TPI Medical Certification for Chiropractors

The Titleist Performance Institute (TPI) Medical Certification is a highly sought-after and specialized credential that allows chiropractors to expand their expertise in the field of sports medicine, specifically in golf performance enhancement. The TPI Medical Certification equips chiropractors with the tools and knowledge necessary to analyze and address the physical limitations and imbalances in golfers, ultimately helping them achieve a more efficient and injury-free swing.

Golf is a highly technical sport that places tremendous stress on the body. Repetitive golf swings can lead to a variety of musculoskeletal injuries, such as low back pain, hip and shoulder issues, and even wrist and elbow problems. Chiropractors, with their unique understanding of biomechanics and the musculoskeletal system, are ideally positioned to help golfers optimize their performance and prevent injury.

The TPI Medical Certification program offers chiropractors a comprehensive curriculum that includes three levels of training. Level 1 focuses on the fundamentals of golf-specific fitness, biomechanics, and swing analysis. Chiropractors learn how to identify the 12 most common physical limitations that can lead to swing faults and injuries in golfers, known as the “Body-Swing Connection.”

Level 2 delves deeper into the assessment, treatment, and management of golf-related injuries. Chiropractors learn advanced assessment techniques to identify the root cause of biomechanical issues and develop a customized treatment plan for each golfer. This level also covers rehabilitation strategies and exercise prescription, empowering chiropractors to guide their clients through the recovery process.

Level 3, the highest level of TPI Medical Certification, focuses on mastering the skills and knowledge acquired in the previous levels. Chiropractors learn how to integrate their expertise with other professionals, such as golf instructors and fitness trainers, to provide a comprehensive, multidisciplinary approach to golf performance enhancement.

TPI Certified chiropractors become part of a global network of professionals dedicated to helping golfers achieve their performance goals. They have access to cutting-edge research and the latest information on golf-specific injuries and treatment strategies. Additionally, TPI certification sets these chiropractors apart from their peers, demonstrating a commitment to excellence and a specialization in golf performance.

In conclusion, TPI Medical Certification for chiropractors is an invaluable asset for those looking to expand their practice and expertise in the field of sports medicine. It equips chiropractors with the skills and knowledge necessary to address golf-specific injuries and limitations, helping golfers optimize their performance and reduce the risk of injury. As golf continues to grow in popularity, the demand for specialized golf performance professionals, including TPI Certified chiropractors, will only increase.

What Are “Superfoods”? 

Superfoods are an increasingly popular concept within discussions and content about health and nutrition. They have many purported benefits, but what really are superfoods? 

Superfoods are nutrient-dense foods thought to provide a wide range of health benefits, beyond their core nutritional value. These foods tend to be packed with antioxidants, minerals, vitamins, and other essential nutrients known to prevent chronic diseases and promote good health 1

Antioxidants are natural compounds that protect cells from damage and may minimize the risk of cancer and heart disease, among other diseases, by reducing oxidative stress on the body. Oxidative stress occurs in the presence of an excess of free radicals in the body and is associated with an array of human diseases 1. Blueberries are a superfood that is filled with antioxidants.  

Minerals are inorganic elements, that come from soil and water, such as calcium, potassium, or iron, which help the body perform at its highest level. Vitamins, in contrast, are made by plants or animals. Superfoods tend to be charged full of both minerals and vitamins. 

Fiber is a type of carbohydrate that the body cannot digest. It is essential in that it helps decrease cholesterol levels, prevent heart disease, and control glucose in Type 2 diabetes. High-fiber foods such as kale promote healthy digestion and provide a sense of fullness. This can support weight loss efforts, among other benefits 2. Dark green leafy vegetables are an excellent source of a wide variety of nutrients, including folate, zinc, calcium, iron, magnesium, vitamin C and fiber 3

Flavonoids, formerly called vitamin P, are found in plant-based superfoods and exert beneficial anti-carcinogenic and anti-inflammatory properties. 

Finally, monounsaturated and polyunsaturated fats, or “good fats”, are also amply found in superfoods. These help lower cholesterol and prevent stroke and heart disease 4. Certain foods like salmon are packed with such healthy fats 5.  

For those wondering whether superfoods are medically defined, and if so, what that definition is, the answer unfortunately is no. A “superfood” is not a scientifically recognized term, as there are no set criteria to determine what defines superfoods, according to the American Heart Association 6.  

