, USA
21Mayo Clinic, Rochester, MS, USA
22University Hospital Antwerp, University Antwerp, Antwerp, Belgium
Correspondence: Dr A Krassioukov, ICORD/Department of Medicine, University of British Columbia, 6270 University Blvd, Vancouver, British Columbia, Canada V6T 1Z4. E-mail:

Received 19 June 2008; Revised 29 August 2008; Accepted 31 August 2008; Published online 28 October 2008.

Top of pageAbstract
Study design: Experts opinions consensus.

Objective: To develop a common strategy to document remaining autonomic neurologic function following spinal cord injury (SCI).

Background and Rationale: The impact of a specific SCI on a person's neurologic function is generally described through use of the International Standards for the Neurological Classification of SCI. These standards document the remaining motor and sensory function that a person may have; however, they do not provide information about the status of a person's autonomic function.

Methods: Based on this deficiency, the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS) commissioned a group of international experts to develop a common strategy to document the remaining autonomic neurologic function.

Results: Four subgroups were commissioned: bladder, bowel, sexual function and general autonomic function. On-line communication was followed by numerous face to face meetings. The information was then presented in a summary format at a course on Measurement in Spinal Cord Injury, held on June 24, 2006. Subsequent to this it was revised online by the committee members, posted on the websites of both ASIA and ISCoS for comment and re-revised through webcasts. Topics include an overview of autonomic anatomy, classification of cardiovascular, respiratory, sudomotor and thermoregulatory function, bladder, bowel and sexual function.

Conclusion: This document describes a new system to document the impact of SCI on autonomic function. Based upon current knowledge of the neuroanatomy of autonomic function this paper provides a framework with which to communicate the effects of specific spinal cord injuries on cardiovascular, broncho-pulmonary, sudomotor, bladder, bowel and sexual function.

Keywords: autonomic nervous system, spinal cord injury, human, international standards