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Articles below (click link below to jump to article):

1. Pregnancy
2. Chiropractic And Kids
3. Why do Infants Need Chiropractic?
4. Disc treatment includes Decompression Distraction at Varon Chiropractic.  
5. Eight Peer Reviewed Articles Regarding Distraction Manipulation for Disk
6. Patients Three Selected Abstracts Regarding Flexion-Distraction Procedure
7. Harmful chemicals in everyday products!
8. BOTTLED WATER: COST VS SAFETY
9. Hydration vs. hyper hydration
10. Case Study: FEMALE PATIENT WITH BACK PAIN AT VARON CHIROPRACTIC
11. LUMBAR DISC HERNIATIONS AND SCIATIC, Do we treat them?
12. Rotator Cuff Exercises

1. Pregnancy

Chiropractic care if you're pregnant? ABSOLUTELY Keeping your spine free from the vertebral subluxation complex is one of the best things you can do if you are pregnant. Pregnant women should see a chiropractor more than anyone else.
Your doctor of chiropractic will examine your spinal column for misalignments (called vertebral subluxation) causing spine and nerve stress. These subluxations damage the nervous system and affect the workings of the entire body. If subluxations are present, the chiropractor will correct them with a gentle chiropractic spinal adjustment in order to release the spinal stress. Without subluxations the body will function better, have higher resistance to disease and express more wholeness (health) than a body with uncorrected subluxations. That is the essential message of chiropractic.

All this is extremely important for the pregnant woman who needs to have her body as healthy and strong as possible in order to handle the rigors of pregnancy and childbirth. Chiropractic care will help ensure that the reproductive and other systems so essential for a healthy pregnancy receive a nerve supply from the spinal column without interference. The slightest interference to the nerve supply could adversely affect the mother and the developing fetus.

Another excellent reason for seeing a chiropractor during pregnancy is that it is a drugless health care system. Drugs, whether prescription or over-the-counter, can harm the growing fetus.

There are so many things pregnant women worry about: staying pregnant, carrying the baby to full term, morning sickness, the baby developing normally, backaches, leg pain and if their labor will be ssafe and (hopefully) easy. Over the past 100 years chiropractic care has proven to help pregnant women by helping to maintain pregnancy, control vomiting during pregnancy, deliver full-term infants with ease and produce healthier infants.

Questions & answers regarding chiropractic & pregnancy:

1. Is chiropractic safe in pregnancy?
Chiropractic is very safe and very sensible for both mother and baby.

2. Is it difficult to receive a chiropractic adjustment when pregnant?
Not at all. Chiropractors are trained in adjusting the spines of pregnant women and many chiropractic adjusting tables have special modifications and pillows for the pregnant figure.

3. How late in pregnancy is it possible to get an adjustment?
Patients have received adjustments even during labor, as that is when movement/shifting happens in the mother's pelvic area.

4. Can spinal care help postpartum depression?
For years chiropractic's beneficial effects on emotional stress and personality have been noted. At least one journal has quoted a doctor as saying that "postpartum depression is a rarity in patients receiving chiropractic care".

5. Can back pain be helped with chiropractic?
Chiropractic is not a treatment or therapy for back or spinal pain. However, with chiropractic spinal adjustments the body will be better able to heal its back and spinal pain, as well as many other health problems. Studies have shown a significant decrease in back and labor pains in mothers receiving chiropractic care.

6. Do I have to have a problem in pregnancy to see a chiropractor? Not at all. Chiropractic should be used as preventive maintenance. Periodic spinal checkups during pregnancy should be as common as periodic weight checkups.

7. Can my baby receive chiropractic?
Infants a few hours old have been given spinal checkups and adjustments, if needed.

Article

2. Chiropractic And Kids

"Chiropractic care for my child? Why? His back doesn't bother him."

How often chiropractors have encountered parents who appreciate the importance of regular checkups for their child's teeth, hearing, eyes and ears, but draw a blank when it comes to a spinal checkup. In fact, a spinal checkup could be one of the most important checkups your child will ever have. Your child's spine is his/her lifeline because running through it is the spinal cord, containing billions of nerve fibers that send messages and energy from the brain to every part of their body. Spinal problems can start earlier than you might think -- much earlier. In fact, the birthing process itself has been shown to wreak havoc on a baby's spine.

And if you've ever watched a toddler struggling to master the art of walking.... lots of stumbles and falls. Older children are also at risk of spinal trauma. Sports activities, poor posture ("slouching"),improper backpack use, and working at an improperly sized desk all take a toll.

It's no wonder that many youngsters develop a spinal condition called vertebral subluxation. This condition occurs when spinal movement is restricted or bones (vertebrae) are out of alignment.
Vertebral subluxation is linked with a myriad of childhood ailments, such as colic, asthma, ear infection, and attention deficit disorders. As children grow older, untreated vertebral subluxations may also spark headaches, back pain and carpal tunnel syndrome.

Dr. Varon and Dr. Jack work to correct these subluxations before the onset of symptoms -- and to prevent new ones from forming. This is accomplished with safe and effective maneuvers called chiropractic adjustments. These are extremely gentle, modified adjusting techniques to alleviate spinal problems in pediatric patients.

