I hope that your summer is rewarding!

Summer is really flying by.  It seemed to start out slow, but by the end of June it ramped up and is in full force.  Remember to hydrate by drinking lots of water and sports drinks when you are outdoors.  This is the hottest summer, with the least amount of rain since 1976 and it is fatiguing to your system.  Just like your yard, your body gets 'dry and crunchy' without water too!

I thought that this month I would return to a solid chiropractic theme in my ENewsletter.  Education is best when it is repeated often and reinforced by truths.

The first article talks about the incredible reliability of the Activator^® Method Chiropractic Technique.  It far surpasses other methods of analysis and correction.  Medicine can investigate and make all of the negative inferences to the treatment of low back pain that they would like, but until successful Chiropractic care is validated by Medicine their noses continue to grow!

The second article discusses the drawback of low back surgery and why cutting the area is not really the problem with surgery.  It also discusses why active chiropractic care sets the stage for low back recovery better than other treatments.

I do revisit the topic of decompression machines for treating low back injury.  I am currently not fond of these procedures.  It is a simple off-shoot of the ineffective 1970's traction protocol, which didn't work either.  The supposed research is flawed, even though the marketing campaign is great.  I think that you will see what I mean.

I finish my articles with exciting research that does support and reinforce my premise of improving body function by using brain physiology as a 'tool' for improved health.  It is good stuff!

Eileen brings you a quick, easy and tasty summer-time meal that has stood the test of time.  I think that you will like it.  Minnesota summers really do have great benefits!

Read on.....

Dr. Frisch

Activator Technique "Reliability"

The Activator Technique^® and the Activator Adjusting Instrument continue to hold their own in the medical arena and in all aspects of physical rehabilitative medicine. I have written about this technique in earlier ENewsletters, but I think that certain aspects of the analysis and technique need to be revisited.

If you noticed, I placed quotes around the word reliability in the heading of this article.  I did that for a reason.  Reliability in the research arena means something different than it does in general conversation.  

"Reliability means the predictability and reproducibility of measurement results"

To be reliable, a research study measurement, must be be able to be reproduced by anyone who might want to perform the study again with a whole new set of subjects.  This means that no matter who does the study, if the same measures are used and they are tested the same way, the same results will be obtained.  The is a true test of reliability.  

A recent study published in the Journal of Physiotherapy (2006) reported the results of a large data base search to determine the reliability of physical examination procedures for low back pain.  They found what they determined to be 48 relevant research studies investigating quality and reliability.

In those studies, it was reported that... "most procedures commonly used by clinicians in the examination of patients with back pain demonstrate low reliability."

I am pleased to report that Activator^® Methods has already performed this research (1989) and the Activator technique scored high in the reliability of analysis.  The research protocol called this range "Fair to Good" and it surpasses most other measures of analysis.

I am not sure why medicine keeps trying to reproduce the wheel, but as long as they do, people will continue to remain confused on how to analyze and correct their low back pain.  I am happy to see that research continues to look at neck and back pain, but I am concerned at the negative tone that I often see and here is why.  

If it can be determined that "No acceptable analysis or treatment exists for back and neck pain.", then it furthers the pharmaceutical approach to drug treatment and other medical measures that may be profitable, but totally ineffective.

For medicine to even consider slighting the Activator Methods Chiropractic Technique^® in credibility is to discredit the whole research process.  Gone are the days when someone could say "I don't believe in Chiropractic."  Chiropractic seriously entered the research arena in the 1980's and study after study validates chiropractic.  Activator^® Methods was and still is a leader in that regard.

When the Chiropractic profession has brought effective treatment for back and neck pain to the world and supports that effectiveness through accurate research, Medicine needs to take an 'honesty inventory' in what they report as serious research to the general public!  Many medical procedures do not have even "fair" reliability, but I will leave that for anther column!

Eileen's Corner

I have eaten versions of this recipe since I was little and I liked them all.  Zucchini and tomatoes are in season and we should enjoy the harvest.  I hope that you like this one!

Options

I like to top each layer with a little butter.

My Mom likes to wait until the last 10-15 minutes of baking to add the top cheese.

Enjoy!

Eileen

Do You Really Want Surgery?

What is the first thing that each of us says when we find out that something is physically wrong with us?  That’s right! We say “It’ll go away!”  But, what happens when it won’t just go away?  Right again! We then demand that someone else “Make it go away!”