However, a number of tips can help identify and better incorporate healthy, nutrient-packed foods into one’s diet, focusing on the current lay definition of superfoods. First, an easy visual tip is to try to have your plate be multicolored, from foods with rich color like kale, beets, and berries. Second, it can be beneficial to regularly add shredded greens to soups and stir fries, while replacing beef or poultry with salmon or tofu. Furthermore, having green tea or matcha tea, and consuming turmeric, cumin, oregano, ginger, clove, and cinnamon can be helpful because of their antioxidant content. When snacking, nuts, seeds, such as Brazil nuts and sunflower seeds, and dried fruit with no sugar or salt added are excellent choices 7

Obtaining nutrients from real foods is preferred over taking supplements, when possible. Many supplements contain ingredients that can have a strong biological effect on the body; they may also interact with certain medications 8. Taking supplements could thus result in vitamin or mineral toxicity or affect postsurgical recovery, among other consequences. The U.S. Food and Drug Administration warns that combining or taking too many supplements can be hazardous. It is thus important to conservatively use only supplements that the Food and Drug Administration has approved. 

Finally, while superfoods are a valuable addition to a healthy diet, no one food can provide all needed nutrients. It is thus essential to eat a variety of whole foods and maintain a balanced diet at all times. 

References 

1. What Are Superfoods? | Live Science. Available at: https://www.livescience.com/34693-superfoods.html. (Accessed: 10th May 2023) 

2. Miketinas, D. C. et al. Fiber Intake Predicts Weight Loss and Dietary Adherence in Adults Consuming Calorie-Restricted Diets: The POUNDS Lost (Preventing Overweight Using Novel Dietary Strategies) Study. J. Nutr. 149, 1742–1748 (2019).  doi: 10.1093/jn/nxz117. 

3. 16 Superfoods That Are Worthy of the Title. Available at: https://www.healthline.com/nutrition/true-superfoods#TOC_TITLE_HDR_2. (Accessed: 10th May 2023) 

4. What Is a Superfood, Anyway? – Cleveland Clinic. Available at: https://health.clevelandclinic.org/what-is-a-superfood/. (Accessed: 10th May 2023) 

5. Heart Disease: Types, Prevention & Treatments | Live Science. Available at: https://www.livescience.com/34733-heart-disease-high-cholesterol-heart-surgery.html. (Accessed: 10th May 2023) 

6. American Heart Association | To be a relentless force for a world of longer, healthier lives. Available at: https://www.heart.org/en. (Accessed: 10th May 2023) 

7. Superfoods: Health benefits, uses, and risks. Available at: https://www.medicalnewstoday.com/articles/303079. (Accessed: 10th May 2023) 

8. Lobo, V., Patil, A., Phatak, A. & Chandra, N. Free radicals, antioxidants and functional foods: Impact on human health. Pharmacogn. Rev. 4, 118 (2010). doi: 10.4103/0973-7847.70902 

How Chiropractors Treat Shin Splints

How Chiropractors Treat Shin Splints

Shin splints, or medial tibial stress syndrome, is a common condition that affects athletes and physically active individuals. It is characterized by pain along the inner edge of the shin bone (tibia) and is often caused by excessive stress on the muscles and bone tissue in the lower leg. Chiropractors, who specialize in musculoskeletal disorders, are well-equipped to diagnose and treat shin splints. This article discusses the various chiropractic techniques used to treat shin splints and how they promote healing and prevent future occurrences.

Diagnosis:

Chiropractors begin by conducting a thorough examination to determine the cause and severity of shin splints. This involves a physical examination, a review of the patient’s medical history, and an assessment of the patient’s gait and biomechanics. Imaging techniques such as X-rays or MRI scans may be used to rule out other potential causes of pain, like stress fractures.

Treatment Techniques:

Manual Therapy:

Chiropractors use manual therapy techniques to alleviate pain and promote healing. This may include joint mobilization and manipulation to restore proper joint mechanics, as well as soft tissue therapies like myofascial release or trigger point therapy. These methods help to decrease muscle tightness, reduce inflammation, and improve blood flow to the affected area.

Kinesiology Taping:

Kinesiology tape is a flexible, elastic tape that can be applied to the skin to provide support and stability to the affected muscles and joints. Chiropractors may use kinesiology tape to help reduce pain, improve circulation, and facilitate the healing process. It also provides proprioceptive feedback, which can help the patient maintain proper alignment during physical activity.

Custom Orthotics:

In some cases, shin splints may be caused or exacerbated by improper foot mechanics. Chiropractors can assess the patient’s gait and foot biomechanics and prescribe custom orthotics, which are shoe inserts designed to correct structural imbalances, provide support, and promote proper alignment. This can help to alleviate stress on the lower leg and reduce the risk of future shin splints.

Rehabilitation Exercises:

Chiropractors often prescribe specific strengthening and stretching exercises to help patients recover from shin splints. These exercises are designed to improve muscle strength, flexibility, and balance, which can help to reduce the risk of future injuries.

Lifestyle and Training Modifications:

Chiropractors also work with patients to identify and address lifestyle and training factors that may contribute to shin splints. This may involve recommending adjustments to the patient’s training regimen, footwear, or running technique, as well as discussing strategies for managing stress and optimizing recovery.