Posture & Scoliosis: Scoliosis - a lateral curvature of the spine - is clinically significant in 5% of youngsters. Early detection is key to keeping scoliosis under control and preventing the conditions associated with it, such as back pain, headache and in severe cases, heart and lung disorders. In-school screenings are not as in depth as when done by a doctor of chiropractic, they are spinal specialists. Posture screenings conducted by chiropractors are extensive, including various orthopedic tests and assessments. The result is a comprehensive evaluation that provides a thorough assessment of a youngster's current spinal health and risk of future postural disorders.

Article

3. Why do Infants Need Chiropractic ?

You do everything to ensure your baby's health during pregnancy: you eat right, avoid drugs, smoking and drinking, take childbirth classes so you can have a natural, drug-free birth. After the baby is born, you breastfeed knowing that is the superior form of nutrition; you do everything you can to make sure your baby is healthy ---- but have you had the most important part of their health, their spine and nervous system, checked?

Birth Trauma - The First Subluxation: "The birth process ... is potentially a traumatic, crippling event.... mechanical stress imposed by obstetrical manipulation --- even the application of standard orthodox procedures may prove intolerable to the fetus. The view has been expressed clinically that most signs of neonatal injury observed in the delivery room are neurological...."
Towbin A., Latent spinal cord and brain stem injury in newborn infants. Develop. Med. Child Neurol., 1969.

"With the birth process becoming more and more an intervening procedure....the chiropractic checkup becomes even more important to the child's future." Larry Webster, DC, of the International Chiropractic Pediatric Association.

Of a random group of 1,250 babies examined 5 days after birth, 211 suffered from vomiting, hyperactivity and sleeplessness -- spinal abnormalities were found in 95% of this group. Spinal adjustment "frequently resulted in immediate quieting, cessation of crying, muscular relaxation and sleepiness." The authors noted that an unhealthy spine causes "many clinical features from central motor impairment to lower resistance to infections -- especially ear, nose and throat infections."

Shaken Baby Syndrome: Babies are very top heavy. Mild to moderate shaking of a child can result in serious neurological damage since their neck muscles are undeveloped. This damage has been known to occur after playfully throwing the child up in the air and catching him/her. The damage caused is called Shaken Baby Syndrome.
When does a Baby need a Spinal Checkup? There are times in a baby's first year of life when spinal examinations are especially important.

1. After the birth process.

2. When the baby starts to hold his/her head up.

3. When the baby sits up.

4. When the baby starts to crawl.

5. When the baby starts to stand.

6. When the baby starts to walk.

"Our children deserve to be treated naturally, not with dangerous chemical drugs and unproven surgeries" Bobby Doscher, DC, director of Oklahaven Children's Center.

Do all you can to give your baby the best possible chance to have a healthy life. That includes childbirth without trauma, avoidance of drugs and medical procedures, and breastfeeding. You have your baby's eyes checked, heart checked, ears checked ---- why not their spine and nervous system?

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4. Disc treatment includes Decompression Distraction at Varon Chiropractic.This is a special table that bends in flexion and tractions/decompresses the disc at the same time. We also use it for chronic degenerated spines with lots of success.

5. Eight Peer Reviewed Articles Regarding Distraction Manipulation for Disk Patients

1. J Manipulative Physiol Ther. 1993 Jun;16(5):342-6.

Distraction manipulation reduction of an L5-S1 disk herniation.

Cox JM, Hazen LJ, Mungovan M.

OBJECTIVE: A computed tomography (CT)-confirmed L5-S1 disk protrusion is

reported to be reduced following chiropractic adjustment, as seen on repeat CT

scanning. Correlation of the CT reports with the patient's symptoms before and

after manipulation is reported.

CLINICAL FEATURES: A 38-yr-old female was

treated for low back pain and right lower extremity first sacral dermatome

sciatica. CT confirmed disk herniations at both the L4-L5 and L5-S1 levels were

found. Motor weakness of the right gluteus maximus muscle was found and

extremely tight hamstring muscles accompanying positive straight leg signs were

elicited. A clinical and imaging diagnosis of an L5-S1 disk herniation was made.

INTERVENTION AND OUTCOME: Distraction type chiropractic manipulation, electrical

stimulation, exercises, nutrition advice and low back wellness class were

administered with complete relief of sciatic pain and nearly complete relief of

low back pain.

CONCLUSIONS: Chiropractic distraction manipulation is an

effective treatment of lumbar disk herniation, if the chiropractor is observant

during its administration for patient tolerance to manipulation under

distraction and any signs of neurological deficit demanding other types of care.

PMID: 8345318 [PubMed - indexed for MEDLINE]

2. J Manipulative Physiol Ther. 1984 Mar;7(1):1-11.

Chiropractic manipulation in low back pain and sciatica: statistical data on the

diagnosis, treatment and response of 576 consecutive cases.

Cox JM, Shreiner S.

