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MCA In Touch: April 2017
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In this issue:


May Is Posture Month: Public Health Campaign for DCs

By Steven Weiniger

May is Posture Month, and it’s our opportunity to get patients engaged and promote your practice. Supported by the Minnesota Chiropractic Association along with 50+ other partner associations, posture is a public health interest for DCs who consider posture a primary cause of back pain, and the majority of medical physicians who agree.

New low back pain guidelines from the American College of Physicians (ACP) favor spinal manipulation, massage, and motor control exercises (like the clinical StrongPosture® protocols) over medications like Tylenol and Advil, creating a potentially historic opportunity for DCs who assess and address posture.

Recently, the editor of the journal Chiropractic and Manual Therapy published “The New Chiropractic”, a 10-step plan for broader cultural acceptance of the profession. A chiropractic area of “generalized special interest” is one step in the outline, for which author Bruce Walker suggests promoting posture awareness and health.

The 2017 Posture Month campaign message is “ACE”, to help everyone create posture Awareness; take Control of their body; and optimize their posture Environment.

Get AWARE of your Posture with a Picture

DCs can and should encourage everyone to have an annual posture assessment. posture assessment. In addition to showing people how to take their own picture, PostureMonth.org has a directory of nearby professionals who offer free posture pictures during the May is Posture Month campaign.

DCs who offer free posture pictures in their community for the May campaign will be included in the directory at no cost. We recommend using the PostureZone app with a posture grid, but doctors are welcome to use any app or program they like, even just a mobile device and a six panel door.

Take CONTROL of how You Stand, Sit and Move

It’s not only IF you move—it’s also HOW you move. All motion is not the same, and all exercise may not necessarily be good exercise. Studies show there’s significant difference between running on a treadmill or lifting weights and focused exercise with attention on slow control of specific links in the kinetic chain.

The new ACP guidelines for “non-radicular low back pain” made national headlines in mainstream media when they recommended their 148,000 members to advise passive therapies such as spinal manipulation, massage or acupuncture, as well as active therapies like yoga, tai chi or other Motion Control Exercise (MCE) (i.e. the StrongPosture® protocols taught by DCs) over commonly prescribed drugs. This is unprecedented!

It’s not an exaggeration to say practically all DCs observe and then care for subtle motion dysfunction. Which is why chiropractors should also incorporate MCE to help patients actively retrain coupled control of segmental and global motion toward more accurate positioning and control.

Create an Intelligent Posture ENVIRONMENT

When people understand common-sense postural bio-mechanics, they have a framework to address their consumer choices for habits of daily life. From how they sit at work to the bed on which they sleep, our choices of desk, chair, mattress, pillow, shoes and more can have a big effect on posture. DCs should educate people in their body motion, and help them find products that are right for their body.

Posture is trending, and there are more choices every day—some great, some good, some otherwise. Understanding the basics helps people make good choices, and avoid gimmicks like supports that help in the short run, but by taking stress off muscles that should be working allowing them to weaken, compounding postural issues.

Positioning the DC as Posture Specialist: The Posture Month Strategy

The May is Posture Month ACE campaign promotes the importance of posture as an important and actionable health indicator.

In addition, the opioid crisis is also setting the stage for doctors of chiropractic to make a far larger contribution to our society. For the first time ever, in March the National Press Club hosted a press conference that brought together non-DCs to publicly communicate the potential savings in dollars and lives chiropractors can make with non-pharmaceutical pain relief. Along with the new back pain guidelines from the ACP, this means new opportunities for inter-professional referrals for DCs from evidence aligned medical physicians who view DCs as “the Posture Specialists.”

Posture is a scalable health concept that aligns with the profession’s history, contemporary science and the Chiropractic Roadmap’s suggestion for DCs to “improve posture through motor control.” Actively integrating and communicating about posture can be the connection between restoring motion and retraining postural baseline to get patients out of pain, and helping everyone in our society to stand taller to keep moving well.

