| September 6, 2005 [Volume 6,
Issue 19]
Profiles in Chiropractic
 Chiropractic
is one of the most sought-after forms of primary health care
in the nation. In fact, it is estimated that two-thirds of all
outpatient visits for back pain are made to doctors of
chiropractic for care. While much is known about the typical
patient who visits a chiropractor, less is known about the
typical doctor of chiropractic. A recently published study
sought to get a better picture of the average chiropractor,
and has found that both doctors and their patients have a
favorable impression of the profession.
In the study,
researchers collected data on 131 chiropractors and 1,275
chiropractic patients in the U.S. and Canada. Among the
factors they examined were annual income and the types of
therapies a chiropractor uses in practice. For chiropractic
patients, the researchers looked at several demographics,
including health status, reasons for seeing a chiropractor,
and satisfaction with treatment.
Eighty-three
percent of the chiropractors surveyed reported working
full-time; 80 percent owned their own practices. Seventy-eight
percent reported an annual income of at least $80,000, and
just under half (48 percent) had been in practice for 11 years
or longer. In terms of chiropractic patients, the majority of
them (76 percent) reported seeing a chiropractor for back
pain. Most patients were highly confident of the care they
received; on a scale of 1 to 10 (10 being best), 78 percent
rated their care an 8 or better. In addition, 90 percent of
the patients said they would "definitely" recommend
chiropractic to their family and friends.
In their
conclusion, the authors wrote, "The results ... describing the
practice, the practitioners, and the patients would seem to
imply that chiropractors have firmly established themselves
within the health delivery system of North America." They
added that "for a majority of patients, the chiropractor is
the primary contact provider for the current episode being
treated by chiropractic."
Coulter ID,
Shekelle PG. Chiropractic in North America: a descriptive
analysis. Journal of Manipulative and Physiological
Therapeutics, February 2005;28(2):83-9.
Prescription
Drugs and Pregnancy: What Are the Risks?
 Everyone
knows that taking prescription drugs while pregnant can put
both the mother and her unborn child at risk. Everyone also
knows - or should know - that some drugs are safer than
others. The question is, how often do pregnant women receive
drugs that might compromise their health, or put their
children's lives in danger? That's what a team of researchers
in the U.S. tried to answer.
In their study,
the authors looked at the health records of more than 152,000
women to determine the number and types of drugs they received
before and during pregnancy. The drugs were divided into five
categories developed by the Food and Drug Administration,
according to their risk to the developing fetus. Category X
medications were considered by the FDA as drugs that possessed
a "definite fetal risk" that clearly outweighed any benefits.
Results: Sixty-four percent of the
women received at least one drug or medical supply other than
a vitamin or mineral supplement. Over 47 percent of the women
received a drug from the three riskiest categories. Using
these figures as a blueprint, the authors estimated that of
the 4 million women who deliver a child in the United States
each year, "as many as 280,000 ... are exposed to drugs with
evidence of potential fetal risk."
If you or
someone you know is pregnant, please make sure to talk with
your doctor about the risks of any medications before you
start taking them. Also, make sure to provide your doctor with
a list of any drugs, herbal remedies or dietary supplements
you are currently taking, to help reduce the risk of
side-effects or potential interactions.
Andrade SE,
Gurwitz JH, Davis RL, et al. Prescription drug use in
pregnancy. American Journal of Obstetrics & Gynecology,
August 2004;191(2):398-407.
The Power of
Positive Feedback and Motivation
Previously
published studies have shown that regular exercise can help
people who suffer from chronic low back pain (LBP).
Unfortunately, however, many LBP sufferers do not follow
through and complete their recommended exercise program. Part
of the reason, some scientists believe, is that these people
do not receive enough motivation from their doctor to complete
the program.
In this study,
researchers looked at the effect motivation and positive
feedback could have on people with chronic low back pain.
Ninety-three patients were randomized into two groups and
followed at different intervals for 5 years. The first group
participated in a series of 10 25-minute training sessions an
average of 2.3 times per week, with gradual increases in
exercise over time. The second group engaged in the same
series of exercises, but also received other interventions,
such as counseling, problem-solving strategies, positive
feedback from practitioners, and the signing a "contract" in
which the patient agreed to stay on the exercise program.
While patients
in both groups showed significant improvements in disability
scores, "the cumulative effect in the motivational group
across all points of assessment was more than twice that in
the control group." In addition, only patients who received
motivation and positive feedback showed a significant increase
in the ability to return to their original level of work
activity. The authors concluded that "the combined exercise
and motivation program was superior to the standard exercise
program" for patients with chronic low back pain.
Exercise is an
important tool that can be used to treat low back pain, but it
is by no means the only one. Receiving encouragement and
support from others, along with a balanced diet, are just as
important. Using these therapies together will help relieve
your back pain - and make you a happier, healthier person.
Friedrich M,
Gittler G, Arendasy M, Friedrich KM. Long-term effect of a
combined exercise and motivational program on the level of
disability of patients with chronic low back pain. Spine,
2005;30(9):995-1000. |