A chiropractic multicenter observational pilot study to compile statistics on

the examination procedures, diagnosis, types of treatments rendered, results of

treatment, number of days of care, and number of treatments required to arrive

at a 50% and a maximum clinical improvement was collected on 576 patients with

low back and/or leg pain. The purpose was to determine the congenital and

developmental changes in patients with low back and/or leg pain, the

combinations of such anomalies, the accuracy of orthodox diagnostic tests in

assessing low back pain, ergonomic factors affecting onset and, ultimately, the

specific difficulty factors encountered in treating the various conditions seen

in the average chiropractor's office. For all conditions treated, the average

number of days to attain maximum improvement was 43 and the number of visits 19.

It was concluded that this study provided useful data for assessment of routine

chiropractic office based diagnosis and treatment of related conditions;

however, further controlled studies are necessary for validation of specific

parameters.

PMID: 6232332 [PubMed - indexed for MEDLINE]

3. J Manipulative Physiol Ther. 1983 Sep;6(3):117-28.

Chiropractic statistical survey of 100 consecutive low back pain patients.

Cox JM, Fromelt KA, Shreiner S.

One hundred consecutive patients with low back and/or lower extremity pain had

the clinical data; including history, diagnosis, treatment and results of

conservative manipulative therapy collected and tabulated on an IBM 370/138

computer at Indiana-Purdue University in Fort Wayne, Indiana utilizing the

Statistical Package for the Social Sciences (SPSS) based on a standardized

examination form. Various congenital, developmental and ergonomic factors in low

back pain patients were collected and correlated for combinations of factors

leading to back pain. Treatment methods and response to treatment as to time and

patient visit numbers were determined. The frequency of congenital anomalies

were found and those effecting or not effecting low back pain onset determined.

Overall, 50% relief of low back and leg pain was obtained in 15.95 days and 10.8

visits average; maximum relief was found in 41.2 days, or 16.1 treatments.

PMID: 6228618 [PubMed - indexed for MEDLINE]

4. J Manipulative Physiol Ther. 1998 May;21(4):288-94.

Manipulative therapy in lower back pain with leg pain and neurological deficit.

Bergmann TF, Jongeward BV.

Methods Department, Northwestern College of Chiropractic, Bloomington, MN 55431,

USA.

OBJECTIVE: To discuss a case of sciatica associated with lower back pain that

originates in a disc. We discuss the use of manipulative therapy as a

conservative approach and compare it with other conservative methods and with

surgery. CLINICAL FEATURES: The patient suffered from lower back and left leg

pain that had increased in severity over a 6-day period. There was decreased

sensation in the dorsum of the left foot and toes. Computed tomography

demonstrated the presence of a small, contained disc herniation. INTERVENTION

AND OUTCOME: The patient was initially treated with ice followed by

flexion-distraction therapy. This was used over the course of her first three

visits. Once she was in less pain, side posture manipulation was added to her

care. Nine treatments were required before she was released from care.

CONCLUSION: We need a nonsurgical, conservative approach to treat lower back

pain with sciatica as an alternative to and before beginning the more

aggressive, and potentially hazardous, surgical treatment. There is some support

for the idea that lumbar disc herniation with neurological deficit and radicular

pain does not contraindicate the judicious use of manipulation. Although

significant questions remain for the evaluation and treatment of lumbar

radiculopathy (sciatica) with disc herniations, there is ample evidence to

suggest that a course of conservative care, including spinal manipulation,

should be completed before surgical consult is considered.

PMID: 9608384 [PubMed - indexed for MEDLINE]

5. J Manipulative Physiol Ther. 1999 Feb;22(2):96-104.

Low back pain and the lumbar intervertebral disk: clinical considerations for

the doctor of chiropractic.

Troyanovich SJ, Harrison DD, Harrison DE.

BACKGROUND: Low back pain exists in epidemic proportions in the United States.

Studies that demonstrate innervation to the intervertebral disk provide evidence

that may account for instances of discogenic low back pain encountered in

general medical and chiropractic practice. Many patients and health care

practitioners believe that intervertebral disk lesions require surgery as the

only method of treatment that will result in satisfactory outcome. Surgery rates

vary widely across geographic regions. Only one randomized prospective study

exists that compares surgical and nonsurgical treatment; it demonstrated

essentially equal outcomes in the long run. OBJECTIVE: To review specific

aspects of the examination, history, imaging, and treatment of patients with

suspected intervertebral disk lesions and to provide guidelines for conservative

management, imaging, and relative and absolute indications for surgical

referral. DATA SOURCES: Review articles, texts, and original articles from

indexed refereed sources that discuss the lumbar intervertebral disk in regard

to patient history, physical examination, imaging, treatment, and referral for

surgery. RESULTS: Patients with low back pain who do not present with so-called

red flags (fever, history of cancer, unexplained weight loss, urinary tract

infection, intravenous drug use, saddle anesthesia, or prolonged use of

corticosteroids) may be treated initially with conservative methods. Imaging

studies are helpful in determining the patient's diagnosis, and computed

tomography, magnetic resonance imaging, or other special imaging studies should

be ordered judiciously. The only prospective, randomized study of conservative

versus surgical management of herniated lumbar intervertebral disk lesions

indicates both methods provide adequate outcome in the long run. Little

consensus exists on the best method of management for patients with

intervertebral disk lesions without absolute indications for surgery.

