Author Archives Mark Croucher

Low Fat??

Posted by Mark Croucher
on January 29, 2016
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Low fat diets don’t seem to help as much as…??

The New England Journal of Medicine Physician’s First Watch reported on this issue this morning.

[Dr. Croucher’s comment is this. We should focus on natural whole foods with our diet dominated by organic veggies. Meat and eggs should be grass fed, truly free range and organic. Find an organic farmer and buy from him/her. I never worry about fat. In fact I often put organic virgin coconut oil in my coffee. It bumps up the calories and the fat provides a good source of energy in the morning. Fish should be smaller creatures as the larger animals like swordfish, tuna and shark absorb more toxins than smaller fish. I think people should avoid artificial sweeteners and flavorings. The “low fat” products that taste sweet are usually full of toxic junk. Spend your hard earned money on good quality whole food. To get to and maintain a healthy weight, eat good food and exercise every day. You’ll probably need to spend less money on medical bills.]

Low-fat diets do not result in greater long-term weight loss than higher-fat diets, a meta-analysis in the Lancet Diabetes & Endocrinology finds.

Researchers examined data from over 50 randomized trials comparing low-fat diets (≤10%–30% of calories from fat) and higher-fat diets in some 68,000 participants. Among the findings for weight loss of 1 year’s duration or more:

Low-fat diets led to significantly less weight loss than low-carbohydrate, higher-fat diets, with a mean difference of 1.15 kg.

Compared with other higher-fat diets, low-fat diets conferred similar weight loss.

Low-fat diets were superior only to usual diets.

By Amy Orciari Herman

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

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Freeze!

Posted by Mark Croucher
on January 29, 2016
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cowboysFreeze!!

Your back pain is most likely NOT muscular. Really.

Studies continue to report that spinal and disc degeneration and spinal joint pain is the driving force behind and cause of low back pain.

Lower back pain is actually one of the most common reasons why people go to the doctor in the world. “Low back pain exerts a tremendous burden on individual patients and society due to its prevalence and ability to cause long-term disability.”

Many people believe that the driving force is muscular (back and core weakness). However, much of the current research tells us that breakdown of the spine is the cause and most specifically the disc.

Intervertebral discs are avascular pads (no blood supply) of fibro-cartilage that allow movement between vertebra. Research indicates that they can begin to break down as early as 13 years of age. By age 40 it has been estimated that more than 90% of people have lower back disc degeneration.  This disc degeneration affects the function of the spinal joints.

The nerves that monitor the discs and joints of the spine become ANGRY when your spine starts to wear down. That causes pain!

Many non-surgical treatments aim to improve spinal motion, stimulate spinal nerve reflexes and mobilize stiff damaged spinal regions.

This is the EXACT approach that we use in chiropractic at our office.

1. Identify areas of pain, damage and poor spinal movement.

2. Establish treatments to reduce pain, improve motion and flexibility which can improve health to the areas of spinal damage. We use (controlled instrument delivered manipulation, mobilization, stretches, exercises, improved nutrition etc..).

3. Create (DOs and DON’Ts) with regard to daily activities that will aim to help the spinal structures to heal and last longer.

Remember Pilgrims…your chronic back pain is probably NOT muscular.

Chiropractors can do a lot to help people live better lives…but we DON’T push bones back in place. (That was 1930s chiropractic philosophy and most of us have moved on)

Some of the above stats come from these studies:

1. Theoretical Biology and Medical Modelling 2015, 12:24 doi:10.1186/s12976-015-0020-3.

2. MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol. 2015 Sep 10.

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Posture and the BRAIN

Posted by Mark Croucher
on January 29, 2016
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posture

“Our results imply that chronic back pain (CBP) is accompanied by brain atrophy…”

ABSTRACT
The role of the brain in chronic pain conditions remains speculative. We compared brain morphology of 26 chronic back pain (CBP) patients to matched control subjects, using magnetic resonance imaging brain scan data and automated analysis techniques.