Having practiced for 20 years, I can’t begin to recall the number of times that patients have demanded that I make their pain disappear.  Usually I can help, but there are instances when a problem won’t go away and the best that a patient can hope for is ‘STABILITY’ of their problem.  With age and maturity, most people come to realize that not every problem in life can be fixed.  That realization, however, does not always comfort the sleepless nights or the gnawing pain when trying to function like a normal, pain-free person.

Chronic pain, as I have discussed in earlier Newsletters, is not simple pain that lasts for a long time.  Chronic pain changes a person.  It can permanently alter brain function and personality traits.  Someone suffering with chronic pain often says, “I’m different than I used to be.”  They do know the difference in themselves, but they can’t always put a finger on what it is or why!  A desperate desire to regain some normalcy and control over their life can also force someone to make a less than rational decision with their health.  They fall for fast-fix gimmicks, slick advertising shams, and let’s not forget about the late night infomercials!!!  Why do you think that advertisers market certain products late at night?  They know who is up watching and why.

Low back pain associated with discal trauma, stenosis, or degeneration can often lead to chronic pain.  Most of this type of trauma can be stabilized with care, and a considerable amount of trauma will actually heal.  Post-treatment MRI studies confirm this.  Some people, however, do not want to take the time to stabilize a problem the right way and they will opt for a ‘quick fix’, which can result in permanent, irreversible damage that will last for the rest of their life.

A study published in the Journal of Spinal Disorders and Techniques (July, 2006) investigated what happens to the low back muscles after a low back operation.  They looked at 5 different surgical techniques to fix low back vertebra and disc injury.  One of the surgeries went through the abdomen and did not even cut into the low back muscles!  They found that in all cases, the low back muscles atrophied (shrunk in size) after surgery to the low back, even with the frontal operation that never cut the low back muscles. 

These findings were significant.  It means that in an attempt to fix an area with surgery, they may actually have made the problem worse by weakening the area that they were trying to stabilize. 

 Another study published in Disability Rehabilitation (June, 2006) investigated all available research up to 2004 on low back pain relating to cardiovascular and muscular deconditioning.  The literature was fairly conclusive that cardiovascular deconditioning did not really play a part in low back injury or recovery.  General strength and low back exercises were equally effective as other active treatment during the recovery process.  The intensity of the exercises did not seem to make that much of a difference either.  This paper concluded that muscle reactivation from active treatment and not the reconditioning itself was the important factor in recovering from a disability.

Chiropractic care is active treatment that is structural and neurological in its focus.  The strengthening of the supporting muscles occurs because the care permits neurological reactivation of those muscles.  Exercises are of greater benefit after a degree of stability to an injured area has occurred. 

“Legitimate Medical Research continues to validate Chiropractic care for acute and chronic injuries, even though they aren’t trying to!!!”

Do You Feel Compressed?

If you do not yet have concerns about the frequent newspaper advertisements regarding disc decompression therapy, you should!

The above picture is one that is frequently used in the marketing of a 'high-tech looking' machine that guarantees an 86% success rate in curing low back discal injuries.  I did explain in a recent ENews issue how the research is flawed and dishonest with the claims made! The problem with this picture, however, is that the MRI shown is not accurate!

The smaller 'before' picture on the left shows a small disc herniation.  You can see it at the top of, and behind, the second vertebra from the bottom. It looks like a little black dot sticking out from behind the vertebra.  This small herniation really is a big deal and would require chiropractic care to properly stabilize it.  

The thicker, dark stuff behind the vertebra is muscle and soft tissue.  This means that the herniation is visible more laterally (to the outside) of the vertebra, rather than into the spinal cord space.

Here is were the dishonest part comes in!  Any first year radiology student could tell you that the 'after' picture on the right is not the same view as the one on the left.  

The 'after' picture shows a central slice into the spinal cord area.  The big, white area behind the vertebra is actually the spinal canal and the stuff that looks like a horse tail in the space is actually the spinal cord.

You do not see the disc herniation because it is outside of that area.  You also do not see the muscle or soft tissue like you did in the 'before' picture because there is no muscle inside of your spinal canal!  

This is like looking at a snowmobile sitting outside and next to your garage, and then moving sideways in front of the garage, looking at your cars, and saying that the snowmobile is gone!

This is only one reason that the supposed research is flawed.  They are not using comparative measures to predict a successful outcome The advertising also fails to acknowledge that:

• Chiropractic and Medical care were used during the study period, medication was also used, light duty work was implemented, and other treatments were used along with the decompression machine. 