Chiropractors utilize a comprehensive approach to diagnosing and treating shin splints, employing a variety of techniques tailored to the individual patient’s needs. By addressing the root causes of shin splints and promoting proper biomechanics, chiropractic care can help to alleviate pain, facilitate healing, and reduce the risk of future injuries.

How Chiropractors Treat Achilles Tendinitis

Achilles tendinitis is a common condition that causes pain and inflammation in the Achilles tendon, which connects the calf muscles to the heel bone. It is often seen in athletes and individuals who engage in regular physical activity. Chiropractors, as skilled healthcare professionals, can provide effective treatment for this condition using a variety of methods.

First and foremost, chiropractors perform a comprehensive assessment of the patient’s condition. This includes a thorough examination of the foot, ankle, and lower leg to identify any structural or functional imbalances that may be contributing to the development of Achilles tendinitis. The chiropractor will also assess the patient’s gait, footwear, and overall biomechanics to identify any factors that may be causing unnecessary stress on the Achilles tendon.

One of the primary treatment techniques used by chiropractors is manual therapy. This involves the use of hands-on techniques, such as soft tissue mobilization, to break down scar tissue, release muscle tightness, and improve the flexibility and function of the Achilles tendon. Chiropractors may also utilize joint mobilization or manipulation to improve joint mobility and reduce any restrictions that may be contributing to the patient’s pain and dysfunction.

In addition to manual therapy, chiropractors often prescribe specific exercises to strengthen the muscles surrounding the Achilles tendon and improve overall function. These exercises are designed to target the calf muscles, as well as other muscles in the lower leg that may be contributing to the development of Achilles tendinitis. By addressing muscle imbalances and weaknesses, chiropractors can help prevent future injuries and promote long-term recovery.

Chiropractors may also recommend modalities such as ultrasound, electrical muscle stimulation, and laser therapy to reduce inflammation and promote healing. These therapeutic interventions can help to improve circulation, reduce swelling, and alleviate pain in the affected area.

Another essential aspect of treating Achilles tendinitis is patient education. Chiropractors will educate patients on proper footwear, stretching techniques, and activity modifications to prevent further injury and promote healing. This may include advice on appropriate running shoes, how to warm up and cool down correctly, and the importance of incorporating cross-training activities to avoid overloading the Achilles tendon.

In conclusion, chiropractors use a multifaceted approach to treat Achilles tendinitis, including manual therapy, exercise prescription, therapeutic modalities, and patient education. By addressing the root causes of the condition and providing patients with the tools and knowledge to prevent future injuries, chiropractors play a crucial role in the successful management and recovery from Achilles tendinitis.

Combining Trigger Point Injections, Myofascial Release, Chiropractic Care and Targeting Strengthening to Provide Long Term Pain Relief

Chronic pain is a complex health issue that often requires a multi-faceted approach for effective management. A combination of various treatment modalities, including Trigger Point Injections (TPIs), Myofascial Release (MFR), Chiropractic Care, and Targeted Strengthening exercises, can often provide long-term pain relief for patients suffering from chronic musculoskeletal conditions. Trigger Point Injections are an effective way to address the pain and discomfort associated with myofascial trigger points. These are hyperirritable spots in skeletal muscle that are associated with a hypersensitive palpable nodule in a taut band. The injection, often consisting of a local anesthetic, saline, or corticosteroid, is directed into these trigger points, which helps to relax the muscle and alleviate pain. Myofascial Release is a type of physical therapy often used to treat myofascial pain syndrome. This technique focuses on reducing pain by easing the tension and tightness in the trigger points. MFR involves applying gentle, sustained pressure to the myofascial connective tissue restrictions to eliminate pain and restore motion. Chiropractic Care, on the other hand, primarily deals with the diagnosis and treatment of mechanical disorders of the musculoskeletal system, particularly the spine. Chiropractors use hands-on spinal manipulation and other alternative treatments to enable the body to heal itself without surgery or medication. Manipulation is used to restore mobility to joints restricted by tissue injury caused by a traumatic event, such as falling, or repetitive stress. Lastly, targeted strengthening exercises are critical for long-term pain relief. Regular exercises strengthen muscles around painful areas, providing them better support and reducing the load on them. For example, core strengthening exercises can reduce chronic lower back pain by improving lumbar spine stability. When used in combination, these approaches can offer more effective and long-lasting pain relief than when used in isolation. This integrative approach is patient-specific and can be tailored to each individual’s needs, depending on the source of the pain, the intensity, and the individual’s overall health status. By addressing pain from multiple angles, it’s more likely to provide lasting relief and potentially reduce reliance on pain medication. It’s always advisable, however, to consult a healthcare provider before starting any new treatment regimen for chronic pain.

Magnesium for Health and Nutrition 

Magnesium is a mineral that plays several key roles in the body [1]. It is necessary for glycolysis and energy production; assists with the development of bone and muscle; regulates blood glucose, blood pressure, and protein synthesis; and influences the maintenance of healthy heart rhythm [1]. Magnesium’s role in health is pivotal, as is an understanding of the role of nutrition in acquiring magnesium — the requisite levels, key sources, and health consequences. 

