​Degenerative disc disease(DDD) is a condition that affects the intervertebral discs of the spine, often leading to pain, stiffness and a reduction in range of motion. As we age, the discs between out vertebrate loose their flexibility, hydration, and elasticity. It is common for DDD suffers to experience symptoms such as back pain, numbness, and weakness in the limbs.
 
In the geriatric population, many individuals are diagnosed with DDD due to back pain, and it is often accompanied by conditions such as radiculopathy, myelopathy, spinal stenosis, degenerative spondylolisthesis, and herniation.(1) The cause of DDD is complex and multifactorial. However, research has indicated that genetic expression influences intervertebral disc(IVD) health, while occupational and mechanical factors are significant risk contributors.(1) For instances, a study showed over 90% of professional soccer players have at least one spinal degeneration condition.(2) This is concurrent with Olympian shows a high rate of DDD in cervical and lumbar spine.(3)
 
A key component of the IVD is type 1/ alpha collagen
Think of our IVDs like rubber car tyres. They have great tensile strength, are strong and tough, and can bend and twist. The outer layer, annulus fibrosis, of our IVD is made up of type 1 collagen, this helps to resist over stretching and mechanical stress. Here are some tips to promote IVD health.
 

1. Avoid inactivity - This reduces the strength of supporting muscles, and decrease hydration and nutrient supply to the disc.
2. Avoid smoking.
3. Avoid sugar and refined carbohydrates.
4. Increase intake of collagen - it can be found in both broth, chicken, fish and egg whites.
5. Increase intake of vitamin C - helps with collagen synthesis.

 
Manual therapies like chiropractic, can provide a non-invasive and drug free approach to maintain spinal health, relieve pressure on the damaged disc and nerves, reduce the level of back pain and improved function. Decompression techniques to gently stretch the spine, increase space between the IVDs and promote greater blood flow to the area for healing. Chiropractic care coupled with exercises and a good balanced diet, is key to longevity of spinal health.
 
If you are eager to learn more, be sure to check out our previous blogs!
 
 
 
 
 
Reference

1.         Hemanta D, Jiang X-x, Feng Z-z, Chen Z-x, Cao Y-w. Etiology for Degenerative Disc Disease. Chinese Medical Sciences Journal. 2016;31(3):185-91.
2.         Bezuglov E, Lazarev A, Petrov A, Brodskaia A, Lyubushkina A, Kubacheva K, et al. Asymptomatic Degenerative Changes in the Lumbar Spine Among Professional Soccer Players. Spine. 2021;46(2):122-8.
3.         Abdalkader M, Guermazi A, Engebretsen L, Roemer FW, Jarraya M, Hayashi D, et al. MRI-detected spinal disc degenerative changes in athletes participating in the Rio de Janeiro 2016 Summer Olympics games. BMC Musculoskeletal Disorders. 2020;21:1-8.

​Unfortunately, for some people migraines are something they are struggling with on a regular basis. While there are many different factors and variables that contribute to the occurrence of migraines, its particularly important to understand the roll hormones play in the presentation of migraines, especially in women.
 Migraines are 3x more prevalent in women compared to men, and in most cases the presentation of migraines begins when menstruation starts to occur (1). This can lead us to believe that hormones, more specifically ovarian hormones, play a crucial role in the development and occurrence of migraines.
Research shows that fluctuations and a decrease in estrogen levels can be a notable trigger of migraines especially on day 1 and 2 of their cycle (1). There are numerous hormonal influences that contribute to migraines; menarche, oral contraceptive use, pregnancy, perimenopause and menopause (2).
It is within reason to assume that management and balance of female hormones can reduce the occurrence of migraines. Beyond migraines, hormonal dysfunction in women can also present as heavy bleeding during menstruation, water retention and bloating, weight gain, depression and other mood disorders, as well as many other symptoms (3).
Stress management, nutrition and exercise are three crucial lifestyle choices that are critical to maintaining hormone health and harmony (3). This includes drinking pure, filtered water, eating whole nutritious foods, and including appropriate supplements (3). While incorporating healthier choices into your lifestyle, chiropractic is another great tool for management of stress and nervous system dysfunction.
If you, or someone you love is experiencing chronic migraines, it may be worth investigating if they can be managed through balancing their hormones.
 