CONCLUSION: Patients should be screened for "red flags" to determine whether

they are candidates for conservative treatment. Magnetic resonance imaging is

perhaps the most practical imaging study for evaluation of lumbar disk lesions

because it involves no use of ionizing radiation and because magnetic resonance

imaging has other advantages over computed tomographic scanning such as

excellent delineation of soft tissue structures, direct multiplanar imaging, and

excellent characterization of medullary bone. Provocation computed

tomography-diskography is an invasive procedure and should be reserved for

patients with normal magnetic resonance imaging findings and continuing severe

pain who have not been helped by conservative treatment attempts and for whom

surgical intervention is contemplated. Both conservative and surgical

interventions have been shown to be effective in the treatment of discogenic and

radicular pain syndromes.

PMID: 10073625 [PubMed - indexed for MEDLINE]

6. J Manipulative Physiol Ther. 1999 Jan;22(1):38-44.

Chiropractic rehabilitation of a patient with S1 radiculopathy associated with a

large lumbar disk herniation.

Morris CE.

Cleveland Chiropractic College, Los Angeles, California, USA.

OBJECTIVE: To describe the nonsurgical treatment of acute S1 radiculopathy from

a large (12 x 12 x 13 mm) L5-S1 disk herniation. CLINICAL FEATURES: A

31-year-old man presented with severe lower back pain and pain, paresthesia, and

plantar flexion weakness of the left leg. His symptoms began 5 days before the

initial visit and progressed despite nonsteroidal anti-inflammatory drugs and

analgesic medication. An absent left Achilles reflex, left S1 dermatome

hypesthesia, and left gastrocnemius/soleus weakness was noted. Magnetic

resonance imaging demonstrated a large L5-S1 disk herniation. INTERVENTION AND

OUTCOME: Initial treatment of this patient included McKenzie protocol press-ups

to reduce and centralize symptoms, nonloading exercise for cardiovascular

fitness, and lower leg isotonic exercises to prevent atrophy. Counseling was

provided to reduce abnormal illness behavior risk. Later, flexion distraction

and side-posture manipulation were provided to improve joint function. Sensory

motor training, trunk stabilization exercises, and trigger point therapy were

also used. He returned to modified work 27 days after symptom onset. A

follow-up, comparative magnetic resonance imaging (MRI) study was unchanged. He

was discharged as symptomatic (zero rating on both the Oswestry and numerical

pain scales) after 50 days and 20 visits, although the left S1 reflex remained

absent. Reassessment 169 days later revealed neither significant symptoms nor

lifestyle restrictions. CONCLUSION: This case demonstrates the potential benefit

of a chiropractic rehabilitation strategy by use of multimodal therapy for

lumbar radiculopathy associated with disk herniation.

PMID: 10029949 [PubMed - indexed for MEDLINE]

7. J Manipulative Physiol Ther. 1999 May;22(4):235-44.

Management of acute lumbar disk herniation initially presenting as mechanical low

back pain.

Crawford CM, Hannan RF.

Unit of Rheumatology, Monash University, Victoria, Australia.

OBJECTIVE: To describe the clinical management with spinal manipulation of a

male patient with risk factors for lumbar disk herniation initially suffering

from what appeared to be mechanical low back pain that evolved into

radiculopathy; also to review issues pertinent to chiropractic/manipulative

management of disk herniation. CLINICAL FEATURES: The patient initially suffered

from unilateral low back pain and nonradicular/nonlancinating referral to the

ipsilateral lower extremity. INTERVENTION AND OUTCOME: Disk

herniation-in-evolution was included in the differential diagnosis, which was

discussed with the patient, who then gave verbal informed consent for

manipulative management. A day or so after the initial manipulation the

presentation evolved to include S1 radiculopathy. Computed tomography, just

after onset of radiculopathy, confirmed the clinical diagnosis of lumbosacral

disk herniation. The patient continued with manipulative management and repeat

computed tomography examination after clinical resolution about 2 months later

revealed reduction in size of the apparently clinically significant herniation.

CONCLUSION: Risk factors for the development of disk herniation should be

considered when assessing patients suffering from what appears to be mechanical

low back pain. The role played by manipulation in the development of disk

herniation in this case was believed to be circumstantial rather than causal.

Manipulation was used in the treatment of this patient over a period of

approximately 2 months; after this time, clinical and partial computed

tomography imaging resolution was evident. Ongoing clinical (neurologic)

evaluation of patients with manifest or suspected disk herniation is an

important aspect of management. Good-quality trials of manipulation for patients

with disk herniation are imperative for the chiropractic profession.

PMID: 10367760 [PubMed - indexed for MEDLINE]

8. J Manipulative Physiol Ther. 1995 Jul-Aug;18(6):335-42.

A series of consecutive cases of low back pain with radiating leg pain treated

by chiropractors.

Stern PJ, Cote P, Cassidy JD.

Department of Orthopaedics, Royal University Hospital, Saskatoon, Saskatchewan,

Canada.

