Study Suggests Back Disease May Run in Families

In an analysis of a database of more than 2 million people, first-degree and third-degree relatives of people with lumbar disc disease had a significantly increased relative risk of developing the back condition themselves compared with expected rates for the general population. "The results of this study support a heritable predisposition to lumbar disc disease," lead author Alpesh A. Patel, MD, and colleagues from the departments of Orthopaedics and Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, report in the February 2 issue of the Journal of Bone and Joint Surgery.

Low back pain is common and costly — its estimated lifetime risk in the United States is 84%, with an annual cost that exceeds $100 billion — yet its etiology remains incompletely understood. Several earlier studies have hinted at a familial predisposition.

To test the hypothesis that lumbar disc disease may be inherited, the authors analyzed data from both the Utah Population Database, which permits the tracking of medical information on the founding pioneers of Utah and their descendents, and the University of Utah Health Sciences Center data warehouse, which has diagnosis and procedure data on all patients treated at the University Hospital. Together, the databases contain information on more than 2.4 million patients. Only patients and control participants with at least 3 generations of genealogical data were included in the study.

Of those individuals, 1254 people had at least 1 diagnosis of lumbar disc disease or lumbar disc herniation, along with the requisite genealogical data. The authors tested for heritability in 2 ways: by estimating the relative risk for lumbar disease in relatives and by determining a genealogical index of familiality (GIF). They compared their findings in affected families with the expected results for the general population of Utah.

First-degree relatives of people with lumbar disc disease had a relative risk of 4.15 of having the disease themselves (95% confidence interval [CI], 2.82 - 6.10; P < .001). In third-degree relatives, the relative risk was 1.46 (95% CI, 1.06 - 2.01; P = .027). Relative risk was slightly elevated in second-degree relatives, at 1.15, but this was not significant (95% CI, .71 - 1.87; P = .60), perhaps because of limitations in the data.

The GIF tests the hypothesis that there is no excess familial clustering, or relatedness, of the phenotype of interest by measuring excess relationships between pairs of patients compared with pairs of control participants. "It is not the absolute value of the GIF statistic that reveals excess relatedness of disease, but the relative value of the case-GIF to the control-GIF," the authors explain. In this analysis, the case overall GIF was 3.05 compared with a mean control GIF of 2.51 (P < .001 for overall GIF), suggesting "a significant excess of relationships among patients compared with controls."

Now that a genetic predisposition to lumbar disc disease has been identified, the identification of the specific genetic products responsible for lumbar disc disease may help in the development of potential biologic interventions to prevent and/or treat lumbar disc disease in the population at large.

Source: http://www.medscape.com/viewarticle/736881

David P. Chen, D.C.
Chiropractor in Laurel, MD
20708

One more reason to take breaks from sitting: a smaller waistline

Always wanted a smaller waist? Scientists have discovered that the answer could be something as simple as taking frequent small breaks from sitting.

A U.S. National Health and Nutrition Examination Survey published in the European Society of Cardiology’s European Heart Journal revealed that participants who took more small breaks from sitting had smaller waistlines than those who did not. This was true even for those who were spent up to 21.2 hours a day sedentary. For the 25% of participants who took the most breaks from sitting, the survey found that waistlines were on average 1.61 inches or 4.1 centimeters smaller than the 25% of participants who took the fewest breaks. The survey, led by University of Queensland researcher followed 4,757 people, all aged 20 and older. The survey lasted for seven days, during which participants wore an accelerometer on their right hips when they were awake. These accelerometers measured the intensity of the participants’ physical activity. Low levels of intensity were equated with sedentary periods.

Having a small waistline indicates less abdominal fat, which in turn is an indicator for better heart health. Larger waists, on the other hand, are linked to cardiovascular disease and high blood pressure as well as higher risk for type 2 diabetes. Another study published in the journal, Obesity, links increases in waistlines to increased chance of premature death.

Participants who took more frequent breaks from sitting also had lower levels of C-reactive protein (CRP). CRPs are produced by the liver. Production is correlated with the level of inflammation in the body. The study also found that taking breaks had a significant effect on lowering HDL-cholesterol, particularly in non-Hispanic whites. Conversely, those who were had higher sedentary times tended to have larger waists, higher HDL-cholesterol, CRPs, triglycerides and insulin.

The benefits of frequent breaks from sitting is linked to muscle activity in the legs and back. When sitting or reclining, these large muscles are largely inactive. However when standing, these muscles are forced to continually contract in order to maintain posture. This increased activity helps to clear plasma triglycerides, which is a risk factor for cardiovascular disease.

Still not convinced? By taking frequent breaks and doing some stretches while sitting at work will also save you from frequent neck and back pain.

Source: http://www.msnbc.msn.com/id/41028986/ns/health-diet_and_nutrition/

Dr. David P. Chen
Chiropractor in Laurel, MD 20708
Laurel Regional Chiropractic

Chiropractic in the Treatment and Prevention of Sports Injuries

The study aims to investigate whether chiropractic manual therapy intervention protocol provided in addition to the current best practice management could prevent the occurrence of and weeks missed due to hamstring and other lower-limb injuries at the semi-elite level of Australian football. The authors used two groups of male semi elite Australian Rules football athletes, matched them in several ways and randomly placed them in one of two arms of the study. All received the usual and customary management and medical care. Half also received chiropractic care which consisted of both soft tissue and high velocity spinal manipulation. The treatment plan was: 1 treatment per week for 6 weeks, 1 treatment per 2 weeks for 3 months, 1 treatment per month for the remainder of the season (3 months). The research evaluated several outcomes. When chiropractic care was added to conventional management, there was a significant reduction in lower limb strain injuries, time missed as a result of knee injuries, lower back pain, and there was improvement in health status. “In addition, although not statistically significant, there was a trend towards prevention of hamstring and primary non-contact knee injuries and there were no reported adverse outcomes from the intervention.”

Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic