Reduction of Labor and Delivery Time Due to Chiropractic Care

Do Chiropractor’s Help Pregnant Patients? Can Chiropractic Help Delivery?

The Journal of Pediatric, Maternal & Family Health published a case study on April 3, 2017, documenting the case of a woman who experienced a shorter and easier birth due to chiropractic care. This improvement was compared to her first pregnancy and delivery where she did not receive any chiropractic care.

Reduction of Labor and Delivery Time Due to Chiropractic Care - Austin-TX-Pregnancy-Chiropractor-Prenatal-Postnatal-Care-Childbirth-ATXThe study begins by noting that chiropractic care has been involved in the care of pregnant women since the early days of the profession over a century ago. The authors note that over 76% of practicing chiropractors report that the care of pregnant women is a part of their practices. This care is rendered for both musculoskeletal issues related to pregnancy as well as care for overall wellness during pregnancy.

In this study, a 28-year-old woman went to the chiropractor for evaluation and possible care. She sought chiropractic for a pain in her tailbone area as well as for wellness care. The woman believed that her pelvis had shifted due to her first pregnancy. She reported that after the delivery of her firstborn, she experienced pain and discomfort at her tailbone any time she sat on a hard surface. The woman reported that her first pregnancy went well, but that her delivery was very long and difficult. This was one of the factors in her desire to receive chiropractic care in anticipation of her second pregnancy.

Her history revealed that between the ages of eight and sixteen, she was a competitive gymnast and was receiving chiropractic intermittently during that time. She also noted that she did not receive any chiropractic care during her first pregnancy. Prior to her first pregnancy, she did not have tailbone pain. She later attributed her long and difficult labor and delivery as being the cause of the tailbone pain.

A chiropractic examination was performed and it was determined that multiple vertebral subluxations were present. Care was started to address the subluxations through a series of adjustments to the areas involved. After a number of adjustments, the woman reported a 50% reduction in the tail bone pain. She then became pregnant for the second time. The chiropractic care was continued to, hopefully, facilitate an easier delivery process.

As with her first birth, the woman decided to have her second child at home. She was supervised by the same Certified Professional Midwife (CPM) that attended her first home birth. According to the midwife, the woman’s first labor and delivery time combined was 32 hours and 25 minutes. After chiropractic care, the midwife reported that the woman’s labor and delivery times for her second child was only two hours and 45 minutes combined.

In their conclusion, the study authors note that chiropractic care during pregnancy is far more valuable than just symptomatic relief of musculoskeletal pains, and should be considered for the overall wellness and process of pregnancy. They stated, “This case report provides supporting evidence that subluxation centered chiropractic care on pregnant patients can have beneficial effects on the birthing process.”

If you or anyone you know could benefit from a better functioning nervous system, please call us at 512-452-2525 to schedule a consultation with Dr. Swanson. Austin chiropractor located in north central Austin, TX.


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Being Overweight Does not Affect Outcome of Back Treatments, But Being Obese Does

How Likely Am I To Get Back Pain? Does BMI Play A Role?

A study published on December 12, 2015, in the journal Chiropractic & Manual Therapies showed that being overweight or underweight does not have a significant effect on the outcome of various lower back pain treatments. However, being obese did have a negative impact on the results of care. The study begins by reporting that nearly 30% of the world population reports suffering from back pain while 80% report back pain at some point in their lifetime.

Being Overweight Does not Affect Outcome of Back Treatments, But Being Obese Does - Austin Texas Chiropractor Best Car Accident Injury Doctor Help PainIn this study, 681 people with lower back pain were included. Data was collected from each of the participants about their history of back pain, demographics, occupation history, disability, health status and mental health status. The participants were enrolled into one of four treatment protocols: medical care only, medical care with physical therapy, chiropractic care only, or chiropractic care with the use of physical modalities.

