Knee and hip osteoarthritis are the twelfth leading cause of global disability (8). OA was the eighth leading cause of the US health expenses in 2016 (8). In countries like Canada, 4 million individuals have OA where 122,000 knee and hip replacements are performed annually (3).

​Both the Osteoarthritis Research Society International (OARSI) and American College of Rheumatology (ACR) published new guidelines for non-surgical management of knee and hip OA (2&5). These guidelines include self-management strategies, exercise, and weight loss for overweight individuals. Manual therapy has not been included in the OARSI guideline due to the lack of supporting evidence.

Manual therapy is a collection of therapeutic interventions used by chiropractors and physiotherapists in the management of OA. The current lack of high-quality evidence prevents manual therapy from being the core treatment for OA (4). However, the National Institute of Health and Care Excellence (NICE) and the US Bone and Joint Initiative recognize the potential effectiveness of manual therapy (6&7).

A recent review on manual therapy found improvements in pain and physical function in the short and long term for patients with OA (4). A systematic review, specifically for knee OA, reviewed 11 RCTs that concluded that the effects of manual therapy with and without exercise provide short-term benefits on pain levels, functional disability, range of motion and physical performance (1). There were other studies on the effectiveness of manual therapy showing effective symptom improvement for people with OA.However, these results can’t be considered conclusive due to the limitations each study had.
If you would like to know more about this condition, feel free to contact us here at Sprouting Health Chiropractic.
 
 
References

1. Anwer S, Alghadir A, Zafar H, Brismée J-M. Effects of orthopaedic manual therapy in knee osteoarthritis: a systematic review and meta-analysis. Physiotherapy. 2018;104(3):264–276
2. Bannuru RR, Osani M, Vaysbrot E, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578–1589
3. Canadian Institute for Health Information. Hip and Knee Replacements in Canada 2017–2018 Canadian Joint Replacement Registry Annual Report. 2019. https://www.cihi.ca/sites/default/files/document/cjrr-annual-report-2019-en-web_0.pdf.
4. French HP, Brennan A, White B, Cusack T. Manual therapy for osteoarthritis of the hip or knee – a systematic review. Man Ther. 2011;16(2):109–117
5. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol. 2020;72(2):220–233
6. National Institute for Health and Care Excellence. Osteoarthritis: care and management – clinical guideline. National Institute for Health and Care Excellence Guidelines; 2014. p. CG177
7. Nelson AE, Allen KD, Golightly YM, Goode AP, Jordan JM. A systematic review of recommendations and guidelines for the management of osteoarthritis: The chronic osteoarthritis management initiative of the U.S. bone and joint initiative. Semin Arthritis Rheum. 2014;43(6):701–712
8. Young JJ, Važić O, Cregg AC. Management of knee and hip osteoarthritis: an opportunity for the Canadian chiropractic profession. J Can Chiropr Assoc. 2021;65(1):6-13.

Lower back pain or pelvic girdle pain happens very often in women during pregnancy and postpartum. In fact, up to 90% of pregnant women experience back pain regardless if they have had back pain previously.(1) Researchers have been investigating the reasons behind pregnancy related back pain and its favourable management. Recently a high quality systematic review of chiropractic care for adults with pregnancy related back pain was published and the results may surprise you or your family and friends!
 
Pregnancy related back pain can hinder daily activities and can be debilitating. Sadly, this type of back pain is often believed to be normal as part of the pregnancy. The cause of back pain during pregnancy is likely to be multifactorial. For example maternal weight gain, biomechanical changes and changes in hormonal levels that promotes ligament flexibility.(1) Although pregnancy related back pain or pelvic girdle pain generally resolves shortly after giving birth, the pain may continue after delivery.
 
Safety of the mother and child is always the first priority for clinicians. Paracetamol and opioid use have been the first solution that a lot of people pick. Yet, newer epidemiological study have found that the use of paracetamol during pregnancy has an impact on immature rodent animals and opioid use can increase the risk of the child developing ADHD/ASD in the future.(2, 3)
 
The systematic review indicates physical therapy provides favourable outcomes that may be effective in pregnant women with variable results. More specifically, spinal manipulation therapy and mobilisations have shown improvements in pain intensity or disability. Increasing numbers of literature studies in this category are emerging, and it’s suggested a clinician(e.g. medical doctor) should consider this approach if the pregnant patient agrees.(1)
 
At Sprouting Health Chiropractic, our first principle is do no harm. We use a variety of techniques, provide advice and modify the treatment for pregnant women. If you or your loved ones are suffering from pregnancy related back pain, talk to one of our chiropractors and see whether we can help manage your concerns.