Learn more about Posture Month, and join the movement at PostureMonth.org.

IQaseem, Amir, Timothy J Wilt, Robert M McLean, and Mary Ann Forciea. “Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of PhysiciansNoninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain.” Annals of Internal Medicine doi:10.7326/M16-2367.

IIWalker, Bruce F. “The New Chiropractic.” Chiropractic & Manual Therapies 24, no. 1 (2016): doi:10.1186/s12998-016-0108-9.

IIIwww.PostureMonth.org

 

Join the Posture Movement!

The 2017 Posture Month campaign will help people “ACE” their posture to become Aware, take Control, and design an intelligent home and work Environment.

Be one of the thousands of chiropractors promoting posture awareness. Help to bring real world solutions to a relevant and growing issue already on people’s minds.

Free tools to engage patients, build awareness and grow your practice.

Posture Month Toolkit

  • Flyers
  • Infographics
  • Social media shares
  • How-to videos
  • Free listing on PostureMonth.org

FREE Educational Webinar

  • Posture Month strategy
  • Leveraging social media
  • Tech and tools
  • Engaging patients

Sign up for your free toolkit at PostureMonth.org.

http://posturemonth.org/professionals/


Research Update

By Dr. Chuck Sawyer, MCA Professional Officer for Legislative Affairs

If you are a member of the American Chiropractic Association (ACA), you may have seen a recent announcement and news release about an important study published the April 11, 2017 issue of JAMA (JAMA Study Provides Further Support for Spinal Manipulation for Acute Low Back Pain). In it, the authors report their extensive review of research published since 2011, including 26 randomized clinical trials focused on acute low back pain, and concluded that spinal manipulation was associated with statistically singificant improvement in both pain and function.

While that should come to no surprise to chiropactic doctors, this report brings into sharper focus how much back pain research has been conducted and, because of an accompanying JAMA editorial, how increasingly well-accepted manipulative therapies have become for the treatment of back and neck pain.

The study was also covered in a National Public Radio story that, among other things, calls attention to the significant concern over the problem of opioid medication overuse for the treatment of pain. I highly recommend both reading and listening to the NPR story (Spinal Manipulation Can Alleviate Back Pain, Study Concludes).

The ACA news release also highlighted a new American College of Physicians (ACP) Clinical Practice Guideline published in Annals of Internal Medicine (Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain). The ACP’s guideline most importantly recommends the use of nonpharmacologic treatment approaches for patients with acute, subacute and chronic low back pain—including spinal manipulation, massage and acupuncture. The guideline also recommends that opioid medication only be considered for patients with chronic low back pain who have been unresponsive to nonpharmacologic treatment and/or nonsteroidal anti-inflamatory drugs.

The MCA believes that both of these recent publications have public policy implications and provide additional support for the core message we bring to the Minnesota Legislature regarding the value of the conservative, nonpharmacological therapies we offer patients suffering from acute and chronic back pain.

Finally, the clinical trial and related research evidence is also well-aligned with high patient satisfaction rates reported by low back pain sufferers who sought help from doctors of chiropractic as illustrated in 2013 by Consumer Reports.

To view the links visit the online version at www.mnchiro.org.


Metabolic Syndrome Becoming More Prevalent

By John L. Stump, DC, PhD, EdD

Metabolic syndrome is a collection of risk factors that increase a person’s chances of developing heart disease, stroke and diabetes. The condition is also known as Syndrome X, insulin resistance syndrome, hypertriglyceridemic waist, and obesity syndrome (also sometimes known as dysmetabolic syndrome). All of these describe the same condition in different ways and lead to the same result.