The participants were all treated according to the protocol of the doctor they were assigned to, using one of the four types of care categories. Outcomes of care were measured at 2 weeks, 4 weeks, 6 weeks, and 6 months after the initial treatment. For the purposes of this study, a comparison of the various types of care was not made to see if one type of care was more effective than another. Only the effects of weight as measured by body mass index (BMI) were evaluated to see if it had an effect on the results of whatever type of care the person was receiving.

The results showed that, across all treatment protocols, people who were considered to be obese had a decreased chance of improvement with their lower back pain. This included all times of follow-up as well as all levels of pain. However, being overweight, but not considered obese, did not have a significant effect on the outcome of care for any of the categories of care. Similarly, those who were underweight also did not show any significant decrease in their percentage of recovery.

The study did show that those who were obese and lost weight during care did have a better chance at recovery, and those who gained weight during care reduced their chance even further. All other groups of people showed no statistical difference in their ability to recover based upon their weight, unless they were considered to be obese.

In their discussion the authors wrote,  Results of this study suggest that BMI is a relevant predictor of response to treatment. Obese participants are less likely to show improvement from LBP treatment regardless of the care they receive.  They also stated in their conclusion,  an association between obesity and less favorable treatment outcomes was inferred in this study. There appears to be an association between obesity and disability as well as obesity and subjective most severe pain.

If you or anyone you know could benefit from a better functioning nervous system, please call us at 512-452-2525 to schedule a consultation with Dr. Swanson. We are located in north central Austin, TX.


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Stroke Risks While Under Chiropractic Care; No Evidence For Causation

With the recent headlines of chiropractic manipulation allegedly causing stroke we have listed some recent and relevant meta-analysis studies that have been done on this topic.  Below is a summary of the conclusions of some recent studies as well as a more in depth overview of the topic.

  • We found no significant association between exposure to chiropractic care and the risk of VBA stroke. We conclude that manipulation is an unlikely cause of VBA stroke. The positive association between PCP visits and VBA stroke is most likely due to patient decisions to seek care for the symptoms (headache and neck pain) of arterial dissection. We further conclude that using chiropractic visits as a measure of exposure to manipulation may result in unreliable estimates of the strength of association with the occurrence of VBA stroke. http://chiromt.biomedcentral.com/articles/10.1186/s12998-015-0063-x

stroke-risks-while-under-chiropractic-care-no-evidence-for-causation-austin-tx-chiropractor

According to the American Heart Association (2010), a stroke “…is a disease that affects the arteries leading to and within the brain. It is the No. 3 cause of death in the United States, behind diseases of the heart and cancer. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood (and oxygen) it needs, so it starts to die…Stroke can be caused either by a clot obstructing the flow of blood to the brain (called an ischemic stroke) or by a blood vessel rupturing and preventing blood flow to the brain (called a hemorrhagic stroke)…The brain is an extremely complex organ that controls various body functions. If a stroke occurs and blood flow can’t reach the region that controls a particular body function, a stroke will ensue, then that part of the body won’t work as it should” (http://www.strokeassociation.org/STROKEORG/AboutStroke/About-stroke_UCM_308529_SubHomePage.jsp).

The AHA (2010) also posts signs and symptoms of an impending stroke. These include numbness or weakness of one side of the face, sudden confusion, difficulty speaking or understanding, problems seeing out of one or both eyes, sudden trouble walking, dizziness, loss of balance or coordination, and severe and sudden headaches with no known cause.

The blood supply to the brain is provided through the vertebral arteries and the carotid arteries. Problems in any of these arteries can result in the development of a thrombus (clot) or an embolism. If the thrombus is large enough it can occlude the normal blood flow. If an embolism occurs, it can move through the circulation into the brain and occlude blood flow. Either way, a stroke can be the result of these situations. One of the unique characteristics of strokes of this nature is that they can involve neck pain and headache.

