Exciting News from the American College of Physicians showing that after many years of successful treatments and interventions Chiropractic Care appears to be finally receiving some recognition for helping thousands of people suffering with lower back pain.

The Chiropractors’ Association of Australia (CAA) welcomes new recommendations published by the American College of Physicians on the non-invasive treatment of acute, subacute and chronic low back pain.

Following a comprehensive update of the systematic review, the ACP has made several recommendations. These include the option of choosing manipul

ation for management of acute low back pain, with recommendation of non-pharmacological therapies (including manipulation) for relief from chronic low back pain. Rehabilitative interventions are also recommended, where chiropractors may play a leading role.

With many Australians burdened by low back pain, chiropractors are well placed to assist with the management and rehabilitation of this disease.

To read the review and clinical recommendations visit www.bit.ly/2lOLQRN

So, we all know that lower back pain is a common problem in this world. As a matter of fact about 80% of us have an intimate relationship with lower back pain, at one time or another.

So who do you go to for help with lower back pain? Your chiropractor, physiotherapist, myotherapist?

Well that depends. Pain killers and anti inflammatories can help you very quickly and give temporary relief of pain until you have time to see a chiropractor or physiotherapist. But then who to go to?

If you already have a relationship with a particular Chiropractor or Physio, then your best point of reference is that practitioner. If they can help, then you’r in the right place. But its important that you know what is causing your pain.

Sometimes we get told that we have “sciatica.” What this really

means is that you have pain in the leg along the sciatic distribution. Great so whats causing it?

I have people come in to see me often, giving me various long winded diagnosis. They mostly aren't even sure what their diagnosis means. Don’t get caught up in the medical terminology, it’s just another language to describe your symptoms. Your chiropractor or physiotherapist should be able to explain your condition in normal language that you understand.

Then once you know whats wrong, who do you see?

Recently the American College of Physicians have released new guidelines for the diagnosis and treatment of acute and chronic lower back pain. The first two recommendations given by the college are:

Recommendation 1: For acute lower back pain clinicians and patients should select non-pharmacologic treatment first (that means manipulation, acupuncture, massage)

Recommendation 2: For chronic pain clinicians and patients should select non-pharmacologic treatment first with exercise and electro therapies. (that means manipulation acupuncture and massage with exercises and elector therapies)

Recommendation 3: if the first line of therapy doesn’t work then non steroid anti inflammatories can be used.

It appears that the health organisations are seeing only now what our patient’s have seen for many years. But that’s ok research usually sits a few steps behind the front runners. If you have any questions or just looking for a second opinion talk to one of our friendly chiropractors, we would be happy to help.

One of the new trends in office design is the standing desk. The goal of these standing desks is to get people to sit less. Some authors have gone so far as to equate sitting to smoking (Buckley, et al., 2015).

While I don't think I would go quite that far, it would appear that such activities have a negative overall effect on our health.

Research presented at the British Psychological Society's Annual Occupational Conference (Duncan, Kazi and Haslam, 2015) stated that, in a typical working week, people spend four hours and 41 minutes per day sitting at their desks. (And that doesn't count the time they spend seated in their cars, while eating, and watching television.) Whatever the final numbers are, it is fair to say that we spend a lot of time sitting. Would standing more be beneficial to our health? Let's take a look...

Standing: Pros & Cons

One of the alternatives to sitting all day is standing while at work. Some of the advantages of standing are:

Reduced risk of obesity

Reduced risk of cancer

Lower long-term mortality risk

Reduced risk of cardiovascular disease

Reduced risk of type 2 diabetes and other metabolic problems

office man - Copyright – Stock Photo / Register Mark It takes more energy (calories) to stand than it does to sit. Livestrong states that standing uses 20-50 more calories per hour than sitting, depending upon your size. That equates to 8-20 pounds during the course of a year (www.livestrong.com, 2014).

Given that Americans tend to be larger today than in years past, standing makes some sense, particularly if you're trying to lose weight.

Unfortunately, standing isn't a panacea. Prolonged standing also comes with a health risk. It can lead to:

Back pain

Leg pain

Varicose veins

Cardiovascular problems

Anyone who spends the work day standing in place (e.g., grocer checkers) can tell you about the problems they encounter as a result of prolonged standing.

The Best of Both Worlds?

Alternating between standing and sitting is probably a healthier alternative. It has been suggested that workers should stand for two hours each work day and gradually increase to four hours (Biswas, et al., 2015). That's half the day standing and half sitting.

Stability Balls

One relatively new and somewhat revolutionary trend has been the use of the gym ball (aka, stability ball) as a chair. Using a stability ball as an office chair strengthens the core muscles, similar to the use of a backless chair or stool. The freedom of movement that comes from using a stability ball may also decrease any confined or constrained body postures that frequently occur at workstations.