• Any successful outcome, however, was given to the machine.

• No accurate follow up MRI's were apparently taken.

WHAT KIND OF RESEARCH IS THIS?

PT Barnum was correct when he said that "A sucker is born every minute.", but what kind of people prey on seriously injured people with a false hope of curing pain?  That word is not printable!

If you or someone that you care about is considering this type of therapy for chronic back pain, please investigate this thoroughly and be aware of what it really is.  There is more published research about the pitfalls of decompressing discs of the spine than there is on the benefits of doing so.  The disc is a kinetic unit that is dependent on many more variables to heal than just a vacuum effect.  The medical field learned this in the 1970's and I hope that the chiropractic field learns this quickly!

A legitimate study published in the medical journal Spine in June of 2006 investigated traction for low back pain, both with and without sciatica, for all years up to November 2004.  They were unable to determine any significant or lasting benefit from low back traction and could not recommend its use!

They're Getting Closer!

I have been using brain physiology to alter pain with patients for many years.  Those of you that have used these program are well aware of the ease and effectiveness of this approach to health.

Recent research has given us even more information about why the hypnotic state is effective with circulation of blood flow and pain.  I was pleased to see that the direction of this research was physically-oriented, rather than talk-therapy.

The Department of Anesthesiology and Pain Clinic at the University of Liege, Sart Tilman, Belgium, found that when using PET scan imaging they were able to distinctly categorize active brain areas when someone was experiencing the hypnotic state ( J. Physiol Paris, 2006).

They determined that while experiencing the hypnotic state, the occipital, parietal, precentral, premotor, and ventrolateral prefrontal and anterior cingulate cortice areas of the brain were all active!  These areas are similarly stimulated when using guided imagery, except that the hypnotic state shuts down the precuneal area.

The precuneal area of the brain is, at least, partly responsible for conscious, cognitive thought.  This means that the hypnotic state is not a conscious state (being awake), even though it does share certain similarities with the conscious state.  By restricting active conscious thought, all changes to both behavior and body function follow a different pathway than used when we are fully awake.

"How Cool is that?"

They were also able to determine that the hypnotic state is a physiological state that is truly different than simple rest.  When compared to rest, the hypnotic state was effective for reducing the perception of pain by at least 50%.  This ability to sense less pain was not a 'made-up' perception, but rather, it was under the control of an area of the brain called the midcingulate cortex.

Finally, the researchers were able to establish a real relationship between brain function while experiencing the hypnotic state and the nerve network that supplies our bodies.

When compared to being awake (alert) and using relaxing imagery, the hypnotic state was able to significantly enhance the reaction and function of the body's nerve network pathways.  This involved the sensory, affective, cognitive and behavioral reactions to signals of pain.

This means that the hypnotic state is actually a 'delivery system' similar to that of drug therapy.  When a drug is ingested it is delivered to specific area of the body to stimulate a response.  Drugs are carried along or 'pushed' by any number of chemical mechanisms,  Many of the mechanisms are still unknown.  This includes aspirin!

The hypnotic state is a 'delivery system' that is capable of targeting both a neurochemical and bio-behavioral response by directed brain activity.

(Please read that again!)

If that sounds like a mouthful, believe me it is.  The actual process of Clinical Hypnosis is an involved therapy procedure.  Hypnosis is the process of entering the hypnotic state (brain frequency), but what happens after that is neurological, chemical, hormonal and behavioral.  

Hypnotic therapy is a distinct type of care that continues to gain recognition because science is becoming more sophisticated and better able to measure what happens inside of us.  Now that the brain is being better monitored and measured, Clinical Hypnosis will take an appropriate place as a true medical therapy that is both effective and has reproducible benefits.

I have offered Clinical Hypnosis therapy in the office for many years.  My goal has always been to be able to support my work by objective, medical research and I have been able to make great strides in that direction.  In addition to the research-supported Allermune™ (allergy relief program) and the Habitack^® Smoking Cessation Program, Vason™ (circulation program) continues to show effectiveness with diabetic vascular deficiencies.

As technology improves and becomes more affordable for independent, clinical research, I will be able to track the brain neurology and neuron sequencing to determine what makes each program effective and reproducible.  I have made inroads for just such testing, but those relationships take time to establish.  I will keep you posted when that research occurs!

I hope that you enjoyed this issue of ENews!

Have a great month,

Dr. Frisch