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High doses of common painkillers hike heart risks

Researchers indicate long-term, high-dose use of painkillers, nonsteroidal anti-inflammatories (NSAIDs, i.e. Motrin), is “equally hazardous” in terms of heart attack risk as use of the drug Vioxx, which was withdrawn due to its potential dangers.

Presenting the results of this large international study, The Lancet said high doses of NSAIDs increase the risk of a major vascular event—a heart attack, stroke or dying from cardiovascular disease—by around one third.

When general practitioners manage conditions such as angina or diabetes, they have toolboxes of diagnostic and practical management skills acquired in training that allow them to provide interventions that make a difference. This is not so with back pain.

Spinal pain patients are common but frustrating for family physicians, who typically provide medication for pain control.

A May 2013 study from the journal Spine reveals a very strong association between surgery and the first provider seen for a lower back injury. Nearly 43 percent of workers who first saw a surgeon had surgery, in contrast to only 1.5 percent of those who saw a chiropractor.

For these and other reasons, there have been growing calls for a new approach to management of back pain patients, based on more extensive use of primary care professionals other than medical physicians, specifically chiropractors, nurses and physical therapists with advanced training.

A new Harvard Medical School booklet, Healing Your Aching Back, endorses chiropractic care as one good option and reports a review of 12 different research studies. It concludes that chiropractic care “improves short and medium-term pain more than other treatments, including exercise, physical therapy, and medication.” People who saw chiropractors also report “being less disabled over the short-term compared with people who received other treatments such as standard medical therapy.”

The evidence supporting the effectiveness of spinal manipulation increases with a new trial published in Spine in April, which reports that patients with acute, low back pain improved much more in terms of both pain and disability. Further, manipulation produced markedly superior results to the use of NSAIDs. Many family physicians start patients on medication and only refer them for spinal manipulation if back pain continues. This trial suggests manipulation should be the first-line treatment of choice for many patients.

Contemporary views on chiropractic care from Harvard Medical School and the American Medical Association recommend spinal manipulation for acute and chronic back pain patients.

In Latin America, the Brazilian Spine Society (SBC) and the World Federation of Chiropractic (WFC) have entered a scientific partnership, under which the WFC is one of the sponsoring professional organizations of the SBC’s journal Coluna/Columna, a leading spine journal in Latin America. The March issue has an editorial on the benefits to both professions and patients when the chiropractic and medical professions work together in spine care and research.

At Danbury Chiropractic and Wellness, we are dedicated to providing the best of care for our patients who benefit from the professional cooperation of the medical community with our Doctors of Chiropractic.

This article was written by Ronald G. Manoni, DC, CCSP, clinical director at Danbury Chiropractic and Wellness.

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