References
 

1. Pakalnis A. Migraine and Hormones, Seminars in Pediatric Neurology [Internet]. sciencedirect.com. 2016. Available from: https://www.sciencedirect.com/science/article/abs/pii/S1071909116000061

1. ‌Lay C, Broner S. Migraine in Women [Internet]. science direct.com. Neurologic Clinics; 2009. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0733861909000036
2. ‌Dr. Bob’s Drugless Guide to Balancing Female Hormones, Dr. Bob DeMaria
   The Encyclopedia of Natural Medicine, Murray, ND & Pizzorno, ND. Available from:

https://www.theholistichealthapproach.com/blog/balancing-female-hormones
 
 
 

​ In recent studies the human gut microbiota, which is the trillions of microorganisms, including bacteria, archaea, fungi, and viruses, have been connected to many components of health and disease. Incredibly, not only has the gut microbiota been found to be essential for maintaining metabolic and immune health, but there is also a lot of evidence suggesting that the gut microbiota influences brain development. The gut microbiota has been found to not only be an essential component immune and metabolic health, but also seems to influence development and diseases of the enteric and central nervous system, including motility disorders, behavioral disorders, neurodegenerative disease, cerebrovascular accidents, and neuro immune-mediated disorders. Bacteria have been shown to produce and/or consume a wide range of mammalian neurotransmitters, including dopamine, norepinephrine, serotonin, or gamma-aminobutyric acid (GABA). Accumulating evidence in animals suggests that manipulation of these neurotransmitters by bacteria may have an impact in host physiology, and preliminary human studies are showing that microbiota-based interventions can also alter neurotransmitter levels, neurogenesis and interacts with the enteric and central nervous systems via communication along the ‘gut-brain-axis”. GABA is the major inhibitory neurotransmitter of the central nervous system, and it and its receptors are widely distributed throughout us. Substantial literature supports the link between altered GABAergic neurotransmission and numerous CNS disorders, including behavioral disorders, pain and sleep. As well in the disruption of important functions of the ENS, such as intestinal motility, gastric emptying, nociception, and acid secretion. Bacteria in the gut have been known to be able to consume or produce GABA for decades. Secretion of GABA serves as a mechanism to decrease intracellular pH via the glutamate acid resistance system. The microbiota seems to influence circulating GABA levels, as in a study done by Strandwitz in 2018, they eliminated the microbiome of animals and in these animals they showed they have substantially reduced luminal and serum levels of GABA. Therefore affecting our brains and nervous systems. So if our gut is on fire, then the whole body is on fire. As our gut is what delivers the nutrients to our bodies. So get your gut checked for imbalances!

​Reference: Strandwitz P. (2018). Neurotransmitter modulation by the gut microbiota. Brain research, 1693(Pt B), 128–133. https://doi.org/10.1016/j.brainres.2018.03.015

​Low back pain is one of the leading cause of disability worldwide and it affects about 570 million people globally (1,2). Do you or a loved one experience low back pain? This is an important article that can make the world of difference to you.
 
“About 39% of the adult population will have low back pain in any given year” (3)
 
A common type of low back pain which is characterised by radiating pain into the lower extremity, and may or may not be with corresponding neurological deficits (eg. weakness, sensory loss) is radicular low back pain. It is low back pain that involves a nerve root lesion (4), depending on severity it can affect the overall quality of life, so it’s important to have it addressed appropriately. Though more conservative approaches involving non-pharmacological therapies are recommended as a first approach in line with current evidence based clinical guidelines (5), pharmacological options are still regularly recommended early on.
 
In a recent research literature, researchers did a retrospective cohort study using US data to look at the likelihood of tramadol prescription in adults with radicular low back pain. Tramadol is an atypical, synthetic opioid that is comparatively lower in potency, which is increasingly being prescribed for low back pain in the US (6). Globally, it is the most consumed opioid in terms of MME (morphine milligram equivalent) per 1000 inhabitants per day (7). From this retrospective cohort study, they looked at 1171 patients per cohort, and it was found that the adults that were receiving chiropractic spinal manipulation for radicular low back pain had a reduced likelihood of receiving a tramadol prescription over a 1-year follow-up (8). Though more studies and cases needs to be looked at to further substantiate these findings, the findings so far are pointing towards a positive outcome with chiropractic spinal manipulation as a conservative first approach to manage radicular low back pain in adults.
 
So if you want to find out if chiropractic care may help manage low back pain for you or your loved ones, have a chat with one of our chiropractors to see how they can assist.
 