The daily Recommended Dietary Allowance (RDA) of magnesium is 400-420 mg for adult men and 310-320 mg for adult women [2]. Approximately 10 to 30% of people do not consume enough of the nutrient [3]. To correct this problem, medical professionals encourage people to focus on nutrition, eating a diet that features leafy greens, mineral water, and certain fortified breakfast cereals, among other sources, to maintain their health [1, 2]. It is important to note, however, that some forms of processing may strip foods of their magnesium content, so foods meant to contain magnesium may lose their nutritional value after cooking in some cases [1].  

The modern Western diet generally features a decreased presence of magnesium, meaning that it may be advisable for people fitting into those food habits to take magnesium supplements, like magnesium oxide, chloride, and citrate, to round out their nutrition and health [1, 4]. Before taking magnesium supplements, though, one should note the various side effects of supplements. For one, they may have a laxative effect [2]. Magnesium supplements may also reduce blood pressure or antibiotic absorption [5]. Moreover, there is a lack of a consensus within epidemiological literature concerning whether magnesium supplements can correct the diseases often characteristic of magnesium deficiency [2]. These caveats illustrate why people should not take magnesium supplements without consulting their doctor. 

By taking the appropriate level of magnesium, people may better avoid severe health conditions. Research demonstrates a lack of magnesium can result in various cardiac, neurological, and other issues [6]. Researchers also suggest that magnesium helps prevent or treat type 2 diabetes, high blood pressure, osteoporosis, heart disease, and migraine headaches [3]. In the elderly, researchers have identified an association between magnesium deficit and hyperemotionality, sleep disorders, cognitive disorders, and asthenia [7]. These occurrences demonstrate the importance of satisfying nutrition guidelines for magnesium in order to optimize health. 

Along with taking sufficient magnesium, it is also important for people not to consume too much magnesium. The Tolerable Upper Intake Level for magnesium ingested via supplementary sources is 350 mg [2]. An overdose of magnesium can have negative consequences, including nausea, cramping, and diarrhea [2]. More serious health effects, such as low blood pressure, depression, cardiac arrest, and heartbeat irregularities, may also be indicative of excessive magnesium intake [3]. Fortunately, these negative effects are attenuated by the kidneys, which dispel excess amounts of magnesium through urine [2]. As a result, otherwise healthy people rarely exhibit signs of magnesium overdose, but those with kidney impairments should be more cautious [3]. 

Given the various health issues associated with magnesium deficiency and overdose, the importance of consuming enough but not too much magnesium cannot be overstated. With magnesium naturally occurring in many consumable goods, along with easily accessible supplements, the RDA can be satisfied with simple adjustments in one’s diet and routine. 

References 

[1] National Institutes of Health, “Magnesium,”  Updated June 2, 2022. [Online]. Available: https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/.  

[2] Harvard T.H. Chan School of Public Health, “Magnesium,”  Updated March 2023. [Online]. Available: https://www.hsph.harvard.edu/nutritionsource/magnesium/.  

[3] J. Leonard, “Can you take too much magnesium?,” Medical News Today, Updated October 16, 2018. [Online]. Available: https://www.medicalnewstoday.com/articles/323349.  

[4] D. Fiorentini et al., “Magnesium: Biochemistry, Nutrition, Detection, and Social Impact of Diseases Linked to Its Deficiency,” Nutrients, vol. 13, no. 4, pp. 1-44, Mar. 2021. [Online]. Available: https://doi.org/10.3390/nu13041136.  

[5] J. Kubala, “Health Benefits of Magnesium,” Health, Updated March 13, 2023. [Online]. Available: https://www.health.com/magnesium-7229399.  

[6] R. Swaminathan, “Magnesium Metabolism and its Disorders,” The Clinical Biochemist Reviews, vol. 24, no. 2, pp. 47-66, May 2003. [Online]. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1855626.  

[7] M. Barbagallo, N. Veronese, and L. J. Dominguez, “Magnesium in Aging, Health and Diseases,” Nutrients, vol. 13, no. 2, pp. 1-20, Jan. 2021. [Online]. Available: https://doi.org/10.3390/nu13020463.

Health Effects of a Vegan Diet 

Vegan diets have become increasingly popular in recent years as people are choosing to eliminate animal food products for environmental, ethical, and health reasons. Consuming a nutritionally balanced vegan diet may result in numerous positive health effects, including protection against liver disease, obesity, and certain kinds of cancer (5). However, those consuming a strictly vegan diet can be at risk of nutritional deficiencies that have a detrimental effect on overall health. 

