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The Prevalence and Progression of Neck and Back Pain in Children Over Time

By Frank M. Painter|July 3, 2013|Chiropractic Care, Neck Pain, Pediatrics|

The Prevalence and Progression of Neck and Back Pain in Children Over Time

SOURCE: Musculoskelet Disord. 2011 (May 16); 12: 98

Per Kjaer, Niels Wedderkopp, Lars Korsholm,
and Charlotte Leboeuf-Yde

Institute of Sports Science and Clinical Biomechanics,
Part of Clinical Locomotion Network,
University of Southern Denmark,
Campusvej 55, DK-5230, Odense, Denmark

The following article appears to be the first study to track and review the progression of back pain in the same group of children, over a prolonged period, to see how (or if) it is a contributor to those same complains in adulthood.

Of particular interest is Table 2, because it breaks down and tracks complaints of either neck, mid back, or low back pain in the same group of children at 3 different time periods: ages 9, 13 and 15 years old.

Table 2: Prevalence rates of different types of back pain in a cohort of Danish children/adolescents surveyed at three time points

Age Group	Age 9	Age 13	Age 15
Neck Pain
All children Boys Girls	10%9%11%	7%5%9%	15%13%18%
Mid Back Pain
All children Boys Girls	20%22%19%	13%13%13%	28%22%32%
Low Back Pain
All children Boys Girls	33%32%34%	28%26%30%	48%39%54%

The Abstract:

BACKGROUND: It is generally acknowledged that back pain (BP) is a common condition already in childhood. However, the development until early adulthood is not well understood and, in particular, not the individual tracking pattern. The objectives of this paper are to show the prevalence estimates of BP, low back pain (LBP), mid back pain (MBP), neck pain (NP), and care-seeking because of BP at three different ages (9, 13 and 15 years) and how the BP reporting tracks over these age groups over three consecutive surveys.

METHODS: A longitudinal cohort study was carried out from the years of 1997 till 2005, collecting interview data from children who were sampled to be representative of Danish schoolchildren. BP was defined overall and specifically in the three spinal regions as having reported pain within the past month. The prevalence estimates and the various patterns of BP reporting over time are presented as percentages.

RESULTS: Of the 771 children sampled, 62%, 57%, and 58% participated in the three back surveys and 34% participated in all three. The prevalence estimates for children at the ages of 9, 13, and 15, respectively, were for BP 33%, 28%, and 48%; for LBP 4%, 22%, and 36%; for MBP 20%, 13%, and 35%; and for NP 10%, 7%, and 15%. Seeking care for BP increased from 6% and 8% at the two youngest ages to 34% at the oldest. Only 7% of the children who participated in all three surveys reported BP each time and 30% of these always reported no pain. The patterns of development differed for the three spinal regions and between genders. Status at the previous survey predicted status at the next survey, so that those who had pain before were more likely to report pain again and vice versa. This was most pronounced for care-seeking.

CONCLUSION: It was confirmed that BP starts early in life, but the patterns of onset and development over time vary for different parts of the spine and between genders. Because of these differences, it is recommended to report on BP in youngsters separately for the three spinal regions, and to differentiate in the analyses between the genders and age groups. Although only a small minority reported BP at two or all three surveys, tracking of BP (particularly NP) and care seeking was noted from one survey to the other. On the positive side, individuals without BP at a previous survey were likely to remain pain free at the subsequent survey.

Background

It is well known that back pain (BP) is a common and costly problem in the general population. Previously, BP in children was considered rare and a sign of a potentially serious disorder [1,2]. Today, according to a recent systematic review, the general opinion would be that BP, including low back pain (LBP), mid back pain (MBP) and neck pain (NP), starts already early in life to accelerate during the early teens up till early adulthood [3] and that its presence in young age is a precursor for BP also in adulthood [4]. In order to approach the issues of prevention and treatment it is helpful to understand the extent and course of a disease, particularly around the time of its onset and that picture is, presently, far from clear. Methodological and definition issues can partly explain this [3]. However, this is also a question of the study objectives and design. It is therefore not surprising that the estimates from various studies vary and that often they make no sense. Also, there appears to be no credible data on the true incidence for each spinal region in young people.

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Downward Dog Gets Thumbs Up From California Judge

By Frank M. Painter|July 1, 2013|News|

Downward Dog Gets Thumbs Up From California Judge

The Chiro.Org Blog

SOURCE: Yahoo News

I say BRAVO! to the California courts for allowing a San Diego-area school district to introduce Yoga as a twice weekly, 30-minute class.