CBP patients were divided into neuropathic, exhibiting pain because of sciatic nerve damage, and non-neuropathic groups. Pain-related characteristics were correlated to morphometric measures. Neocortical gray matter volume was compared after skull normalization.

Patients with CBP showed 5-11% less neocortical gray matter volume than control subjects. The magnitude of this decrease is equivalent to the gray matter volume lost in 10-20 years of normal aging. The decreased volume was related to pain duration, indicating a 1.3 cm3 loss of gray matter for every year of chronic pain. Regional gray matter density in 17 CBP patients was compared with matched controls using voxel-based morphometry and nonparametric statistics.

Gray matter density was reduced in bilateral dorsolateral prefrontal cortex and right thalamus and was strongly related to pain characteristics in a pattern distinct for neuropathic and non-neuropathic CBP.

Our results imply that CBP is accompanied by brain atrophy and suggest that the pathophysiology of chronic pain includes thalamocortical processes.

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Chronic pain?? Is your brain okay?

Posted by Mark Croucher
on January 29, 2016
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Chronic pain barrages the brain with specific, repetitive nerve impulses. This can cause “bad” changes in brain matter. It appears however, that these changes are reversible when the pain signals are reduced.

“Using functional imaging, we recently investigated how repeated painful stimulation over several days is processed, perceived and modulated in the healthy human brain. Considering that activation-dependent brain plasticity in humans on a structural level has already been demonstrated in adults, we were interested in whether repeated painful stimulation may lead to structural changes of the brain. 14 healthy subjects were stimulated daily with a 20 min pain paradigm for 8 consecutive days, using structural MRI performed on days 1, 8, 22 and again after 1 year. Using voxel based morphometry, we are able to show that repeated painful stimulation resulted in a substantial increase of gray matter in pain transmitting areas, including mid-cingulate and somatosensory cortex. These changes are stimulation dependent, i.e. they recede after the regular nociceptive input is stopped. This data raises some interesting questions regarding structural plasticity of the brain concerning the experience of both acute and chronic pain.”

Study Title: Changes in brain gray matter due to repetitive painful stimulation

Cover image
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Chiropractic in the military

Posted by Mark Croucher
on January 28, 2016
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Dr. Croucher will be attending the National Chiropractic Leadership Conference again this year as he does every year.  We are lobbying to try to get chiropractic coverage for retired veterans (Tricare for Life).  The American Chiropractic Association has been working hard for years trying to get this legislation passed through congress.

A paper in the Journal of Evidence Based Complementary Alternative Medicine published the following position on the topic.  Doctors of chiropractic that are integrated within military and veteran health care facilities.  They manage common neurological, musculoskeletal, and other conditions; severe injuries obtained in combat; complex cases; and cases that include psychosocial factors. Chiropractors collaboratively manage patients with other providers and focus on reducing morbidity for veterans and rehabilitating military service members to full duty status. Patient satisfaction with chiropractic services is high.  Preliminary findings show that chiropractic management of common conditions shows significant improvement.

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Why take standing X-rays?

Posted by Mark Croucher
on January 27, 2016
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This is one good reason why we recommend standing X-rays instead of lying down.  First it should be pointed out that unless there is a red flag during the examination, we don’t immediately recommend X-rays of the spine prior to treatment.  Normally conservative treatment can ensue for a few weeks to see if our interventions are going to be helpful.  If expected improvement is not achieved then imaging may be necessary.  In those cases, to obtain a better understanding of posture and weight baring, we recommend standing films.

Report in Clinical Spine Surgery


Conclusions: Routine standing lateral radiographs should be standard practice to identify DS, as nearly 1/3 of cases will be missed on supine MRI. This may have implications on whether or not an arthrodesis is performed on those patients requiring lumbar decompression. Flexion-extension radiographs demonstrated no added value compared with standing lateral x-rays for the purposes of diagnosing DS.

Want to read the study?  Click here!

 

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