Plant-based diets, including vegan diets, have repeatedly been linked to favorable blood lipid profiles and a lower risk of cardiovascular disease (1). Meat and animal products are higher in low-density lipoprotein cholesterol and saturated fats, contributing to plaque build-up. On the other hand, plant-based foods that are rich in monounsaturated fats and polyunsaturated fats help regulate blood lipoprotein levels (1). 

As a result, consuming more plant-based foods and reducing or eliminating meat and animal products results in lower levels of low-density lipoprotein cholesterol—a type of cholesterol that contributes to plaque build-up in blood vessels. Plaque build-up in arteries reduces the supply of oxygen-rich blood tissue to vital organs, increasing the risk of heart attack or stroke (1).  

Another of the positive health effects of a vegan diet is that nutritionally balanced plant-based diets can be rich in phytonutrients, including vitamins, antioxidants, and dietary fiber (4). Soluble fiber from fruits, vegetables, whole grains, and legumes helps facilitate cholesterol being flushed out of the body and reduces the synthesis of liver cholesterol (1). Fiber-rich foods may also help lower inflammation and reduce levels of leptin—a hormone that regulates appetite and body weight—protecting those who consume more plant-based foods against obesity and cardiovascular disease (2). 

The health effects of a vegan diet on cognitive function and brain health are less conclusive. Consuming a balanced vegan diet that is abundant in vitamins and antioxidants may help fight cognitive decline as we age (4). However, vegans who are not taking supplements can be deficient in key nutrients like vitamin B12, vitamin D, and DHA—an omega-3 fatty acid that serves as the main structural component of our brains (4). These deficiencies may increase the risk of Alzheimer’s disease and mental illnesses like depression (3). 

Those consuming vegan diets are also at risk of being deficient in nutrients that are less bioavailable in plant foods (6). Bioavailability refers to the percentage of a particular nutrient that the body is able to absorb and utilize. For example, although many plant-based foods are plentiful in iron, plants provide the non-heme form of iron, which is less bioavailable than heme-iron from animal products (6). As a result, vegans and vegetarians can have lower levels of ferritin and hemoglobin (6). Similarly, vegans can suffer from zinc deficiency due to low zinc bioavailability in plants, putting them at greater risk of depression, diarrhea, dermatitis, and alopecia (6). 

Many of the benefits of consuming a vegan diet also result from following other plant-based diets, including vegetarian and pescatarian diets. Low-fat, reduced animal-product omnivorous diets that are rich in whole grains, legumes, fruits, and vegetables have also been shown to provide many of the same benefits regarding lipoprotein profiles and the risk of cardiovascular disease (7). Plant-based diets that reduce the intake of animal products but do not necessarily completely eliminate them also have a much larger body of scientific literature to support their benefits compared to exclusively vegan diets (4). A non-vegan plant-based diet that incorporates some amount of animal products may be a better fit for some people depending on the desired health effects and the ability to intake essential nutrients. 

Ultimately, reducing your consumption of animal-based foods like meat can reduce your risk of developing certain illnesses, including cardiovascular disease. However, consuming a well-rounded diet that prioritizes plant foods and ensures that you absorb the necessary nutrients for proper organ function is key to harnessing the positive health effects of eating plant based, including vegan. 

References 

  1. Elliott, Patrick et al. “Plant-Based Diets and Lipid, Lipoprotein and Inflammatory Biomarkers of Cardiovascular Disease: A Review of Observational and Interventional Studies.” Nutrients, vol. 14, no. 24, 17 Dec 2022, doi: 10.3390/nu14245371 
  1. Gogga, Patrycja et al. “Plant-based diets contribute to lower circulating leptin in healthy subjects independently of BMI.” Acta biochimica Polonica, vol. 69, no. 4, 2022, pp. 879-882., doi:10.18388/abp.2020_6388 
  1. Jain, Rishika et al. “Association between vegetarian and vegan diets and depression: A systematic review.” Nutrition Bulletin, vol. 47, no. 1, pp. 27-49, 19 Jan 2022, doi:10.1111/nbu.12540 
  1. Katonova, Alzbeta et al. “Effect of a Vegan Diet on Alzheimer’s Disease.” International journal of molecular sciences, vol. 23, no. 23, pp. 1494,, 29 Nov 2022, doi:10.3390/ijms232314924 
  1. McManus, Katherine D. “With a little planning, vegan diets can be a healthful choice.” Harvard Health Blog, Feb 6 2020, www.health.harvard.edu/blog/with-a-little-planning-vegan-diets-can-be-a-healthful-choice-2020020618766 
  1. O’Keefe, James H et al. “Debunking the vegan myth: The case for a plant-forward omnivorous whole-foods diet.” Progress in Cardiovascular Diseases, vol. 74, pp. 2-8, September-October 2022, doi: 10.1016/j.pcad.2022.08.001 
  1. Turner-McGrievy, Gabrielle M et al. “Effect of a Plant-Based vs Omnivorous Soul Food Diet on Weight and Lipid Levels Among African American Adults: A Randomized Clinical Trial.” JAMA network open, vol. 6, no. 1, 3 Jan 2023, doi:10.1001/jamanetworkopen.2022.50626 