“It is better to try more conservative care before pharmacological or invasive procedures where appropriate”
 
 
1. Wu, A., March, L., Zheng, X., Huang, J., Wang, X., Zhao, J., Blyth, F.M., Smith, E., Buchbinder, R. and Hoy, D., 2020. Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Annals of translational medicine, 8(6).
2. Abbafati, C., Machado, D.B., Cislaghi, B., Salman, O.M., Karanikolos, M., McKee, M., Abbas, K.M., Brady, O.J., Larson, H.J., Trias-Llimós, S. and Cummins, S., 2020. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.
3. Hoy, D., Bain, C., Williams, G., March, L., Brooks, P., Blyth, F., Woolf, A., Vos, T. and Buchbinder, R., 2012. A systematic review of the global prevalence of low back pain. Arthritis & rheumatism, 64(6), pp.2028-2037.
4. Trager, R.J., Cupler, Z.A., Srinivasan, R., Casselberry, R.M., Perez, J.A. and Dusek, J.A., 2023. Association between chiropractic spinal manipulation and gabapentin prescription in adults with radicular low back pain: retrospective cohort study using US data. BMJ open, 13(7), p.e073258.
5. Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166:514–30.
6. Coyne, K.S., Barsdorf, A.I., Currie, B.M., Poon, J.L., Maziere, J.Y., Pierson, R.F., Butler, S.F., Schnoll, S.H., Farrar, J.T., Fisher, H.J. and Franks Jr, M.J., 2021. Insight into chronic pain in the United States: descriptive results from the Prescription Opioid Misuse and Abuse Questionnaire (POMAQ) validation study. Current Medical Research and Opinion, 37(3), pp.483-492.
7.Jayawardana, S., Forman, R., Johnston-Webber, C., Campbell, A., Berterame, S., de Joncheere, C., Aitken, M. and Mossialos, E., 2021. Global consumption of prescription opioid analgesics between 2009-2019: a country-level observational study. EClinicalMedicine, 42.
8. Trager, R.J., Cupler, Z.A., Srinivasan, R., Casselberry, R.M., Perez, J.A. and Dusek, J.A., 2024. Chiropractic spinal manipulation and likelihood of tramadol prescription in adults with radicular low back pain: a retrospective cohort study using US data. BMJ open, 14(5), p.e078105.
 

​A study conducted in 2023 looked at the patterns of people with acute neck pain. The researchers were interested to know what the most cost effective therapy for neck pain was and also what type of treatments people received, depending on who they were seen by.
 
The cohort included 770,326 patients with new-onset neck pain visits. The most common initial provider specialty was chiropractor (45.2%), followed by primary care (33.4%). Initial provider specialty was strongly associated with the receipt of subsequent neck pain visits with the same provider specialty. Rates and types of diagnostic imaging and therapeutic interventions during follow-up also varied widely by initial provider specialty. While uncommon after initial visits with chiropractors (≤2%), CT, or MRI scans occurred in over 30% of patients with initial visits with emergency physicians, orthopedists, or neurologists. Similarly, 6.8% and 3.4% of patients initially seen by orthopedists received therapeutic injections and major surgery, respectively, compared with 0.4% and 0.1% of patients initially seen by a chiropractor.(1)
 
The summary is that within a large national cohort, chiropractors were the initial provider for a large number of patients with new-onset neck pain. Compared with patients initially seen by physician providers, patients treated initially by chiropractors or therapists received fewer and less costly imaging services and were less likely to receive invasive therapeutic interventions during follow-up.(2)
 
If you want to find out if chiropractic may help manage neck pain for you or your loved ones, have a chat with one of our chiropractors to see how they can assist.
 
 
References
1. Fenton, Joshua J. MD, MPHa,b; Fang, Shao-You PhDb; Ray, Monika PhDb,c; Kennedy, John CCS, CDIPb; Padilla, Katrine MPPb; Amundson, Russell MDd; Elton, David DCd; Haldeman, Scott DC, MD, PhDe; Lisi, Anthony J. DCf; Sico, Jason MD, MHSf,g; Wayne, Peter M. PhDh; Romano, Patrick S. MD, MPHb,c. Longitudinal Care Patterns and Utilization Among Patients With New-Onset Neck Pain by Initial Provider Specialty. Spine 48(20):p 1409-1418, October 15, 2023.