Livestrong (www.livestrong.com, 2015) states that the stability ball is a piece of exercise equipment that is used for strength training and to improve balance and stability. The website indicates that replacing the traditional office chair with a stability ball has become increasingly popular because of the potential for improved health, posture and strength. Some of the potential benefits of sitting on a ball include:

It encourages "active" sitting.

It improves the endurance of sitting and postural muscles.

It improves sensory perception.

It acts as a stimulus for the regulation of posture.

It allows an alternate loading and unloading of the intervertebral disks.

It improves blood circulation.

It improves the effectiveness of all the organ systems.

The following tips are offered in order to use a stability ball as an office chair;

Use the correct size and make sure that it is fully inflated. Properly fitted, the thighs should be parallel to the floor and the knees should be at 90 degrees.

Perform normal workday activities while on the ball.

Stay on the ball as long as is comfortable, then return to the normal chair. Begin with 20-30 minutes, then increase the time gradually.

Use a stability base to keep the ball stable.

The bottom line: When sitting on a stability ball, you can't sit still. The ball forces the body to constantly adjust to the forces of gravity. Sitting on such a labile surface is a constant challenge to the musculoskeletal system and can actually be quite fatiguing, if you're not used to it. Consequently, it is suggested that yo shouldn't throw your normal chairs out.

I have used a stability ball as an office chair and like it more than the standing desk. However, I am of the opinion that the stability ball shouldn't be a total replacement to the traditional office chair. Instead, it should be used in conjunction with the chair.

Movement Is Key

Rather than just sitting or standing, it would seem that movement is the key to a long and healthy life. One author looked at individuals in Okinawa, Japan (Buettner, 2014). He found that they tend to sit on the floor, rather than in chairs. They apparently go from sitting to standing approximately 30 times each day (constantly moving). Buettner discusses the advantages of going from a sitting to a standing position.

As an aside, some of the healthiest and oldest individuals come from Okinawa. Perhaps there is a connection.

A survey performed a number of years ago (Belloc and Breslow, 1972) attempted to identify common denominators in healthy octogenarians. One of the factors identified was regular physical activity (30-45 minutes every day of the week). There were no marathon runners or extreme athletes. They just kept moving, similar to the individuals in Okinawa.

Closing Thoughts

The standing desk is a reasonable alternative to sitting at work. One alternative is to use a treadmill as a desk. This encourages movement and activity during the workday.

However, standing rather than sitting should not be considered an ideal alternative. Instead, it would appear that changing positions is the critical link. Some time spent sitting and some spent standing is probably best.

In addition, the use of a stability ball seems to be a reasonable alternative to sitting on a traditional office chair. While the stability ball is a positive modification, one of the advantages is the limited amount of time an individual can spend on it. It almost forces a change of position.

Finally, it would appear that movement is the key to reducing problems. Rather than sit or stand for long periods, time spent moving from sitting to standing (and back again) is advantageous.

References

Belloc NB, Breslow L. Relationship of physical health status and health practices. Prev Med, 1972 Aug;1(3):409-21.

Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, Alter DA. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Ann Intern Med, 2015;162(2):123-132.

Buckley JP, Hedge A, Yates T, Copeland RJ, Loosemore M, Hamer M, Bradley G, Dunstan DW. The sedentary office: an expert statement on the growing case for change towards better health and productivity. Br J Sports Med, 2015 Nov;49(21):1357-62.

Buettner D. Blue Zones. www.bluezone.com, 2014.

Cespedes A. "Calories Burned Standing vs. Sitting." Livestrong.com, 2014.

Duncan M. Kazi A, Haslam C. Presentation at the British Psychological Society's annual conference, Loughborough University.

Lee T. "Health Benefits of Standing Desks: Separating Hype From Reality." Livestrong.com, 2015.

Paul Hooper, DC, MPH, MS, a 1975 graduate of Cleveland Chiropractic College - Kansas City, is the clinical communications editor for Comprehensive Industrial Disability Management Corp. He can be reached via e-mail with questions and comments at paul.hooper@cidmcorp.com .

World Spine Day – Sunday 16 October 2016

For World Spine Day on Sunday 16 October 2016, the Chiropractors’ Association of Australia (CAA) is encouraging people to ‘Straighten Up and Move’.

World Spine Day is a global campaign to highlight the importance of physical activity and improving posture for good spinal health and prevention of injury, as part of the Bone and Joint Decade’s Action Week.

It is estimated that one in six Australians (3.7 million) had chronic back problems in 2014–15, according to an August 2016 report released by the Australian Institute for Health and Welfare (AIHW).

