Maintaining Good Health

During the 1800's life expectancy was only about 40 years. Today that figure has almost doubled. If the current trend continues 1 in 3 babies born today can expect to live to be 100. However, although life expectancy is now around 80 years, healthy life expectancy is somewhat lower at 63.5 years according to the Office for National Statistics. Prof Les Mayhew, of the Cass Business School at the City University, London argues that although people are living longer, there are concerns about our ability to continue to work up to the new UK full state pension age (68), because of poor health.

Poor health comes in many guises. In recent years stress (and mental health problems) and musculoskeletal problems (of which back pain makes up a significant proportion) have been the main causes of long term absence from work. As we all live longer, it seems there may never have been a more important time to consider ways to maintain good health. In earlier blog posts I've discussed the importance of diet and exercise with respect to keeping healthy. I also believe chiropractic may be able to provide another small part of the good health equation.

In my practice I see more patients with back pain than any other condition. Over recent years there have been a number of studies supporting the treatment offered by chiropractors for this very common problem. Until recently however, support for chiropractic preventative care was more anecdotal than research led. In 2011 however, two important papers were published which begin to build support for preventative or 'Maintenance Care' for chronic back pain sufferers. Chronic back pain is generally defined as back pain which has been present for greater than 3 months. Chronic back pain can be tremendously debilitating for those suffering from it and can put a huge burden on general health resources.

The first of these 2 studies was conducted by Senna and Machaly and published in the journal Spine. Study participants (who had at least a 6 month history of low back pain) were randomised into one of 3 groups:

1. Sham spinal manipulation x 12 over 1 month, plus prescribed back exercises.
2. Spinal manipulation x 12 over 1 month, plus prescribed back exercises.
3. Spinal manipulation x 12 over 1 month, plus prescribed back exercises; plus maintenance care (treatment with spinal manipulation every 2 weeks).

Results:
Study participants who received spinal manipulation were significantly better than the sham treatment group at 1 month, however only the spinal manipulation + maintenance group were still significantly better on all outcome measures at 10 month follow-up.

Conclusions:
Spinal manipulation is effective for nonspecific chronic low back pain. Best outcomes are achieved in the longer term when maintenance treatment and exercise are included.

The second study by Cifuentes, Willetts & Wasiak was published in the Journal of Occupational & Environmental Medicine. This study examined how health maintenance care provided by chiropractors, physical therapists and physicians affected recurrences of low back pain in workers following treatment for an initial episode of back pain. Of the 3 treatments, those who received chiropractic maintenance care had the lowest disability recurrence rate.

In practice, I have found that patients most suited to receiving maintenance care are those who have chronic or recurring back pain. The frequency of maintenance care is something that is highly individual but may vary from a treatment every few weeks in the worst cases to every few months in patients with less unstable back problems. As the first study above indicates, regular exercise to improve spinal stability and flexibility is also an integral part of a health maintenance program.

By reducing back pain related disability, I believe chiropractic can play an important role in improving healthy life expectancy. Chiropractic - helping you be healthy and happy into old age!