OBJECTIVE: To report the clinical presentation and outcome of consecutive

patients who received a course of nonoperative treatment, including

manipulation, for low back and radiating leg pain. This review was conducted to

generate hypotheses for a future clinical trial involving manipulation for the

treatment of lumbar spine disk herniation. DESIGN: A case series of consecutive

patients presenting to a postgraduate teaching chiropractic clinic between 1990

and 1993 was evaluated. Three thousand, five hundred and fifty-three charts were

reviewed; in 71 of the cases, the patient had low back pain (LBP) with radiating

leg pain clinically diagnosed as lumbar spine disk herniation. OUTCOME MEASURES:

All outcome measures were extracted from the patients' charts. Subjective

improvement reported by the patient, range of motion and nerve root tension

signs were used to assess improvement. RESULTS: Of the 59 patients who received

a course of treatment, 90% reported improvement of their complaint. A subgroup

analysis indicated that 75% of the patients that reported improvement of their

conditions had an increase in straight leg raising (SLR) and lumbar range of

motion. The maximum complication rate associated with this treatment approach

was estimated to be 5% or less. A previous history of low back surgery was a

statistically significant predictor of poor outcome. CONCLUSION: Based on our

results, we postulate that a course of nonoperative treatment including

manipulation may be effective and safe for the treatment of back and radiating

leg pain. This hypothesis remains to be tested in a prospective study.

PMID: 7595106 [PubMed - indexed for MEDLINE]

6. Three Selected Abstracts Regarding Flexion-Distraction Procedure

1. Abstract from the Proceedings of the International Society for the study of the Lumbar Spine, Singapore 1998

Intervertebral Disc Pressure Changes During The Flexion-Distraction Procedure for Low Back Pain

Authors: Gudavalli MR*, Cox JM*, Baker JA*, Cramer GD*, Patwardhan AG**
*National College of Chiropractic, 200 East Roosevelt Rd, Lombard, Illinois, U.S.A. **Loyola University Chicago, Maywood, Illinois, U.S.A.

Introduction: One type of conservative procedure used in the treatment of low back pain applies flexion and traction motions to the lumbar spine. In this procedure the prone patient's head and thorax are supported by the fixed portion of a special treatment table. The legs rest on the movable section of the table with the ankles attached by straps. The doctor positions the patient in such a way that the vertebral joint of interest is over the fulcrum of the movable section. The doctor contracts the spinous process of the superior vertebra of the joint with one hand and moves the caudal section of the table downward with the other hand, thus creating traction and flexion motions at the joint of interest. The treatment is based on the hypothesis that the intradiscal pressure decreases during the procedure and may provide an opportunity for the disc bulge to reduce. The purpose of the present study was to measure the changes in the intradiscal pressures in the lumbar spines of unembalmed cadavers during the flexion-distraction procedure.
Methods: Five unembalmed whole cadavers (four male and one female; age range 43-75 years) were frozen at -20°C immediately after death and thawed at room temperature prior to experimentation. An anatomy consultant dissected some of the paraspinal musculature to permit accurate insertion of the needle (17 Gaauge Touhy epidural needle with stylette) into the nucleus of the disc (either L2-L3, L3-L4, or L4-L5). With the cadavers in a prone position similar to that for a patient, we removed the stylette and inserted the miniature pressure transducer so that the sensor was exposed to the nucleus. We connected the pressure transducer to a computer through a signal amplifier and analog-to-digital converter. The treatment procedure consisted of five cycles of table motion in approximately twenty seconds. We monitored the intradiscal pressures during the procedure under two conditions: (1) discs unpressurized and (2) discs pressurized with water. The intradiscal pressures were monitored during three separate trials with thirty minute intervals between each trial. Mean values of the pressures before each cycle of the treatment procedure, pressures in the distracted position, and the changes in the pressures were computed for all fifteen cycles (three trials, five cycles per trial) for each cadaver.
Results: Figure 1 shows a typical plot of the change in the intradiscal pressure at an L4-L5 disc during five, four-second applications of the procedure. The same graph also shows the downward table motion. The downward table motion and the decreases in intradiscal pressure changes are in phase. The flexion-distraction procedure significantly decreased the intradiscal pressure in both the unpressurized and pressurized discs. In the unpressurized discs, the pressure went into the negative range at the distracted position corresponding to the extreme downward motion of the table. The decrease in intradiscal pressure varied from 39-192 mm Hg among the four discs tested in unpressurized mode (mean: 88.6, S.D. 64.2), and the decrease was statistically significant (p<0.01). Injection of water in the disc raised the initial disc pressure to aa mean value of 456mm Hg (S.D.227) in the prone position. The decrease in pressure ranged from 117-720 mm Hg (mean: 330, S.D.222) during the procedure and the decrease was statistically significant (p<0.01).
Discussion: Cyriax, Quilette, and Kramer hypothesized that as the vertebrae in the spine are distracted, a negative pressure develops in the disc, and sucks back a protrusion. The present study shows that the decrease in the intradiscal pressures may provide the opportunity for the reduction in the disc bulge during the flexion-distraction procedure. Ramos et al. reported decreases in the intradiscal pressures during Vertebral Axial Decompression (VAD) procedure on three patients measured intraoperatively. The result of the present study are in general agreement with the study reported by Ramos and Martin. Andersson et al. reported increases in the intradiscal pressures at L3-L4 disc on four volunteers during active and passive traction. A possible reason for the increase in the intradiscal pressures could be that the muscles of the in vivo subjects could have been contracting while under active and passive traction. Work is in progress to monitor the muscle activity during in vivo situations of treating the patients using the flexion-distraction procedure.
Acknowledgement: The authors acknowledge the financial assistance of the Health Resources and Services Administration (HRSA) through a grant #1 R18 AH10001-01A1, financial donations from numerous chiropractic physicians, and Williams Healthcare Systems Incorporated for donating the flexion-distraction table.