Complementary Health Approaches to Pain Management 

Complementary and integrative health approaches to pain management can offer a safer, more cost-effective, and less invasive alternative to pharmaceutical and surgical methods for some people. Integrative health approaches can be used in the management of both acute and chronic pain and can be combined with pharmaceutical interventions to achieve the best possible outcomes for a patient (3). These therapies include long-held Eastern medical practices such as acupuncture, yoga, and tai chi, as well as mind-body therapies, spinal manipulations, aromatherapy, and even music therapy. 

More robust research is required to fully understand the benefits of complementary health approaches to pain management. However, current clinical guidelines and research demonstrate an optimistic outlook for integrative health in the management of fibromyalgia, arthritis, migraines, cancer pains, labor pains, and other forms of acute and chronic pain (2). 

To illustrate, research suggests that acupuncture—a centuries-old healing practice from Chinese medicine—could be an effective form of pain management for neck and back pain, migraines, headaches, arthritis, and postoperative pain (3). Acupuncture is a therapy that involves inserting sterile needles into “acupoints” to stimulate the body’s intrinsic healing abilities and invigorate a person’s “chi” or life force. Under the right conditions, acupuncture produces analgesic effects similar to those of pharmaceuticals and may stimulate the release of endorphins, chemicals that act as the body’s natural pain killer (3). Current clinical guidelines from the Society of Integrative Oncology and the American Society of Clinical Oncology recommend acupuncture for adult patients who are suffering from joint pain related to aromatase inhibitors, a type of medication used in breast cancer treatment (2). Acupuncture may even help relieve cancer pain or other musculoskeletal pains (2). 

Mind-body therapies like meditation, mindfulness, and yoga are other forms of complementary health approaches to pain management with an array of benefits. Mind-body therapies work by creating a connection between the mind and body to improve both physiological and psychological health outcomes in patients (6). Yoga, for example, can help reduce the symptoms of rheumatoid arthritis, including morning stiffness, inflammatory markers, and joint pain (6). In particular, mind-body therapies may be beneficial for patients suffering from rheumatoid arthritis who also present with depressive symptoms. 

Complementary health pain management approaches have also demonstrated efficacy in labor pain management for birthing people. One cognitive behavioral approach to labor pain management is the use of relaxation and breathing techniques to lower both labor pain and labor anxiety (5). A combination of breathing and relaxation techniques can help relieve fear and anxiety around labor as well as pain perception and ultimately reduce the negative health outcomes of cesarean sections and related financial and emotional burdens for patients (5). 

Patients and providers alike are becoming more knowledgeable about complementary health approaches to pain management as more and more research emerges around integrative health methods and their benefits. These alternatives to surgical and pharmaceutical interventions offer the possibility of not only decreasing a patient’s experience of pain, but also improving their overall ability to function and quality of life (3). Not to mention, integrative pain management methods can help reduce or eliminate the use of opioids for patients suffering from both acute and chronic pain, reducing the incidence of opioid dependency and addiction (4). All in all, increased research around and implementation of complementary health approaches for pain management are essential for continuing to improve the quality of patient care. 

References 

  1. “Complementary and Integrative Management of Pain.” National Center for Complementary and Integrative Health. www.nccih.nih.gov/about/nccih-strategic-plan-2021-2025/top-scientific-priorities/complementary-and-integrative-management-of-pain 
  1. “Complementary Health Approaches for Chronic Pain: What the Science Says.” NCCIH Clinical Digest for Health Professionals. Sept 2022, www.nccih.nih.gov/health/providers/digest/complementary-health-approaches-for-chronic-pain-science 
  1. Hamlin, Amy S and T. Michelle Robertson. “Pain and Complementary Therapies.” Critical Care Nursing Clinics of North America, vol. 29, no. 4, Dec 2017, pp. 449-460, DOI:10.1016/j.cnc.2017.08.005 
  1. Haskins, Julia. “Managing pain differently: A look at alternative therapies.” AAMCNews, 26 March 2019 
  1. Kaple, Gayatri S and Shubhangi Patil. “Effectiveness of Jacobson Relaxation and Lamaze Breathing Techniques in the Management of Pain and Stress During Labor: An Experimental Study.” Cureus, vol. 15, no. 1, 1 Jan 2023, doi:10.7759/cureus.33212  
  1. Slagter et al. “The Effect of Meditation, Mindfulness, and Yoga in Patients with Rheumatoid Arthritis.” Journal of Personalized Medicine, vol. 12, no. 1, 15 Nov 2022, doi:10.3390/jpm12111905 

Can a Chiropractor Treat Every Joint? 

