Hello and welcome to this week’s edition of HealthBeat, Chiropractic OnLine Today’s Health, News and Informational Podcast.
In this week’s news: We’ll Be Looking At –
- Study Links Failed Back Surgery Syndrome to Fibromyalgia
- And Finally, a Story about Evidence in Favor of Spinal Manipulation
For HealthBeat …. This is Dr. Todd Eglow!
Welcome to HealthBeat Podcast #592 recorded May 12, 2017.
HealthBeat is Chiropractic OnLine Today’s radio program, providing current news and commentary about Chiropractic and Health.
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And Now for some news ….
Study Links Failed Back Surgery Syndrome to Fibromyalgia
A new study shows that one in four patients with failed back surgery syndrome (FBSS) also has a diagnosis of fibromyalgia.
According to the retrospective analysis, patients with FBSS and fibromyalgia also had more surgeries than patients with FBSS alone.
The association between fibromyalgia and FBSS is significant, the authors noted, with 25% of FBSS patients having a diagnosis of fibromyalgia compared with 1.75% in the general population
According to the data, 49% of patients diagnosed with both fibromyalgia and FBSS had undergone at least four surgeries.
For patients without a diagnosis of fibromyalgia, however, that rate was only 30.5%.
The study concluded that:
- Association between FM and FBSS is significant, with 25% of FBSS patients having a diagnosis of FM versus 1.75% in the general population. 
- Patients with FM have more (a larger number of )surgeries, in a larger variety.
- Some patients with central sensitization undergo a high number of procedures in an effort to decrease their symptoms. Yet, given the central, rather than peripheral cause of their pain, surgeries are less likely to meet expectations.
- Surgery can lead to worsening pain as acute phase nociceptors lead to neuroplasticity with decrease of inhibitory neurons and increase in nociceptive signals. 
- The impact of FBSS is tremendous, with direct costs ranging between $30,000-40,000 per patient,  high incidence of disability, decreased quality of living, and unemployment. Given increasing rates of lumbar surgeries and high rates of failure, it is critical to identify patients with FM prior to surgery and educate them regarding worsening symptoms and realistic expectations.
Surf to our Show Notes for Links – http://www.painmedicinenews.com/Clinical-Pain-Medicine/Article/04-17/Study-Links-Failed-Back-Surgery-Syndrome-to-Fibromyalgia/40805
Evidence in Favor of Spinal Manipulation
A recent article in the NY Times published a positive article about Chiropractic and Spinal Manipulation.
About two of every three people will probably experience significant low back pain at some point. For initial treatment of lower back pain, it may be time for me (and other physicians) to rethink these biases.
Spinal manipulation — along with other less traditional therapies like heat, meditation and acupuncture — seems to be as effective as many other more medical therapies we prescribe, and as safe, if not safer.
Researchers have been looking at the evidence supporting spinal manipulation for some time. Almost 35 years ago, a systematic review evaluated the available research, most of which was judged to be low in quality, and found that there might be some short-term benefits from the procedure.
Two reviews from 2003 agreed for the most part, finding that spinal manipulation worked better than a “sham procedure”, or placebo, but no better or worse than other options.
Almost a decade later, a Cochrane review assessed the literature once more, and found 12 new trials had been conducted. This review was more damning. It found that spinal manipulation was no better than sham interventions.
In February 2017, in Annals of Internal Medicine, another systematic review of nonpharmacologic therapies generally agreed with the other recent trials.
Based upon this review, and other evidence, the American College of Physicians released new clinical practice guidelines for the noninvasive treatment of subacute back pain.
They recommended that patients should try heat, massage, acupuncture or spinal manipulation as first-line therapies.
As always, discuss all Spinal Related issues with your Doctor of Chiropractic.
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– Will Rogers
For Chiropractic OnLine Today’s HealthBeat, This has been
Dr. Todd Eglow.