2. Abstract from the Proceedings of the Bioengineering Conference, Phoenix

Intervertebral Disc Pressure Changes During a Chiropractic Procedure

Authors: Gudavalli MR1, Cox JM2, Baker JA1, Cramer GD3, Patwardhan AG4
1Research Department, 2Postgraduate Division, 3Department of Anatomy, National College of Chiropractic, 200 East Roosevelt Road, Lombard, Illinois, U.S.A., 4the Department of Orthopedic Surgery, Loyola University Stritch School of Medicine, Maywood, Illinois, U.S.A.

Introduction:
Some of the treatments for low back pain use traction as the loading mechanism to the spine. One such treatment protocol used by chiropractic physicians in the treatment of low back pain is the Cox flexion-distraction procedure (1). The Cox procedure consists of placing the patient in a prone position on a flexion-distraction table and then reating traction and flexion motions at the joint of interest. The treatment is based on the hypothesis that the intradiscal pressure decreases during the procedure and may provide an opportunity for the disc bulge to reduce. However, no data exist to support this hypothesis. The purpose of the present study was to measure the changes in the intradiscal pressures in the lumbar spine on unembalmed cadavers during the flexion-distraction procedure.
Materials And Methods: Two miniature pressure transducers (Model#SPR-524) were purchased from Millar Instruments, Houston, Texas, for this study and calibrated with specially built devices that can be pressurized or create a vacuum. We procured five unembalmed whole cadavers for the purpose of the study (four male and one female; age range 43-75 years). The cadavers were frozen at -20°C immediately after death and thawed at room temperature prior to experimentation. An anatomy consultant dissected some of the paraspinal musculature to permit accurate insertion of the needle and pressure transducer. We inserted a Touhy epidural needle with stylette (17 Gauge) into the nucleus of the disc (either L2-L3, L3-L4, or L4-L5). We then removed the stylette and inserted the miniature pressure transducer so that the sensor was exposed to the nucleus. We connected the pressure transducer to a computer through a signal amplifier and analog-to-digital converter. We placed the cadavers in a prone position on the flexion-distraction table, similar to the positioning for a living patient. The treatment procedure consisted of five cycles of table motion in approximately twenty seconds. The discs were pressurized with water using a Cornwall continuous pipetting outfit (B-D #3052) connected by flexible tubing to a second needle in the disc of interest. LUER-LOK stopcocks allowed air to be bled from the system before pressurizing.
We monitored the intradiscal pressures under two conditions: (1) the discs unpressurized and (2) the discs pressurized with water. The pressures were monitored during three separate trials with thirty-minute intervals between each trial. Mean values of the pressures before each cycle of the treatment procedure, pressures in the distracted position, and the changes in the pressures were computed for all fifteen cycles of the three trials.
Results: Figure 1 shows a typical plot of the change in the intradiscal pressure at an L4-L5 disc during five, four-second applications of the flexion-distraction procedure. The same graph also shows the downward table motion. Tables 1 and 2 list the means and standard deviation values of the intradiscal pressures before the treatment cycle and in the distracted position.
Discussion And Conclusions: We observed a significant decrease in intradiscal pressure during the flexion-distraction procedure for low back pain. When the discs were not pressurized, the pressures went below 0 mm Hg. When the discs were pressurized, the decrease in the intradiscal pressures was much larger, suggesting that in patients with higher intradiscal pressures, the decrease may be much higher during the treatment. The pressures returned to their original values when the spine was brought back to the initial prone position. Quilette(2), and Kramer (3) hypothesized that as the vertebrae in the spine are distracted, a negative pressure develops in the disc, and sucks back a protrusion. Ramos et al. (4) reported on the intradiscal pressure during Vertebral Axial Decompression (VAD) procedure on three patients measured intraoperatively. The results showed that the disc pressures reduced during the VAD therapy. They demonstrated that the disc pressures can go as low as -160 mmHg. The results of the present study are in general agreement with the study reported by Ramos and Martin (4). Anderson at al. (5) reported the intradiscal pressures at L3-L4 disc on four volunteers during standing, lying, active traction, and passive traction. The findings showed an increase in the disc pressure during both active and passive traction. The results from the present study do not agree with the results reported by Anderson et al. (5). A possible reason could be that the muscles of the in vivo subjects could have been contracting while under active and passive traction. Work is in progress to monitor the muscle activity during in vivo situations of treating the patients using flexion-distraction procedure.
Acknowledgments: The authors acknowledge the financial assistance of the Health Resources and Services Administration (HRSA) through a grant # 1 R18 AH10001-01A1. We acknowledge Williams Healthcare Systems Incorporated for donating the flexion-distraction table. Also the partial financial assistance of numerous chiropractic physicians is greatly acknowledged.
References
1. Cox, J.M. Low Back Pain: Mechanism, Diagnosis and Management, Williams and Wilkins. 1990.
2. Quillette J.P. Low Back Pain: An Orthopedic Medicine Approach. Can Fam Physician 1987, 33: 693-694
3. Kramer J. Intervertebral Disc Diseases: Causes, Diagnosis, Treatment, and Prophylaxis. Year Book Publishers 1981: 164-166.
4. Ramos, G. And Martin, W.: Effects of Vertebral Axial Decompression on Intradiscal Pressure. Journal of Neurosurgery 81: 350-353, 1994.
5. Andersson, G.B.J., Schultz, A.B., and Nachemson, A.L. "Intervertebral Disc Pressures During Traction". Scandinavian Journal of Rehabilitation, Suppl. 9:88-91, 1983.
Note for tables below: For cadaver #5, two joints were monitored using two transducers without pressurization. The numbers in parentheses represent standard deviation values for N=15 cycles.)

