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September 2004

• Study Shows  Chiropractic Better Than Muscle Relaxants for Low Back Pain
• Sugary Soft Drinks May Raise Risk of Diabetes
• Backpack Safety Starting to Pay Off
• Medical Journals Insist Drug Manufacturers Register All Trials
• Back Pain Sufferers Prefer Drug Free Care
• Antidepressants for Kids Expected to Get Stronger Warnings

Study Shows Chiropractic Better Than Muscle Relaxants for Low Back Pain

A study published in the July / August  2004 peer-reviewed scientific journal, "Journal of Manipulative and Physiological Therapeutics", compared the effects of chiropractic adjustments to muscle relaxants in a group of patients with subacute low back pain. 

This study defined subacute low back pain as lower back pain (LBP) with a duration of 2 to 12 weeks.  The study noted that in the United States the incidence of low back pain is as high as 75% to 85% of the population being affected at some time in their lives. On a yearly basis, the study noted that between 15% to 20% of the adult population can expect to experience LBP in any given year.

In the study, conducted at Life University in Georgia, 192 subjects with LBP from 2 to 6 weeks were separated into three groups.  One group received Chiropractic adjustments with placebo medication. The second group received muscle relaxants with sham (fake) adjustments. The third group was a control group and received both placebo medication as well as the sham (fake) adjustments.  Care was rendered to the group for a 4 week period with evaluations being done at the 2 week and 4 week marks.

Results were measured in terms of patient reported pain, severity, disability and depression, as well as measured flexibility and the patients self usage of over the counter acetaminophen (Tylenol).  The results of this short study showed that for the two primary indicators of pain and severity, the chiropractic group did better than the other two groups.  No significant differences were seen for disability, depression, flexibility, or acetaminophen usage across groups in a study of this short a period of time.  All three groups showed improvement in the areas of depression, disability and drug usage.

The authors of the study did note that a longer study could have yielded more differences in recovery.  However, in the area of pain, a primary patient concern in subacute LBP cases, the group that received the chiropractic adjustments faired the best.  Their comments were: "Statistically, the chiropractic group responded significantly better than the control group with respect to a decrease in pain scores."

Sugary Soft Drinks May Raise Risk of Diabetes

An Associated Press story on August 25, 2004, reported on a new study which shows women who drink more than one sweetened soft drink a day are slightly more likely to develop diabetes than women who drink less than one a month.  Researchers performed the study at Harvard University.

This soft drink study, was published in the August 24th 2004 issue of Journal of the American Medical Association and involved an analysis of information from a continuing health study of 51,603 female nurses. The Harvard researchers analyzed surveys filled out by the nurses in the years 1991, 1995 and 1999.  These surveys detailed their eating habits, weight, physical activity and other health issues. The study showed that there were 741 new cases of type 2 diabetes during the span of time covered in the study.

Results showed that women who drank one or more sugar-sweetened soft drinks a day were twice as likely to develop diabetes as women who drank fewer than one a month. The researchers found that even when they considered such factors as weight, diet and lifestyle differences, women drinking sugary sodas were 1.3 times as likely to develop diabetes.

As expected there were many critics of the study.  A trade group representing the soft drink industry said the study’s conclusions were not scientifically sound and that the focus should be on the unhealthy lifestyles and weight gain that can lead to diabetes, not the soft drinks.

Dr. Walter Willett, one of the study’s co-authors and chairman of the Department of Nutrition at the Harvard School of Public Health stated, "I think there is a very practical implication of this study, both for weight control and for type 2 diabetes — keep soda consumption low."

The study noted that drinking fruit juice was not associated with diabetes risk. It also noted that diet soft drinks were not statistically significant in this study, but sugared fruit punch showed similar results to sugared soda.

Backpack Safety Starting to Pay Off

A report in a September 7, 2004 release from "Business Wire" states that the efforts to educate the public about backpack safety have begun to show positive results.  For several years the chiropractic profession, through the major associations as well as independent organizations, has been on a mission to educate the public about the dangers of improper backpack usage in young spines.

According to the United States Consumer Products Safety Commission, the number of emergency room visits related to backpack injuries is down from 7,860 to 7,649 over a one year period. Prior to this reduction, for the previous six years, reports of such emergency room visits were up each year, having increased 360 percent since 1996.

Dr. Marvin Arnsdorff of Chiropractic USA and co-founder of Backpack Safety America / International thinks that this is good news and bad news.  He states, "For the first time since these numbers have been reported, we see that parents, teachers, students and health care professionals are becoming aware of the issue and taking steps to address it." He continued, "The bad news is that the numbers are still needlessly high and the pain and suffering caused by overloaded and improperly worn backpacks is easily preventable."

 "Students, parents and educators should understand the risks involved in using backpacks," says Dr. Arnsdorff. "We're committed to the health and safety of these children, so we help raise awareness through our
work with schools and the community."