‘Straighten Up’

Poor posture may cause headaches, soreness, back pain and fatigue, by putting pressure on your spine. In many cases, this can be prevented with education about the issue. While it may take some diligence to undo bad habits, it’s worth persevering.

Straighten Up Australia is an ongoing community service initiative of the CAA, and is an easy and enjoyable everyday program to improve your health and the way your body functions.

Consisting of a set of simple exercises and taking just three minutes to complete, Straighten Up Australia will help improve posture, stabilise core muscle groups, enhance health and prevent spinal disability. You can download the Straighten Up Australia exercise program at www.chiropractors.asn.au/sua

‘and Move’

Modern lifestyles – such as office work and extended use of computers or mobile devices – may make us less active or adopt poor posture.

Walking is a low impact exercise that assists in improving flexibility and mobility. Accompanied by a regimen of stretching, walking can improve flexibility and a better range of motion. Walking strengthens the body and helps position the spine in its upright natural shape, assisting posture.

CAA’s Just Start Walking app is one way to help get you moving. Available from the App Store and Google Play, this app allows you to track your walks via GPS, log your walking history, share your walks with friends online and find walking events in your local area.

Spinal Health Week 2016 runs from 23 to 29 May and this year the chiropractors at Templestowe Family Chiropractic are encouraging you to ‘Back Your Inner Athlete’.

With the Olympics around the corner, thousands of elite athletes are using health treatments like chiropractic care to perform at their peak. Chiropractors at Templestowe Family Chiropractic would like to remind people that everyone can back their own inner athlete and perform to their peak by reducing pain, improving posture and living a healthy lifestyle.

“Every day more and more Australians experience disabling low back pain, neck pain and headaches, limiting their ability to work and engage in an active healthy life,” said chiropractor David Bagas.

“Think about all the hours you spend each day sitting at work or school, commuting, on your computer or other mobile device and watching television,” David Bagas said.

“Poor posture used during these activities increases pressure on your spine which can cause lower back pain, neck pain, headaches and fatigue.”

If you suffer from back pain, neck pain or headaches or if poor postural fitness is impacting on your ability to live life to the fullest, visit a chiropractor at Templestowe Family Chiropractic to help you Back Your Inner Athlete.

Chiropractic care is an increasingly common and effective treatment for back pain, neck pain and headaches, eliminating the need for drugs or surgery.

“Helping patients make positive changes, with respect to nutrition, exercise and wellness is also fundamental to maintaining normal spinal function,” added David Bagas.

“Adopting healthy habits today, such as improving postural fitness, can significantly reduce the risk of injury or pain in later years. What’s more, good spinal health can benefit our self-esteem, social relationships and mental health.”

CAA Back App: Your Pocket Chiropractor

To help Back Your Inner Athlete, the Chiropractors’ Association of Australia (CAA) has developed a CAA Back App - the closest thing to having a chiropractor with you 24/7.

The CAA Back App will be released on 23 May, 2016. It can be downloaded free from www.backyourinnerathlete.com.au, Apple App Store or Google Play and is like your pocket chiropractor. As you go about your day, it sends subtle reminders about checking your posture, activity levels, water consumption and movement. Its state of the art ‘augmented reality’ feature animates when hovered over Spinal Health Week postcards, which are free from your local CAA Chiropractor. This shows users the correct posture they should maintain in everyday situations.

“We hope people enjoy using this interactive technology to improve their posture, which in turn can help improve their health,” added David Bagas.

During Spinal Health Week 2016, make an appointment at Templestowe Family Chiropractic for a spinal health check-up and discover what steps you can take to improve your health and wellbeing and Back Your Inner Athlete.

You can also visit www.backyourinnerathlete.com.au to learn more about chiropractic care and Spinal Health Week 2016 and to download the Back Your Inner Athlete app – CAA Back App.

Spinal Health Week 2016 is a national initiative of the Chiropractors’ Association Australia (CAA).

For further information on Spinal Health Week 2016, chiropractic care, or to arrange a photo opportunity, please contact: Templestowe Family Chiropractic (03) 9850 2110.

David Bagas is a member of the Chiropractors’ Association of Australia.

The Chiropractors’ Association of Australia (CAA) has called on Australia’s educators to rethink the load they are placing on students’ backs – literally.

“There is mounting evidence pointing to the fact that heavily laden school bags place unnecessary stress on growing spines and can lead to acute and long-term back problems,” warned CAA national spokesperson, Dr Patrick Sim, chiropractor.

“Lugging an overloaded school bag to and from school is an outdated concept that must be discouraged.

“Why treat our kids as pack horses when most of the information they need at school or for homework could be contained on a tiny memory stick?”

According to Dr Sim, a growing child should limit the weight they carry in a school backpack to no more than 10 per cent of their body weight.