3. Abstract from the Proceedings, Dallas

Intervertebral Disc Pressure Changes During Low Back Treatment Procedures

Authors: Gudavalli MR1,5 , Cox JM2, Cramer GD1,3, Baker JA1, Patwardhan AG4
1Research Department at NCC,
2Postgraduate Division at NCC, and 3Department of Anatomy, National College of Chiropractic, 200 East Roosevelt Road, Lombard, Illinois, 4The Department of Orthopedic Surgery, Loyola University Stritch School of Medicine, Maywood, Illinois. 5Kinex IHA at Texas Back Institute, 6300 West Parker Road, Plano, Texas

Introduction: Some of the treatments for low back pain use different motions to the spine. One such treatment protocol used by chiropractic physicians in the treatment of low back pain is the Cox flexion-distraction procedure (1). The Cox procedure consists of placing the patient in a prone position on a flexion-distraction table and then creating distraction, flexion, extension, lateral flexion, and circumduction motions at the joint of interest. Gudavalli et al. (2) reported decreases in intradiscal pressures during the combined motions of flexion-distraction motions. However, no data exist during other motions of the table. The purpose of the present study was to measure the changes in the intradiscal pressures during all the maneuvers of the treatment protocols.
Materials and Methods: Miniature pressure transducers (Model #SPR-524) were purchased from Millar Instruments, Houston, Texas, for this study and calibrated with specially built devices that can be pressurized or create a vacuum. We procured one unembalmed whole cadavers for the purpose of the study (male; age 72 years old). The cadaver was frozen at -20°C immediately after death and thawed at room temperature prior to experimentation. Some of the paraspinal musculature was dissected to permit accurate insertion of the needle and pressure transducer. We inserted a Touhy epidural needle with stylette (17 Gauge) into the nucleus of the disc (L3-L4). We then removed the stylette and inserted the miniature pressure transducer so that the sensor was exposed to the nucleus. We connected the pressure transducer to a computer through a signal amplifier and analog to digital converter. We placed the cadavers in a prone position on the flexion-distraction table, similar to the positioning for a living patient. The discs were pressurized with water using a Cornwall continuous pipetting outfit (B-D #3052) connected by flexible tubing to a second needle in the disc of interest. LUER-LOK stopcocks allowed air to be bled from the system before pressurizing. We monitored the intradiscal pressures under the following table motion: (1) flexion (2) extension (3) lateral flexion and (4) circumduction. The pressures were monitored during four cycles of the table motions. Mean values of the pressures from the neutral position of the table to the treatment positions is various were computed.
Results: Table 1 lists the mean values of the intradiscal pressures before the treatment cycle and in the distracted position. Figure 1 shows the changes in the intradiscal pressures for different motions of the treatment procedure.
Discussion and Conclusions: We observed a significant decrease in intradiscal pressure during the flexion-distraction procedure for low back pain. The pressure has increased during extension motion of the table. The pressures have increased during right lateral motion whereas the pressures have decreased during the left lateral motion. During circumduction the pressures have decreased during the left lateral and flexion motions, where as they have increased during right lateral and flexion combined motions. In all of the motions the pressures returned to their original values when the spine was brought back to the initial prone position. One of the reasons for the increase and decrease during lateral motions is due to the fact that the transducer was inserted some what right laterally from the center of the disc. The results clearly show that the pressures are affected during different motions of the spine associated with the motions of the table. Even though the present study is limited to one cadaver, the results are very interesting and studies with more number of cadavers and studies on animals can give further insight into the changes in the pressures at different regions of the spine.
Acknowledgments: The authors acknowledge the Health Resources and Services Administration (HRSA) for the grant # 1R18 AH10001-01A1, Williams Healthcare Systems Incorporated for donating the flexion-distraction table, and partial financial assistance of numerous chiropractic physicians.
References:
1. Cox, J.M. Low Back Pain: Mechanism, Diagnosis and Management, Williams and Wilkins. 1990.
2. Gudavalli, M.R., Cox, J.M., Baker, J.M., Cramer, G.C., and Patwardhan, A.G. "Intervertebral Disc Pressure Changes During a Chiropractic Procedure". Advances in Bioengineering, Vol. 36, 1997 pp. 215-216

7. Harmful chemicals in everyday products!

We encourage you to look at the labels on your, shampoos, moisturizers, facial cleansers, toothpastes, bubble baths Etc. Be Sure you know about the hidden carcinogens and harmful ingredients in them! You Owe it to Yourself to Know what you are putting on your body and those of your loved ones.