Dr. Arnsdorff, along with thousands of Chiropractors and other health professions have joined together to promote backpack health and safety and have issued the following safety tips from Backpack Safety America / International:

• Choose right: Bring a friend to help you measure your backpack properly. The proper size backpack is 75 percent of the length of your back, approximately the space between the shoulder blades and waist.
• Pack right: The maximum weight of the loaded backpack should not exceed 15 percent of your body weight. Pack only what you need for the day. Carry a book or two by hand to relieve the load if necessary. If the backpack forces the wearer to lean forward to carry, it's overloaded.
• Do not swing your backpack. It could hurt you and it is dangerous to those around you.
• Make sure that pens, pencils and other sharp objects are stored in a safe spot so they don't poke through and injure you or someone else.
• When lifting you backpack follow these procedures, 1. Face the pack. 2. Bend at the knees. 3. Using both hands, check the weight of the pack. 4. Lift with your legs. 5. Apply one shoulder strap at a time. Avoid slinging the pack onto your back.

For more information on backpack safety and how you can bring a program to your school or school district, visit www.backpacksafe.com or contact Backpack Safety America / International at 1 800 672-4277 or send an e-mail message to info@backpacksafe.com .

Medical Journals Insist Drug Manufacturers Register All Trials

The September 9, 2004 issue of the Washington Post contains a news story that speaks to drug companies only publishing the best results from drug trials while hiding the ones that may not have been so successful.  In response a dozen editors of the most prestigious medical journals jointly announced that they will refuse to publish drug research sponsored by pharmaceutical companies unless all the studies on the drugs are registered in a public database from the outset. 

This step is designed to bring to light unpublished studies that find medications to be ineffective or dangerous. In many cases such studies are just buried while the more favorable ones are submitted for publishing. Gregory D. Curfman, executive editor of the New England Journal of Medicine explains the rationale by stating, "When a pharmaceutical company sponsors a clinical trial and the results turn out not to be in the best financial interests of the company, it has been our experience these results are never made public."

The article noted that more than two-thirds of the studies on antidepressants given to depressed children demonstrated that the medications were no better than sugar pills.  The Journal of the American Medical Association, the Annals of Internal Medicine, the Lancet, the New England Journal of Medicine as well as several other international publications have signed on to the new initiative. It is expected that more scientific journals will join in.

A number of initiatives are also underway in the US Congress to enforce registration of drug trials. One such possible initiative may impose penalties on companies that do not register their trials with the government-run database before recruiting patients.  Representative Edward J. Markey of Massachusetts noted that there would be resistance from the drug industry to such legislation. He stated, "I understand the concern of some companies that if they report an adverse result their stock might suffer. But consider the alternative, patients suffer as doctors prescribe in the dark."

Back Pain Sufferers Prefer Drug Free Care

On August 20, 2004, PRNewswire reported on the results of a study that shows that most people prefer drug free care for back pain over taking medications.  The survey, conducted by the I/H/R Research Group, a full service market research firm that includes experienced health care managers, interviewed 800 adults nationwide in the Spring of 2004.

The survey, commissioned by the American Chiropractic Association, showed that more than 80 percent of chronic back pain sufferers surveyed would prefer to avoid the use of medication to treat their ailments.  However, a majority of those surveyed were taking either narcotics, muscle relaxants or over-the-counter medications to deal with their pain.

The survey also showed that more than 64 percent of the respondents said that they would consider seeking the health care services of a Doctor of Chiropractic to provide their drug free care.  However, the survey showed that only 13.8 percent of respondents were currently seeking health care from a Chiropractor.

The survey also showed the following:

• 18 percent of all chronic back pain was reported as the result of an accident or injury
• Almost 40 percent reported their pain as very severe or severe at the time of the survey
• 71 percent of respondents said they had suffered from chronic back pain for five or more years

The survey participants were also asked if they felt their pain was under control as a result of their current treatment.  To this question 30 percent indicated their pain was not, and an additional 39.3 percent said their pain was only moderately under control.

Antidepressants for Kids Expected to Get Stronger Warnings

The September 8, 2004 edition of the USA Today contained a feature reporting that scientific advisers to the Food and Drug Administration are expected to recommend tougher warning labels or other restrictions on antidepressants linked to suicidal behavior in children. The story notes that presently more than 1 million U.S. children take this type of medication.

The article reported that an analysis of previous studies, confirmed that those children on antidepressants may be nearly twice as likely to become suicidal as kids given sugar pills.  Dr. Graham Emslie, child and adolescent psychiatrist at the University of Texas Southwestern Medical Center in Dallas, stated, "They're going to have to do something. The horror stories have been just too horrible, and their advisory committee is going to be influenced."

At a US Food and Drug Administration hearing held in February of 2004 dozens of parents testified that antidepressants had caused their children to kill themselves. The USA Today article notes that some psychiatrists say in real-life medical practice, kids with minor adjustment problems are all too often put on antidepressants. Many doctors say the drugs occasionally trigger a frenzied, impulsive agitation that can lead to suicide.

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