Global Wellness

Chiropractic Care | Lewiston, ID | Joan P. Burrow DC NMD


1 Comment

Should I have epidural steroid injections?

This is the medical model for treating low back and leg pain that is caused by spinal stenosis (pictured, here) – a narrowing of the space that the spinal cord or nerve root passes through:

  • Try exercises and physical therapy first.
  • If you are still having more problems than you can deal with, try an epidural injection of steroids at the pain clinic.
  • When that doesn’t help, surgery is then offered to open up the space.

A small study published in the February 2014 issue of the journal Spine suggests that the injections may do more harm than good!

The Spine Patient Outcomes Research Trial (SPORT) was a four year comprehensive study to look at different ways of treating low back and leg pain and how effective they were for patients, funded by the National Institutes of Health (NIH).  Some patients had surgery, others had non-surgical interventions, and the research published from the trial said, basically, that those who had surgery were, by and large, happier with their results one to four years later than those who didn’t.

Researchers with access to the SPORT database took a look at the results from a group of those non-surgical patients, specifically those patients with lumbar spinal stenosis, to see how the patients who received epidural steroid injection compared to those who didn’t.

There were 276 patients in the original SPORT study who had the diagnosis of lumbar spinal stenosis, and the data from this subgroup was analyzed to see how well the 69 who received the epidural steroid injections within the first 3 months of the study did, compared to the 207 who didn’t have the injections.

The conclusions? Pretty scary if you’ve already had the injections!

  • Those patients who had epidural steroid injection were associated with significantly less improvement at 4 years among all patients with spinal stenosis in SPORT.
  • Furthermore, for those who eventually had surgery, having epidural steroid injections were associated with longer duration of surgery and longer hospital stay.
  • There was no improvement in outcome with epidural steroid injection whether patients were treated surgically or non-surgically.

In case you didn’t catch it:  At the end of four years, everyone who had the injections had significantly less improvement than those who didn’t have them (whether they ended up in surgery or not).

Okay.  Yes, this is a small study.  Yes, it only studied the people with one of the possible causes for low back/leg pain.  Do you really want to have such an injection IN CASE they find something different when they look at the rest of the population?

Should you have epidural steroid injections as part of the recommended course of treatment for your low back pain?  I think not.


1 Comment

Acid Blocking Medications

The fact that a drug is purchased ‘over the counter’ doesn’t change the fact that it is a drug.  Take, for example, that class of drugs that stop the production of acid in the stomach, widely taken for GERD (acid reflux).  The symptoms of acid reflux include heartburn, wheezing, and tightness or a feeling of food caught in the throat.  The solution is to take just one of those harmless little pills every day, stopping the production of acid in the stomach.  Voila!  No symptoms of acid reflux!  Life is now good, right?

Wrong!  There is actually a very good reason for that acid in your stomach.  Like, digesting food!  Without the acid, the protein you eat can’t be broken down.  The pH has to be very much on the acid side before the valve that lets the food out of the stomach is triggered to open, and without acid the only way that can happen is for the food in your stomach to rot (a process that doesn’t take terribly long at body temperature).  If you can still taste the food you ate for breakfast in a burp before lunch, that food is still sitting in your stomach, rotting away.

Let’s set that part of digestion aside, and look at some of the longer term problems.  Without an acid environment, calcium cannot be broken down or absorbed, no matter what food or supplement you ingest.  You need a certain level of calcium in your blood for muscles, including your heart, to relax, so your body is very good at keeping enough calcium in your blood – it steals it from your bones!.  No calcium in the diet = calcium stolen from the bones = osteoporosis.  Using this class of medication more than one year causes measurable loss of bone density.

Need more?  A recent article in JAMA (The Journal of the American Medical Association) associates long term (2 years) use of proton pump inhibitors (like Prilosec, Prevacid and Nexium, and their generic and OTC equivalents) with a 65% increased risk of vitamin B12 deficiency, since the cells that make the stomach acid also make intrinsic factor, a protein that helps vitamin B12 be absorbed.  As you’d expect, the higher the dose of inhibitor, the higher the risk of B12 deficiency.

So, why should we worry about B12 deficiency?  Not enough B12 can lead to some very troubling ailments.  These include anemia, nerve damage, psychiatric problems and dementia, just for starters.  As we age we naturally lose the ability to produce hydrochloric acid and intrinsic factor and to absorb B12 – which means if you are over 50, you should consider B12 supplementation even if you haven’t been on an acid blocker.

How do we get B12 in our diet?  Almost exclusively from animal tissues (vegans beware).  And, unlike most B vitamins, your body stockpiles B12, sometimes enough for 7 years – so a deficiency may not show up for a while.   If you decide to supplement B12, make sure you do so by injection or an oral spray that’s absorbed through your mouth.  B12 is the largest vitamin molecule known and isn’t passively absorbed from the digestive track.  Taking B12 in a pill is simply not effective.

So, you have GERD and knowing all of this, don’t want to take those acid blockers anymore.  While I cannot recommend that you stop taking anything that your medical doctor has prescribed, I can help you stop the acid reflux, so that you and your medical doctor together can decide to reduce or stop that medication.   Call me.  Let’s talk.


Leave a comment

Treat the cause or the effect?

I use the work being done by Dr. Marty Hinz and his team at NeuroResearch in Duluth, MN to help my patients balance neurotransmitters with nutrition.

And, you say, what is a neurotransmitter?

A neurotransmitter is a chemical released at the end of a nerve fiber that causes the transfer of an impulse to another nerve or muscle fiber or organ – it’s what your body uses to ‘transmit’ the signal.

If you don’t have enough of the signaling chemicals, the message doesn’t get across – like not having enough bars on your cell phone to get a message through.  If you have the wrong blend of signaling chemicals it’s like being in an area without a tower that talks to YOUR carrier.

There are many illnesses caused by an imbalance or deficiency in neurotransmitters, and correcting the underlying cause keeps us from having to chase each issue.

Here is a partial listing of diseases and disorders that are related to unbalanced or inadequate neurotransmitter levels:

Adrenal fatigue or burnout
Addiction
Alzheimer’s disease
Anorexia
Anxiety
Asperger’s Syndrome
Attention Deficit Disorder (ADD)
Attention Deficit Hyperactivity Disorder (ADHD)
Autism
Bulimia
Serotonin driven coronary artery disease
Chronic pain
Chronic stress
Cognitive deterioration
Cortisol Dysfunction
Crohn’s disease
DARPP-32
Dementia
Depersonalization disorder
Depression
Fibromyalgia
GABA dysfunction
Hormonal dysfunction
Hyperactivity
Impulsivity
Inappropriate Aggression
Insomnia
Irritable Bowel Syndrome
Migraine Headaches
Nocturnal Myoclonus (Restless Leg Syndrome)
Obesity
Obsessionality
Obsessive Compulsive Disorder
Organ system dysfunction
Panic Attacks
Parkinson’s disease
Phobias
Post-traumatic stress disorder (PTSD)
Premenstrual Syndrome (PMS)
Psychotic illness
Schizophrenia
Seasonal Affective Disorder
Social anxiety disorder
Tension Headaches
Tourette’s syndrome
Traumatic brain injury
Trichotillomania
Ulcerated Colitis

If you have any of these (and, especially, if you suffer with several) and are not getting satisfactory results with the treatment you are currently receiving, please consider working on the cause, instead of the effects.