Many of these, enter directly into your digestive tract while others are absorbed into your skin. Remember, when you read the label, if it doesn’t sound like something you would want to eat, you don’t want it on you or in you! Below is a partial list only.

For your better Health,

Dr. Varon and Dr. Jack Keshishyan

MINERAL OIL

The Ninth Report on Carcinogens from the US Government states: Coal Tars and Mineral Oil Comes from crude oil (petroleum) used in industry as metal cutting fluid. May suffocate the skin by forming an oil film. Healthy skin needs to take in oxygen and release carbon dioxide. This process should not be inhibited. Holding large amounts of moisture in the skin can "flood" the biology, and may result in immature, unhealthy, sensitive skin that dries out easily. This includes Vaseline and Baby mineral oil.

SODIUM LAURYL SULFATE (SLS)

Potentially, SLS is perhaps the most harmful ingredient in personal-care products. SLS is used in testing-labs as the standard skin irritant to compare the healing properties of other ingredients. Industrial uses of SLS include: garage floor cleaners, engine degreasers and car wash soaps. Studies show its danger potential to be great, when used in personal-care products. Research has shown that SLS and SLES may cause potentially carcinogenic nitrates and dioxins to form in the bottles of shampoos and cleansers by reacting with commonly used ingredients found in many products. Large amounts of nitrates may enter the blood system from just one shampooing.

 PROPYLENE GLYCOL(MSDS)

Called a humectant in cosmetics, it is really "industrial anti-freeze" and the major ingredient in brake and hydraulic fluid. Tests show it can be a strong skin irritant. Material Safety Data Sheets (MSDS) on Propylene Glycol warn to avoid skin contact, as it is systemic and can cause liver abnormalities and kidney damage.

What is it used for? Industrial uses: anti-freeze, brake and hydraulic fluid, paint, floor wax. Personal care products: shampoos, hair conditioners, hand and body lotions, skin and beauty creams, deodorants.

Implicated in contact dermatitis, kidney damage and liver abnormalities; can inhibit cell growth in human tests and can damage membranes causing rashes, dry skin and surface damage.

 GLYCERIN

Draws moisture from inside the skin, and holds it on the surface for a better "feel". Dries skin from the inside out. Listed on MSDS as hazardous. The vegetable source is found in many natural products and seems to be ok.

Sodium  Fluoride

This on is very controversial! It’s used as Rat poison, do you want it in your toothpaste?

Primary uses:

INSECTICIDE, ENAMELS, GLASS MIXES, STEEL DE-GASSING AGENT, ELECTROPLATING FLUXES, FLUORIDATION OF DRINKING WATER, DISINFECTING FERMETATION APPARATUS, PRESERVING WOOD, PASTES, MANUF. COATED PAPER, DENTAL CARIES PROPHYLACTIC (MERCK 1989)

Cocoamide, DEA, TEA, MEA, diethanolamine, triethanolamine,

These are sudsing agents, known carcinogens, seen on CBS News in 1998.

Manufacture warning:

EFFECTS OF OVEREXPOSURE INHALATION OF VAPORS MAY CAUSE SEVERE IRRITATION OF THE RESPIRATORY SYSTEM.CONTACT WITH SKIN OR EYES MAY CAUSE SEVERE IRRITATION OR BURNS.INGESTION MAY CAUSE NAUSEA, VOMITING, HEADACHES, DIZZINESS, GASTROINTESTINAL IRRITATION.INGESTION MAY CAUSE IRRITATION AND BURNING TO MOUTH AND STOMACH.CHRONIC EFFECTS OF OVEREXPOSURE MAY INCLUDE KIDNEY AND/OR LIVER DAMAGE.TARGET ORGANS, EYES, SKIN MEDICAL CONDITIONS GENERALLY AGGRAVATED BY EXPOSURE ASTHMA, PULMONARY DISEASE, DAMAGED SKIN ROUTES OF ENTRY EYE CONTACT, SKIN CONTACT, ABSORPTION, INHALATION, INGESTION

Titanium Dioxide

Now FINALLY declared a carcinogen, 2001

Potential Health Effects

Inhalation:
May cause mild irritation to the respiratory tract.
Ingestion:
Not expected to be a health hazard via ingestion.
Skin Contact:
May cause mild irritation and redness.
Eye Contact:
May cause mild irritation, possible reddening.
Chronic Exposure:
Long-term exposure to titanium dioxide dust may result in mild fibrosis (scarring of the lungs).
Aggravation of Pre-existing Conditions:
Persons with pre-existing lung disease may be more susceptible to the effects of this substance.