Antidepressants are now being prescribed by Medical Doctors (MD’s) to treat common lower back pain

In 1996 about 13 million Americans were using antidepressants. By 2005 that number rose to 27 million. Not only are more Americans being prescribed antidepressants, but those individuals are taking more antidepressants. (1)

More than 164 million prescriptions were written for antidepressants in 2008. More than 1 out of 10 Americans are on antidepressants as of 2008.

Researchers Olfson and Marcus examined the clinical data from 1995-2005 and focused on 50,000 people to study. They found that those on antidepressants were more likely to then go on to use more powerful anti-psychotic drugs and less likely to partake in psychotherapy. (2) In that sense, antidepressants are a type of gateway drug and they apparently aren’t effective enough in many cases because more powerful antipsychotic drugs are later prescribed.

Dr. Eric Caine of the University of Rochester in New York said he was concerned by the findings, and noted that several studies show therapy is as effective as, if not more effective than, drug use alone. “There are no data to say that the population is healthier. Indeed, the suicide rate in the middle years of life has been climbing,” he said.

Therapy is not as easy to simply popping pills, though, which leads us to the low back pain issue.

Low back pain is one of the most common and most expensive medical conditions in the United States. Most people will have to deal with low back pain at some point in their lives. The cost of prescription drugs and expensive surgeries are two of the major factors causing an explosion in healthcare costs in the past decade. Surgery is a significant cost associated with treating low back pain, and this is despite the fact that research repeatedly shows that chiropractic care is a safer, less expensive and more effective way to treat most cases of low back pain. (3) Research has also shown that contemporary medical treatment of lower back pain is more likely to lead to disability than is chiropractic care. (4) Still, most people do not know these facts and instead go see a medical doctor.

Medical doctors routinely prescribe painkillers and muscle relaxers to their patients who complain of low back pain, often doing so rather than referring them to a chiropractor. On top of those drugs, now medical doctors have begun to prescribe antidepressants to their back pain patients.

This is where we come to a thought experiment. Think with me for a moment: as anti-depressant use doubled in the United States from 1996-2005, did the incidence of lower back pain decrease alongside it?

If anti-depressant use has more than doubled, and medical doctors consider antidepressants a treatment for lower back pain, then the prevalence of lower back pain should have dropped significantly.

But it didn’t.

That should tell you all you need to know about using prescription psychiatric drugs to treat a problem with your lower back.

1.       http://www.ncbi.nlm.nih.gov/pubmed/19652124

2.       http://www.ncbi.nlm.nih.gov/pubmed/21135326

3.       http://www.ncbi.nlm.nih.gov/pubmed/21036279

4.       http://www.ncbi.nlm.nih.gov/pubmed/21407100

“Once you go to a chiropractor, you ALWAYS have to go.”

Dr. Stephanie Maj discusses some important new research about chiropractic care for back pain and the benefits of maintenance care.

Many people are told by friends that once you start going to the chiropractor  you have to keep going in order to keep the pain away. Chiropractors often advise their patients to go on “maintenance care” in which regular spinal adjustments are given every two or four weeks. This is thought to keep the spine and low back healthy and prevent re-injury and pain. New research further confirms this.

This new, single blinded placebo controlled study, conducted by the Faculty of Medicine at Mansoura University, conclusively demonstrates that maintenance care provides significant benefits for those with chronic low back pain.

BACKGROUND: Spinal manipulation (SMT) is a common treatment option for low back pain. Numerous clinical trials have attempted to evaluate its effectiveness for different subgroups of acute and chronic LBP previously, but the efficacy of maintenance SMT in chronic non-specific LBP has never been studied.

In this study, 60 patients with chronic, nonspecific LBP lasting at least 6 months were randomized into 3 groups:

1. One third of them received 12 treatments of sham SMT over a one-month period.

2. One third of them received 12 treatments of SMT during a one-month period, with no follow-up care during the next nine months, and

3. One third of them received 12 SMT visits during the first month, followed by “maintenance” SMT every two weeks, for the next nine months.

To determine any difference among these 3 care groups, researchers measured pain and disability scores, generic health status, and back-specific patient satisfaction at baseline, and at 1-month, 4-months, 7-months, and at 10-months

RESULTS: Patients in manipulative groups (groups 2 & 3) experienced significantly lower pain and disability scores than the sham group at the end of the first 1-month period.

At the 10-month follow-up, only the maintenance group maintained improvements in pain and disability, while the group that only received 1-months care had reverted to their pretreatment pain and disability levels.

CONCLUSIONS: This is the first medically managed trial that clearly demonstrates that maintenance care provides significant benefits to those who suffer from chronic low back

To summarize that information above: the group that received chiropractic maintenance care experienced better health and less pain. The group that received just one month of care for their back pain experienced improvement, but less than the group that stayed on for maintenance care. And both chiropractic groups did better than the group that was not adjusted at all.

Headache and Neck Pain Research Update

Here at Park Bench Chiropractic in Frederick we think it’s very important to stay up-to-date with the latest scientific research regarding chiropractic and conditions like neck-related headaches. From time to time we will summarize recent research on topics we find important for our patients as a service to the community. We believe that knowledge is power – especially with your health – and this will help people make informed decisions about their health options.

Today’s article is about the difference between headaches that originate from the head and those headaches that originate from the neck. Many times you can get a headache and the cause of that headache is a problem in your neck muscles or spinal misalignment.

While neck-related headache (“cervicogenic headache”) can have symptoms very similar to a migraine, one of the main differences is the presence of pain down to the shoulder or arm and a history of neck trauma.

This makes sense when you consider that for a headache to be cervicogenic it must be one that has a source in the neck which refers pain to the head. This means that a source must be identified. Restricted range of cervical motion, tenderness over the zygapophyseal joints, and occipital tenderness have all been used as diagnostic criteria, although interobserver reliability is low.

Studies have been done that completely anesthetize different nerve root levels, and some of these studies were successful in completely eliminating the pain. This clearly demonstrates that the pain was being referred from nerves in the neck. Other similar studies doing the same thing weren’t successful.

Perhaps the best way to definitively diagnose a headache as cervicogenic is to treat the supposed neck condition and then, if the treatment is successful, then researches concluded that the headache must have been from a pain source in the neck.

Source: Distinguishing primary headache disorders from cervicogenic headache – Clinical and therapeutic implications, University of Newcastle Department of Clinical Research, Newcastle Hospital, New South Wales, Australia