“That’s only around 4-5 kilos for a 40-50kg student and it quickly adds up when you throw in a few text books, pencil case, lunch box and water bottle,” he said.

A survey by CAA in Victoria into the average bag weights of 1,000 children found that almost half (486 children) carried bags well over the 10 per cent recommendation.

“Lifting a bag that is too heavy causes immediate strain on the spine,” Dr Sim explained. “The longer a child carries that load, the more severe the damage.

“The problem is compounded even further by badly loaded bags, poor posture and the ‘fashion factor’ which dictates the latest trendy way for carrying the bag, usually negating any inbuilt ergonomic features.”

With the 2010 school year about to kick off, Dr Sim is realistic about the fact that we have a long way to go before heavy text books are replaced with memory sticks and he is encouraging parents and students to brush up on their bag carrying technique now to prevent problems later in life.”

The CAA recommends a fitted backpack, worn properly – over both shoulders with the waist band done up – as a growing back’s best bet, while wheeled bag options should be treated with caution.

“A wheeled bag with an extendable handle may seem like a good solution for a heavy load but they aren’t designed for the routine wear and tear that a trip to school entails,” Dr Sim explained.

“Students may have to pull a bag over rough ground or grassy areas as well as lift it up stairs and on and off public transport. All of these actions impact normal posture and could prove problematic in the long run.

To avoid the back to school backache, the Chiropractors’ Association of Australia recommends:

• Backpacks should be no heavier than 10 per cent of a student’s weight when packed.

• Make sure the backpack is sturdy and appropriately sized – no wider than the student’s chest.

• Put comfort and fit at the top of the priority list, rather than good looks.

• Choose a backpack with broad, padded shoulder straps.

• Use both shoulder straps – never sling the pack over one shoulder.

• Use waist straps attached – they are there for a good reason.

• Don’t wear the backpack any lower than the hollow of the lower back.

• Don’t overload the backpack – use school lockers and plan homework well in advance.

• Place all heavy items at the base of the pack, close to the spine, for a better distribution of the weight.

New data, released by the Chiropractors’ Association of Australia to mark the start of National Chiropractic Care Week (May 23 to 29), shows that Australians’ postures are ageing at an increased rate due to heavy mobile device usage.

Our love affair with portable electronic devices is causing growing health problems according to new research1 from the Chiropractors’ Association of Australia (CAA), with chiropractors reporting an increasing trend amongst younger people with posture probl

ems that were traditionally the domain of the middle-aged office worker.

“When it comes to spinal health, our younger people are getting older much earlier,” said CAA National President.

Confirming a societal trend towards greater frequency and increased usage of gadgets, the research highlighted that nearly 50 per cent of Australians are using their laptop more than they were five years ago, while one third has increased their use of PC/desktops and texting on mobile phones.

The increase in usage is most marked amongst younger Australians (aged 18 – 39), with 54 per cent using a laptop more, 40 per cent texting more, 37 per cent talking on mobile phones more and 29 per cent using mobile/electronic games more than they did five years ago.

According to the CAA, chiropractors have seen an interrelated trend in the rise of mobile/electronic device use and posture problems during the past five years.

The research also shows people are not taking regular breaks when using electronic devices – spending up to two hours at a time using hand held electronic devices and more than three hours at their computer in one sitting.

And, while we are more mobile and connected through technology, Australians are less mobile (literally) with activity levels amongst Gen Ys and Zs having decreased compared with the activity levels of their Gen X parents at the same age.

Common postural problems chiropractors are reporting include an increase in forward head posture, round shoulders and forward pelvis in young Australians (under 29 years) symptomatic of today’s gadget culture, while slouching is highest in older people (50+ years).

“The majority of technology users assume poor posture while using electronic devices.” “According to the research, 80 per cent of users acknowledge the need to improve their posture while using computers but not other devices. In fact, only 49 per cent of respondents consider their posture while texting.”

Chiropractors are particularly concerned about the impact of modern technology on tomorrow’s adults. “We are already seeing a jump in problems triggered by handheld computer games and excessive mobile phone texting amongst children and teens.

“This group is most likely to spend their leisure time using electronic devices for long periods of time without taking a break and they are also 4.5 times more likely to have a daily TV habit, rather than a daily physical activity habit.

To help counteract our addiction of modern technology, the CAA is recommending good, old fashioned walking with the launch of its Just Start Walking initiative featuring a free downloadable mobile phone app and website:

www.juststartwalking.com.au

“Technology is here to stay, so we are taking the message about being mobile and active to people’s computers and mobile phones and encouraging people to improve their posture by taking a break and going for a walk.”

1 Note: The CAA commissioned independent research in early 2011 to identify key findings around mobility and posture in relation to the increased use of laptops and mobile devices and the impact on the health of the public. The research was conducted by Square Holes market research agency.