Many patients will seek chiropractor care for neck pain and headaches. In the great majority of cases, the pain involved is not related to a stroke. However, on occasion, it may be. When the pain is related to a stroke, some of these patients developed a full range of stroke symptoms. Over the years, reports in the popular press and the scientific literature have suggested or stated outright that in patients who experience a stroke following chiropractic care, the stroke was caused by the chiropractor! We now know that this is very unlikely to be the case. What is far more likely is that the patient developed a thrombus or embolism in their vertebral arteries, producing neck pain and headache. This person sought health care for the pain. Whether they saw a chiropractor or their medical provider, they would progress on to a stroke at virtually the same rate. While the argument that the chiropractor caused the problem is convenient, the science indicates that it is in all likelihood a mistake to draw such a conclusion.

In 2008, Cassidy, Boyle, Côté, He, Hogg-Johnson, Silver, and Bondy  studied the occurrence of this problem in the province of Ontario over a nine year period with a database representing almost 110 million person-years (12.2 million people, studied over 9 years equals 110 million person-years). The purpose of this study was to investigate if an association between chiropractic care and vertebral basilar artery stroke exceeded the association between medical primary care providers and vertebral basilar artery stroke. The premise was that if there was a greater association between chiropractic care and this stroke then one could logically say there was a cause and effect relationship between chiropractic care and this problem. There was no greater likelihood of a patient experiencing a stroke following a visit to his/her chiropractor than there was after a visit to his/her primary care physician. The results were conclusive; there was no greater association between manipulation (chiropractic adjustments) and ischemic stroke or TIA’s (transient ischemic attacks).

The research did conclude that overall, 4% of stroke victims had visited a chiropractor within 30 days of their strokes, while 53% of the stroke cases had visited their medical primary care providers within the same time frame. The authors offer the perspective that because neck pain is associated with some stroke, patients visit their doctors prior to the development of a full-blown stroke scenario. Cassidy et al. (2008) noted, “Because the association between chiropractic visits and [vertebral basilar artery] stroke is not greater than the association between PCP [medical primary care providers] visits and [vertebral basilar] stroke, there is no excess risk of [vertebral basilar] stroke from chiropractic care” (p. S180). In fact, the incident of chiropractic vs. medical care was substantially lower in certain situations based upon the data.

In 2010, Murphy considered the argument that a chiropractic manipulation could cause stroke and concluded, “…if this is a possibility, it would have to be considered so rare that a case-control and case crossover study covering over 109,000,000 person-years failed to detect it” (http://www.chiroandosteo.com/content/18/1/22). He also reports that “… in 20% of cases of [vertebral artery dissection and stroke] the individual does not have neck pain or headache and in a very small percentage of vertebral artery dissections can occur in a person who has no symptoms of any kind. Thus, in cases in which an asymptomatic individual experiences [vertebral artery dissection and stroke] after [chiropractic manipulation] it is not clear whether manipulation was a cause or contributing factor to the dissection or whether the patient had an asymptomatic arterial dissection prior to the chiropractic visit” (Murphy, 2010, http://www.chiroandosteo.com/content/18/1/22). He concluded his report with the following, “…current evidence indicates that [vertebral artery dissection and stroke] is not a ‘complication to [chiropractic manipulation]’ per se. That is, the weight of the evidence suggests that [chiropractic manipulation] is not a cause of [vertebral artery dissection and stroke]…” (Murphy, 2010, http://www.chiroandosteo.com/content/18/1/22).

The real issue is not whether chiropractic or medical primary care causes stroke, as the research conclusively refutes this, but rather it is an issue of public awareness and perception. The argument must shift to the real issue of protecting the public and making people aware of the importance of recognizing risk factors and of getting immediate care to avoid long term disability or death.

