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The Risk of Strokes in Relation to Chiropractic. New Research Points to the Importance of Detection Rather than Causation. Dr. Cohen is Alert.

September 2, 2010 | Filed under: General Interest,Headaches

Over the past 5 years, the relationship between chiropractic neck adjustments and stroke have been revealed. It isn’t that chiropractors are causing vertebral artery dissection and stroke (VADS), but rather the patient is having a VADS and sees a chiropractor for the associated pain.

This is a positive thing for patients and chiropractors alike because patients have less reason to be afraid of getting their neck adjusted by a skilled chiropractor. While there are risks in any medical procedure, including getting adjusted by a chiropractor, the risk of a neck adjustment causing an adverse reaction is less than the risk of taking Advil for neck pain.

However, it is important that we take advantage of this research and be more aware of the confounding relationship between stroke and neck pain. I know I will be more diligent about screening San Francisco patients and referring them to the ER if they describe the pain as different from their usual headaches. This is not an absolute rule though, which is why you need to see a professional (such as myself) when you have headaches.

Questions I will ask. Have you been experiencing::
blurred vision?
double vision?
trouble swallowing or speaking?
dizziness?
fainting spells?
nausea?
trouble with walking or balance?
numbness in your hands or feet?

Murphy; Chiropractic & Osteopathy 2010

There are a number of important points in regards to VADS according to the study:

1. VADS is a rare but potentially serious disorder.

2. Some of the initial symptoms of this disorder can mimic more common and relatively benign neck and headache problems.

3. Because of this, diagnosis can be difficult, so some individuals and their health care providers are not aware that they are experiencing VADS.

4. However, there can often be subtle signs and symptoms that may alert a health care provider to the possibility of VADS

5. If you experience any of these signs and symptoms inform your health care provider immediately or call your local emergency service.

I try to remain up-to-date on the most recent research which may help me treat you more effectively, or in the case of stroke and VADS, refer you to a proper practitioner after a brief neurological exam.

Improve GERD Symptoms Without the Weight gain and Other Drug Side Effects

November 18, 2009 | Filed under: Drugs,General Interest,Headaches

Gastroesophageal Reflux Disease or GERD, which is a return of stomach contents up into the esophagus and frequently causes heartburn, is typically treated with a class of drugs called proton pump inhibitors (PPI) such as Prilosec, Prevacid, and Nexium.  The commonly know side effects include diarrhea, headaches and even hip fractures.

A recent study published in the World J Gastroenterology found that patients on PPIs gained an average of 8 pounds over 2 years of use compared to those receiving a placebo.

This is a significant problem.  The study goes on to say that “patients should be encouraged to manage body weight through lifestyle modifications.”  That is good advice, but many patients already battle with weight gain so another card stacked against them is not ideal.

I have been able to improve GERD symptoms through natural supplements which are supported by research that they do not have this negative side effect.  When I work a patient up from a functional medicine approach, this is a common problem that quickly responds favorably to conservative care.  Even if a person is on a PPI, the natural supplement that I use has been commonly shown to decrease heartburn and the need for the medication.  The patient’s medical doctors are often shocked but excited about the improvement because typically a person is on a PPI for life.

These drugs are commonly prescribed prophylactically when a patient has pain that is being managed by NSAIDs due to gastrointestinal events (or bleeding in the patient’s gut).  Very often a person’s pain can be managed through chiropractic care so the need for both the PPI and the NSAID will be dramatically reduced.

Pills 2

Bottom Line: Drugs should be utilized short-term while the health care provider and patient search for the cause of the problem. Too often patients are put on drugs for life (e.g., NSAIDs or PPIs) and the cause of the problem is then forgotten about. EVERY drug has a side effect, many of which we don’t know yet.  So utilize medications conservatively and just for short-term periods of time so you can cope while a more sustainable solution is found.

Chiropractic as Effective as Drugs Commonly Used for Headaches

May 18, 2009 | Filed under: Drugs,Headaches

Regardless of the trigger, chiropractic has been shown to alleviate the pain of headaches as well as medications (without the side effects). The recent study highlighted in Psychology Today discussed the research comparing chiropractic manipulation with amitriptyline, an antidepressant commonly used to treat migraines. “The study found that chiropractic healing was about as successful as the drug.”