According to a national health survey, nearly 1 in 4 Americans experience this condition at this time. 1 The prevalence of metabolic syndrome increases with age, affecting more than 40 percent of people who are 60 years of age or older. I am a chiropractor but my practice includes nutritional consults, and it astonishes me to see that this national survey is true. Almost every patient I have complete the nutritional survey questionnaire shows blood sugar issues. Metabolic syndrome is beyond a doubt the No. 1 nutritional issue for people under the age of 60, and it’s something chiropractors can help correct with dietary advice and monitoring. To date, we have corrected close to 100 blood sugar (metabolic syndrome) cases in the past five years.

Warning Signs

According to the new International Diabetes Federation (IDF) definition, a person diagnosed with metabolic syndrome must have the following clinical criteria present:

  • Central obesity (a primary factor defined as waist circumference with ethnicity-specific values in the United States as greater than 35 inches for women and 40 inches for men), including any two of the following four secondary factors:
    • Elevated blood pressure (>130/85 mg/dL)
    • Increased fasting blood sugar (>100 mg/dL)
    • Increased triglycerides (>150mg/dL)
    • Decreased HDL cholesterol (<50mg/dL women, <40 mg/dL men)

Metabolic syndrome can lead to harmful changes to the body, such as:

  • Damage to the lining of the coronary and other arteries. This is a key step toward the development of heart disease or stroke.
  • Changes in the kidney’s ability to remove salt, leading to high blood pressure, heart disease and stroke.
  • Increase in triglycerides levels leading to an increased risk of developing cardiovascular disease.
  • Increased risk of blood clot formation, which can block arteries and cause heart attacks and stroke.
  • Slowing of insulin production, which can signal the start of type II diabetes, a disease associated with an increased risk of heart attack and or stroke.
  • Uncontrolled diabetes is also associated with complications of the eyes, nerves, kidneys and more, such as neuropathy.

Helping Metabolic Syndrome

There are four key ways to help treat metabolic syndrome:

  • Achieve weight loss;
  • Treat comorbidities (hypertension, hyperlipidemia, overt diabetes);
  • Consider alternative medicine procedures (diet, exercise, etc.);
  • Consider pharmaceutical prophylaxis, when necessary.

As a doctor, my first objective and focus is to entice a person faced with metabolic syndrome to lose weight. Weight loss includes changing dietary habits, physical activities, sleep and an often-overlooked aspect: the gut microbiota.2 This is what I call the short-term personal approach we doctors see daily now.

In essence, what I am describing to you is just the tip of the iceberg. In the U.S., our standard of living is facing some tough challenges. Our population is aging; as the population bulge of Baby Boomers snakes through the life cycle, 10,000 Boomers retire each day.3 This results in increasing needs for our aging population, including personal and financial support, which subsequent generations will have to provide. The financial burden is daunting from an individual level as well our U.S. population as a whole. We are experiencing an escalation of metabolic syndrome,4 which leads us down a spiraling vortex of worsening health and wellness.

Do your part now, and consider the dietary and exercise changes that must be made in your lifestyle and the lifestyle of your patients. This is a good time to institute new resolutions based on the American Heart Association’s guidelines for metabolic syndrome.5

References

  1. Carr WH. A Constellation of Concerns. Chiropractic Economics, September 20, 2016.
  2. Greenlaw P and Messina N. TDOS Syndrome. Centennial, CO. 2015.
  3. Hyman M. The Blood Sugar Solution. Little, Brown and Co., New York, 2012.
  4. Lipman F. and Claro D. The New Health Rules. Workman Publishing, New York, 2014.
  5. American Heart Association. Your Risk for Metabolic Syndrome. 2017 Life is Why. http://www.heart.org.

John Stump has doctorate degrees in chiropractic, acupuncture and sports medicine. He feels that nutrition is the one area that ties them all together and makes them functionally more efficient. He studied Western nutrition while completing his Master’s and EdD in Sports Injury at the United States Sports Academy. Additionally he completed an Eastern Nutrition course while completing a PhD in China. He is the Clinic Director of the Integrative Medicine Centre in Fairhope, Ala. Dr. Stump can be contacted at Bamashogun@gmail.com.


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