References

1.         Weis CA, Pohlman K, Draper C, Stuber K, Hawk C. Chiropractic Care for Adults With Pregnancy-Related Low Back, Pelvic Girdle Pain, or Combination Pain: A Systematic Review. Journal of manipulative and physiological therapeutics. 2020.
2.         Bührer C, Endesfelder S, Scheuer T, Schmitz T. Paracetamol (Acetaminophen) and the Developing Brain. International Journal of Molecular Sciences. 2021;22(20):11156.
3.         Trønnes JN, Lupattelli A, Handal M, Skurtveit S, Ystrom E, Nordeng H. Association of Timing and Duration of Prenatal Analgesic Opioid Exposure With Attention-Deficit/Hyperactivity Disorder in Children. JAMA Network Open. 2021;4(9):e2124324-e.

Low back pain is one of the leading causes of disability globally (1), it affects many different aspects of daily life including many day to day functions and especially with children affecting their sporting activities and goals (2). Do you or a loved one experience low back pain? This is an important article that could make the world of difference to you.
 
“Low back pain is common in the young athlete population, with reports of 33-64% annual prevalence in field hockey and 64% in football” (3,4,5)


Low back pain may have long term consequences if left unattended to, and is found to be associated with other musculoskeletal complaints and neuromuscular impairments in the lower back area and pelvis (6,7,8). These impairments have been reported to predispose athletes to lower extremity injuries (9). Back pain history has been reported to decrease overall performance and is also reported to be associated with new changes seen in imaging studies in the lower back of young athletes (10,11).
 
In a recent research study, where they looked at 17 players from a sports club, the players were tested for flexibility and trunk extensor muscle endurance. The group that received sports chiropractic therapy showed significant improvement in flexibility of the lower back and a reduction in lower back pain and trunk extensor muscle endurance. (12)  So although this study is small and more work needs to be done it can be seen that chiropractic may help support young athletes with low back issues and may help with overall performance and function.
 
If you want to find out if chiropractic 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.
 
“Making sure that children are functioning optimally is vital for their overall development!”
 
 
1. Vos T, Barber RM, Bell B, Bertozzi-Villa A, Biryukov S, Bolliger I, Charlson F. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;9995:743-800.
2. Froud R, Patterson S, Eldridge S, Seale C, Pincus T, Rajendran D, Fossum C, Underwood M. A systematic review and meta-synthesis of the impact of low back pain on people’s lives. BMC Musculoskeletal Disord. 2014;15:50.
3. Rossi M, Pasanen K, Kokko S, et al. Low back and neck and shoulder pain in members and non - members of adolescents' sports clubs: the Finnish Health Promoting Sports Club (FHPSC) study. BMC Musculoskel Dis. 2016;17(1):263. doi: 10.1186/s12891 -016 -1114 -8. 4. van Hilst J, Hilgersom NFJ, Kuilman MC, Kuijer, P Paul F M, Frings -Dresen MHW. Low back pain in young elite field hockey players, football players and speed skaters: Prevalence and risk factors. Journal of Back & Musculoskeletal Rehabilitation. 2015;28(1):67 -73.
5. Schmidt CP, Zwingenberger S, Walther A, et al. Prevalence of Low Back Pain in Adolescent Athletes: An Epidemiological Investigation. Int J Sports Med. 2014;35.
6. Hestbaek LDC, Leboeuf-Yde C, Kyvik KO, Manniche, C D M S. The Course of Low Back Pain from Adolescence to Adulthood: Eight-year Follow-up of 9600 Twins. Spine. 2006;31.
7. Ståhl M, El-Metwally A, Rimpelä A. Time trends in single versus concomitant neck and back pain in finnish adolescents: results from national cross-sectional surveys from 1991 to 2011. BMC Musculoskelet Disord. 2014;15: 296 .
8. Nguyen A, Shultz SJ, Schmitz RJ, Luecht RM, Perrin DH. A preliminary multifactorial approach describing the relationships among lower extremity alignment, hip muscle activation, and lower extremity joint excursion. J Athl Training. 2011;46(3):246.
9. Zazulak BT. Deficits in neuromuscular control of the trunk predict knee injury risk: a prospective biomechanical-epidemiologic study. Am J Sports Med. 2007;35(7):1123 -1130. doi:10.1177/0363546507301585.
10. Nadler SF, Moley P, Malanga GA, Rubbani M, Prybicien M, Feinberg JH. Functional deficits in athletes with a history of low back pain: a pilot study. Archives of Physical Medicine & Rehabilitation. 2002;83(12):1753 -1758.
11. Kujala UM, Taimela S, Erkintalo M, Salminen JJ, Kaprio J. Low-back pain in adolescent athletes. Med Sci Sports Exerc. 1996;28.
12. Saad, M., Zaghloul, E., Alin, L. and LIVIU, M., 2020. Effect of sports chiropractic on the primary prevention of low back pain for track and field players. Ovidius University Annals, Physical Education and Sport/Science, Movement and Health Series, 20(2), pp.149-152.