Although some parents were miffed because they thought it promoted Eastern religion (???) a federal Judge ruled in favor of the school.

SAN DIEGO (AP) — A judge is allowing a San Diego-area school district to teach yoga, rejecting the claims of disgruntled parents who called it an effort to promote Eastern religion.

Yoga is a religious practice, but not the way that it is taught by the Encinitas Union School District at its nine campuses, San Diego Superior Court Judge John S. Meyer said in Monday’s ruling.

Meyer said the school district stripped classes of all cultural references including the Sanskrit language. He noted that the lotus position was renamed the “crisscross applesauce” pose.

The judge said that the opponents of the yoga class were relying on information culled from the Internet and other unreliable sources.

“It’s almost like a trial by Wikipedia, which isn’t what this court does,” Meyer said.

An attorney for the parents, Dean Broyles, said he will likely appeal.

“It was the judge’s job to call balls and strikes and determine the facts. I think he got some of the facts wrong,” he said.

In the lawsuit Broyles argued that the twice weekly, 30-minute classes are inherently religious, in violation of the constitutional separation between church and state.

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Coenzyme Q10: A Building Block of Healthy Aging

By Frank M. Painter|June 27, 2013|Complementary and Alternative Medicine, Health Promotion, Nutrition|

Coenzyme Q10: A Building Block of Healthy Aging

The Chiro.Org Blog

SOURCE: Dynamic Chiropractic

By Holly Lucille, ND, RN

Supporting biologic activity as we age with ubiquinol, the active form of CoQ10.

Coenzyme Q10 has gained enormous attention in recent years, and with good reason — it’s the Energizer Bunny of the cellular world.

This essential quinine molecule is found in the mitochondria of every single cell in the body, where it plays a key role in energy production. CoQ10 not only assists in the production of adenosine triphosphate (ATP), but also scavenges free radicals. [1] To carry out these critical tasks, mitochondrial CoQ10 continuously cycles from ubiquinone, its ATP production state, to ubiquinol, its reduced active state. [2]

More than 4,000 published studies suggest that high CoQ10 levels are essential for optimal health — and this is especially true for the heart and brain. Since both of these organs require huge amounts of energy, supplementation can often help support their high biologic activity. [2, 3] Research shows that CoQ10 supplementation can improve energy production and extend cell life by enhancing cellular mitochondrial levels of CoQ10. In turn, this supports not only the heart and brain, but also periodontal, skin, reproductive, and immune health. [4-9] However, before you advise patients to add CoQ10 to their daily routine, be aware that there’s a catch to taking this multitalented nutrient in supplemental form.

CoQ10’s Critical Conversion

Creating ATP inside the mitochondria is quite complicated and involves a series of biochemical reactions. Since the body cannot store ATP, this multi-step process — known as the electron transport chain — ensures that this critical energy source is continually replaced. [1, 10] Here’s how it works: Ubiquinone contributes to ATP production by passing electrons from one enzyme complex to another, much like a bucket brigade. [3] During this process, ubiquinone is converted to its reduced active state, ubiquinol.

Surprisingly, our mitochondria are the most important cellular source of free radicals. [11] While most of the oxygen radicals generated by the mitochondria stay with its membrane folds, about 2 percent “escape” and create toxins that can threaten the health and survival of the entire cell. [11-13] Ubiquinol is able to neutralize these free radicals, both within the mitochondria and the cell membrane itself. [14]

There are many more articles like this @ our:

Coenzyme – Q10 (Co–Q10) Page

which is just one page from our

Nutrition Section

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Adolescent Idiopathic Scoliosis Treated by Spinal Manipulation: A Case Study

By Frank M. Painter|June 22, 2013|Chiropractic Care, Scoliosis|

Adolescent Idiopathic Scoliosis Treated by Spinal Manipulation: A Case Study

The Chiro.Org Blog

SOURCE: J Altern Complement Med. 2008 (Jul); 14 (6): 749–751

Kao-Chang Chen, Elley H.H. Chiu

Division of Acupuncture and Chinese Traumatology, Department of TCM, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China.

OBJECTIVE: This report of one case illustrates the potential effect of chiropractic manipulative therapy on back pain and curve progression in the at-risk, skeletally immature patient with adolescent idiopathic scoliosis.

CLINICAL FEATURES: A 15-year-old girl experienced right thoracic scoliosis for 4 years. She received regular (medical) rehabilitation and brace treatment for 4 years, but the curvature of the thoracic spine still progressed. The Cobb angle was 46 degrees and surgical intervention was suggested to prevent significant deformity, which may be accompanied by cardiopulmonary compromise.