Chiropractic care consists of joint and spine adjustments that are used to treat various pains and aches around the body [1]. An open question in chiropractic care is whether it can treat all joints in the body. Evidence on this point is conflicting, especially given how chiropractic care may indirectly contribute to pain alleviation via undirected adjustments. It is important for both patients and practitioners to understand where a chiropractor’s limitations are and whether they can treat every joint. 

One pathway through which chiropractic care alleviates joint pain is spinal manipulation [2]. Specifically, a core belief of the field is that manipulating spinal vertebrae and releasing pressure helps reduce joint pain [2]. Theories as to how this occurs are wide-ranging. Some practitioners believe that this practice of extension causes fibrous adhesions between joints to break; another theory is that the manipulations change how excitable and active the central nervous system is, and others hold other views [2]. 

Irrespective of our understanding of how chiropractic care can treat joints, pockets of research suggest that this mode of treatment can have beneficial effects on worn or painful joints. In the context of Parkinson’s disease (PD), Chu et al. detailed a case study in which a patient demonstrated improved gait and posture after eleven weeks of chiropractic manipulation [3]. According to a meta-analysis of seven trials by Cheatham and colleagues, short-term joint range of motion has also been said to improve following instrument-assisted soft tissue mobilization, which is a type of chiropractic treatment [4]. And a 2018 JAMA Network Open study reported that chiropractic care helped alleviate back pain in a cohort of active-duty military personnel [5]. While all of these studies require supplementary evidence to ensure the replicability of their results, they do seem to indicate that, at least in some instances, chiropractic care can help patients with joint problems. 

Nevertheless, chiropractors can’t treat every joint in the body, as illustrated by the case of arthritis. Medical professionals generally advise against using spinal manipulation on inflamed joints because such methods could cause greater harm [6, 7]. As a result, traditional chiropractic care may not always be an appropriate treatment for arthritis-afflicted joints [6]. Alternative modes of treatment like soft tissue therapies do exist, however, and they may be able to improve the range of motion and/or pain for people who suffer from arthritis [6]. Chiropractors often can provide soft tissue therapy in addition to traditional manipulations. 

Moreover, chiropractic care can be used to indirectly treat arthritis patients. For instance, a 2015 study indicated that chiropractic care helped assuage a patient’s inflammatory pain [1]. It is important to note, however, that this positive result was owing to the chiropractor’s treatment of the patient’s mechanical injuries [1]. Those injuries stemmed from the compensatory movements she engaged in as a result of her rheumatoid arthritis, rather than rheumatoid arthritis itself [1]. As such, this study does not indicate that chiropractic can treat all sources of joint pain, but rather that it can help lessen stress on already-inflamed joints. 

There are other contraindications for chiropractic care as well, such as acute joint injuries and osteoporosis. Chiropractors can’t treat every joint, however, more research is needed to better understand when alternative therapies are preferred for joint-related issues. 

References 

[1] R. Zimlich, “Can Chiropractic Care Help Relieve Symptoms of Rheumatoid Arthritis?,” Healthline, Updated March 14, 2022. [Online]. Available: https://www.healthline.com/health/advancing-rheumatoid-arthritis/chiropractor-for-rheumatoid-arthritis.  

[2] E. Ernst, “Chiropractic: A Critical Evaluation,” Journal of Pain and Symptom Management, vol. 35, no. 5, pp. 544-562, May 2008. [Online]. Available: https://doi.org/10.1016/j.jpainsymman.2007.07.004.  

[3] E. C. P. Chu, A. Y. L. Wong, and L. Y. K. Lee, “Chiropractic care for low back pain, gait and posture in a patient with Parkinson’s disease: a case report and brief view,” AME Case Reports, vol. 5, no. 34, October 2021. [Online]. Available: https://doi.org/10.21037%2Facr-21-27.  

[4] S. W. Cheatham et al., “The efficacy of instrument assisted soft tissue mobilization: a systematic review,” The Journal of the Canadian Chiropractic Association, vol. 60, no. 3, pp. 200-211, September 2016. [Online]. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039777/.  

[5] R. H. Shmerling, “Should you see a chiropractor for low back pain?,” Harvard Health Publishing, Updated August 16, 2019. [Online]. Available: https://www.health.harvard.edu/blog/should-you-see-a-chiropractor-for-low-back-pain-2019073017412.  

[6] S. Langmaid, “Chiropractic Care for Joint Problems: What to Know,” WebMD, Updated September 30, 2022. [Online]. Available: https://www.webmd.com/rheumatoid-arthritis/chiropractic-care-for-joint-problems.   

[7] D. M. Taibi and C. Bourguignon, “The Role of Complimentary and Alternative Therapies in Managing Rheumatoid Arthritis,” Family and Community Health, vol. 26, no. 1, pp. 41-52, January-March 2003. [Online]. Available: https://www.jstor.org/stable/44954079.