Murphy (2010) offers the following advice, “…engage in a public health campaign to educate the public about the warning signs and symptoms of this uncommon but potentially devastating disorder…public education materials regarding stroke in general are available from organizations such as the American Stroke Association

 

(http://www.strokeassociation.org/presenter.jhtml?identifier=3030387 accessed 1 April 2010) the National Stroke Association

(http://www.stroke.org/site/PageServer?pagename=HOME accessed 1 April 2010) the British Stroke Association

(http://www.stroke.org.uk/information/index.html accessed 22 May 2010), the Heart and Stroke Association of Canada

(http:/ / www.heartandstroke.com/ site/ c.ikIQLcMWJtE/ b.2796497/ k.BF8B/ Home.htm?src=home accessed 22 May 2010) and the National Stroke Foundation – Australia

(http://www.strokefoundation.com.au/ accessed 22 May 2010)…” (http://www.chiroandosteo.com/content/18/1/22).

References:
1. American Heart Association, Inc. (2010). About stroke. Retrieved from http://www.strokeassociation.org/STROKEORG/AboutStroke/About-stroke_UCM_308529_SubHomePage.jsp
2. American Heart Association, Inc. (2010). Warning signs. Retrieved from http://www.strokeassociation.org/STROKEORG/WarningSigns/Warning-Signs_UCM_308528_SubHomePage.jsp
3. American Heart Association, Inc. (2010). Ischemic (clots). Retrieved from http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/IschemicClots/Ischemic-Clots_UCM_310939_Article.jsp
4. Cassidy, J. D., Boyle, E., Côté, P., He, Y., Hogg-Johnson, S., Silver, F. L., & Bondy, S. J. (2008). Risk of vertebrobasilar stroke and chiropractic care: Results of a population-based case-control and case-crossover study. Spine, 33(45), S176-S183.
5. Murphy, D. R. (2010). Current understanding of the relationship between cervical manipulation and stroke: What does it mean for the chiropractic profession?Chiorpractic & Osteopathy, 18(22),
http://www.chiroandosteo.com/content/18/1/22

Written by Gerard Clum DC, Past President, Life Chiropractic College West & Mark Studin DC, FASBE (C), DAAPM, DAAMLP

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Medicare Patients Using Chiropractic Reduce Costs

Is Chiropractic Care Cost Effective? By Seeing A Chiropractor Can I Avoid Surgery?

The January 2016 issue of the Journal of Manipulative and Physiological Therapeutics published a study titled, The Association Between Use of Chiropractic Care and Costs of Care Among Older Medicare Patients With Chronic Low Back Pain and Multiple Comorbidities. The study showed that patients on Medicare who used chiropractic care decreased overall costs compared to those who did not seek chiropractic.

Medicare Patients Using Chiropractic Reduce Costs - Austin TX Chiropractor Personal Injury from Car and Truck AccidentsThe study’s objective was to determine if seeing a chiropractor saved money in healthcare expenses for Medicare beneficiaries. Researchers conducted a retrospective review of services for chiropractic care on Medicare patients between the years of 2006 and 2012.

The study reported the results of 72,326 Medicare beneficiaries who were 66 years or older and had chiropractic services that were covered by Medicare. Medicare currently only pays for chiropractic care for adjustments of subluxations.

The study compared the cost of total care for patients who received just chiropractic, with those who received chiropractic and medical care, and those who only received medical care without chiropractic. The study also only reviewed those who were seen for chronic lower back problems in order to have consistency in comparing results.

The results of the study showed that those patients who only received chiropractic care had the lowest costs for the care for their problem. This highest cost of care were those who only received medical care. Those who received chiropractic also had a much lower chance of having spinal surgery. Additionally, those who only received chiropractic care had a better outcome in a shorter period of time.

In response to this study, Dr George Curry, president of the International Chiropractors Association commented, “This study highlights the fact that those who receive chiropractic save money on healthcare expenditures. Although this study specifically looked at Medicare patients who were suffering from lower back issues, it should not be a far leap to extrapolate this out to a number of health issues that people seek chiropractic for. Chiropractic care should be viewed as a real solution to the spiraling costs of medical care.”

If you or anyone you know could benefit from a better functioning nervous system, please call us at 512-452-2525 to schedule a consultation with Dr. Swanson.


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