INTERVENTION AND OUTCOME: This patient was treated with spinal manipulation two times per week for 6 weeks at the outset, which was gradually decreased in frequency. After 18 months of consecutive treatment, follow-up radiographs and examinations were conducted. The Cobb angle decreased by 16 degrees. Meanwhile, the patient’s lower backache eased and there was also an improvement in defecation frequency, which had been problematic.

Learn more about Scoliosis @ our:

Scoliosis and Chiropractic Page

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Early Adolescent Lumbar Intervertebral Disc Injury: A Case Study

By Frank M. Painter|June 20, 2013|Chiropractic Care, Disc Injury, Pediatrics|

Early Adolescent Lumbar Intervertebral Disc Injury: A Case Study

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2013 (Apr 26); 21: 13

Chris T Carter, Lyndon G Amorin-Woods and Arockia Doss

School of Health Professions,
Murdoch University,
Murdoch, Western Australia, Australia

This article describes and discusses the case of an adolescent male with lumbar intervertebral disc injury characterized by chronic low back pain (LBP) and antalgia. A 13-year-old boy presented for care with a complaint of chronic LBP and subsequent loss of quality of life. The patient was examined and diagnosed by means of history, clinical testing and use of imaging. He had showed failure in natural history and conservative management relief in both symptomatic and functional improvement, due to injury to the intervertebral joints of his lower lumbar spine. Discogenic LBP in the young adolescent population must be considered, particularly in cases involving even trivial minor trauma, and in those in which LBP becomes chronic. More research is needed regarding long-term implications of such disc injuries in young people, and how to best conservatively manage these patients. A discussion of discogenic LBP pertaining to adolescent disc injury is included.

The Full-Text Article:

Background

LBP in children and adolescence is an important and increasing problem, and prevalence increases with age [1]. Systematic review and meta-analysis studies of LBP in adolescence found mean LBP point prevalence and one-year prevalence for adolescents to be around 12%, and 33% respectively [2,3]. Watson et al. [4] reported a one month period prevalence of 24% in schoolchildren aged 11–14 years in northwest England. Historically considered as trivial and non-limiting, LBP in this age-group may have both immediate and long-term consequences for an important proportion of those affected [4]. Risk factors have been debated, although ergonomics of school furniture, school bag weight and mechanics, trauma, history of scoliosis, and involvement of strenuous physical activity may be associative or causative factors in young persons with LBP [5]. There is also increasing evidence that psychological and psychosocial factors may play a significant influence in the aetiology of LBP in this age group [6, 7].

There are many more articles like this in our:

Chiropractic Pediatrics Section

You will also enjoy our:

Disc Herniation and Chiropractic Page

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Trends in the Use and Cost of Chiropractic Spinal Manipulation Under Medicare Part B

By Frank M. Painter|June 19, 2013|Cost-Effectiveness, Medicare|

Trends in the Use and Cost of Chiropractic Spinal Manipulation Under Medicare Part B

The Chiro.Org Blog

SOURCE: Spine J. 2013 (Nov); 13 (11): 1449–1454

Whedon JM, Song Y, Davis MA.

The Dartmouth Institute for Health Policy and Clinical Practice,
Dartmouth College, 30 Lafayette St,
Lebanon, NH 03756
james.m.whedon@dartmouth.edu.

BACKGROUND CONTEXT: Concern about improper payments to chiropractic physicians prompted the US Department of Health and Human Services to describe chiropractic services as a “significant vulnerability” for Medicare, but little is known about trends in the use and cost of chiropractic spinal manipulation provided under Medicare.

PURPOSE: To quantify the volume and cost of chiropractic spinal manipulation services for older adults under Medicare Part B and identify longitudinal trends.

STUDY DESIGN/SETTING: Serial cross-sectional design for retrospective analysis of administrative data.

PATIENT SAMPLE: Annualized nationally representative samples of 5.0 to 5.4 million beneficiaries.

OUTCOME MEASURES: Chiropractic users, allowed services, allowed charges, and payments.

METHODS: Descriptive statistics were generated by analysis of Medicare administrative data on chiropractic spinal manipulation provided in the United States from 2002 to 2008. A 20% nationally representative sample of allowed Medicare Part B fee-for-service claims was merged, based on beneficiary identifier, with patient demographic data. The data sample was restricted to adults aged 65 to 99 years, and duplicate claims were excluded. Annualized estimates of outcome measures were extrapolated, per beneficiary and per user rates were estimated, and volumes were stratified by current procedural terminology code.

You may also want to refer to our:

Cost-Effectiveness of Chiropractic Page

and our

Medicare Information Page

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