Pros and Cons of Intermittent Fasting 

Intermittent fasting (IF) describes the restricting or eliminating of one’s caloric intake for specified periods [1]. The two primary types of IF regimes are whole-day fasting, wherein one fasts for at least an entire day, and time-restricted feeding, in which caloric intake is limited to specific hourly windows during the day [2]. Since its surge in popularity, many alleged advantages and disadvantages of IF have come to light, but in some cases, the evidence backing them is tenuous [3]. This article will discuss the pros and cons of intermittent fasting, along with the evidence supporting these points, to assess the efficacy of this dieting strategy. 

The claimed benefits of intermittent fasting are numerous. They include short-term weight loss, increased brain-derived neurotrophic factor (BDNF), improved metabolic outcomes, reduced cancer risk, and slowed aging [1, 2, 4]. However, some of the claims of the pros of intermittent fasting are not well supported by existing research, and there are also the cons to consider. While various studies support the idea that, at least in some populations, IF can result in significant reductions in weight [5], some researchers have identified no difference in metabolic outcomes between IF and standard caloric restriction diets [1]. Additionally, the evidence supporting BDNF secretion is also unclear. Although IF increases BDNF levels and, thus, can produce mental health benefits in nonhuman animals, this result has not consistently carried over to human studies [1]. Similarly, it remains unclear whether IF causes slowed aging and decreased cancer risk in humans, suggesting that IF’s central benefit may be limited to weight loss [4].  

It is important to note that different forms of intermittent fasting produce different benefits. For instance, some researchers have identified an association between periodic fasting and weight loss, improved insulin sensitivity, decreased blood pressure, and lowered postprandial lipemia [6]. Meanwhile, time-restricted feeding seemingly led to sustained muscle mass and decreased fat mass in resistant-trained males according to one study; another, however, found no significant changes in weight among participants, while their oxidative stress decreased and their insulin sensitivity rose [6]. In view of this conflicting data, more research is necessary to confirm the benefits of these respective forms of IF. 

Having discussed the potential pros of intermittent fasting, we can now look at the cons. Fortunately, the most common risks associated with intermittent fasting tend to be moderate in nature [6]. They include fatigue, headaches, weakness, irritability, and halitosis [1, 6]. Nevertheless, more serious risks are possible: They can range from malnutrition, hypotension, insomnia, and anxiety [1]. Hypoglycemia may also occur in patients with Type 2 diabetes [5]. And women may be particularly vulnerable to risks because of the potential link between IF and adverse effects on reproductive and bone health [1]. 

Along with the possibility of adverse events, another disadvantage of IF is backsliding. As a reward for adhering to an IF regime, or perhaps as a result of fatigue or excessive hunger, people may engage in compensatory overeating [1]. Pre-existing emotional dysregulation or baseline disinhibition may be indicators of a person’s likelihood to engage in binge eating while on an intermittent fasting diet [1]. With adherence rates being reportedly low according to some studies [5], the risk of overeating is non-negligible and may jeopardize the overall success of the diet. 

Before deciding whether to direct a patient to adopt an IF regime, medical professionals should consider the pros and cons of the strategy in light of a patient’s individual circumstances. While intermittent fasting may not be appropriate for everyone, it may be an alternative to traditional weight loss methods. 

References 

[1] S. Harding, “Intermittent Fasting: Clinical Considerations,” The Journal for Nurse Practitioners, vol. 17, no. 5, p. 545-548, May 2021. [Online]. Available: https://doi.org/10.1016/j.nurpra.2021.01.019.  

[2] R. L. Taft, “Intermittent Fasting for Weight Loss: Pros and Cons for People With Diabetes,” AADE in Practice, vol. 7, no. 4, p. 42-46, July 2019. [Online]. Available: https://doi.org/10.1177/2325160319853769

[3] G. M. Tinsley and B. D. Horne, “Intermittent fasting and cardiovascular disease: current evidence and unresolved questions,” Future Cardiology, vol. 14, no. 1, December 2017. [Online]. Available: https://doi.org/10.2217/fca-2017-0038.  

[4] “Not so fast: Pros and cons of the newest diet trend,” Harvard Health Publishing, Updated July 31, 2019. [Online]. Available: https://www.health.harvard.edu/heart-health/not-so-fast-pros-and-cons-of-the-newest-diet-trend.  

[5] S. Anton et al., “The effects of intermittent fasting regimens in middle-age and older adults: Current state of evidence,” Experimental Gerontology, vol. 156, p. 1-8, December 2021. [Online]. Available: https://doi.org/10.1016/j.exger.2021.111617.  

[6] R. Freire, “Scientific evidence of diets for weight loss: Different macronutrient composition, intermittent fasting, and popular diets,” Nutrition, vol. 69, p. 1-11, January 2020. [Online]. Available: https://doi.org/10.1016/j.nut.2019.07.001.