Lifestyle Effect On Dementia & Feeling A Stiff Back May Not Mean A Stiff Back
CF 112: Lifestyle Effect on Dementia & Feeling A Stiff Back May Not Mean A Stiff Back
Today we’re going to talk about Lifestyle and Dementia and Does the feeling of a stiff back really mean your back is actually stiff?
But first, here’s that sweet sweet bumper music
OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.
We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers.
I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.
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You have found yourself smack dab in the middle of Episode #112
Now if you missed last week’s episode , we talked about how the American Family Physicians my be warming up to chiropractic and what supplements actually have some evidence behind them. Make sure you don’t miss that info. Keep up with the class.
While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points.
On the personal end of things…..
You remember how I mentioned that my life has been a bit of a soup sandwich lately? Yeah, well, I had my front door glass broken out yet again. That’s twice in about 3 weeks. We’ve not had any issue whatsoever with our building or break-ins in over 10 years in the same locations. All of the sudden, bam…. here we are about $500 lighter in deductible fees and about to be a lot lighter in the bank account because now I have to invest in some security cameras.
Because I’m done folks. Luckily, they caught the little a-holes and they’re sitting in the Randall County Jail. I’m hoping that’ll be their new home for a while. Hopefully long enough for them to learn their lessons.
Other than than, life is motoring a long. Wrapped up January in fine fashion. My goals are always 10% better. If you can do better than that, then heck yeah. But for me, 10% better is a minimum for me each year. In each category. Are you keeping stats? I mean accurate, robust stats.
I keep them for just about everything I can think of. And you should too. I hit my numbers big time in 2019. Now, I’m getting with my main marketing girl and trying to see how we’re going to improve 10% over what was already a big big year for us.
That’s another question I have; without getting into politics, I’m going to tell you that all was well up through 2014 or so. But then 2015 and 2016 came along. We dropped off. Not dangerous numbers but I’d classify it as a significant dropoff for sure.
Then came 2017 through 2019 and we saw tremendous growth and numbers. So, my question, if we look at what was happening in the USA around that time, we had the winding down of the Obama Presidency and the election of a different President.
Now, anyone can say anything they want about the White House’s current occupant but I don’t think anyone can deny that the economy has been hitting on all cylinders.
So back to the question at hand; does it matter at all which President is in office? Which party holds the office at The White House? Does it matter?
I may get some blow back here but I’m trying to look at it in a non-partisan, non-political way and say, that in my expereince, it has mattered and my business has done much better since the 2016 election than the years prior to.
Now let’s be fair, a lot of research has emerged in that time. The American College of Physicians recommended spinal manipulation, the White House recommended spinal manipulation, The Lancet Papers came out, Dr. Goertz kicked the VA doors down with her research…..basically, I don’t think it’s one thing like which party is in the Presidency.
But, can we deny that when the economy is killing it like right now, that patients seem more willing and more confident to spend money? My uneducated but experienced guess is that yes, the economy has an effect on our businesses and the party in power affects the economy.
Alright, those of you that disagree, go fire up my email inbox. I’m always all ears and willing to learn so feel free to tell me all about it.
I want to talk about some much much cooler stuff than that right now though. I want to discuss some papers on lifestyle and genetics in regard to dementia as well as if feeling back stiffness actually means you have a stiff back. Pretty interesting stuff there.
Before we dive into the reason we’re here, it’s good to support the people that support evidence-informed practitioners. Well, ChiroUp certainly does just that.
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Let’s start out with this one in JAMA called “Association of Lifestyle and Genetic Risk With Incidence of Dementia” by Lourida, et. al. and published on July 14, 2019(Lourida I 2019)….it’s not sizzlin but it’s steamy folks.
Why They Did It
The authors objective was to investigate whether a healthy lifestyle is associated with lower risk of dementia regardless of genetic risk.
How They Did It
- The study included 196,383 subjects
- They were followed up for 1,545,433 person-years
- This paper was a retrospective cohort study i
- It included adults of European ancestry aged at least 60 years
- The subjects had no cognitive impairment or dementia at baseline.
- They joined the UK Biobank study from 2006-2010 and were followed until 2016 or 2017
- They scored for dementia
- and paid close attention to lifestyle factors such as smoking, physical activity, diet, and moderate alcohol consumption
The authors concluded the following, “Among older adults without cognitive impairment or dementia, both an unfavorable lifestyle and high genetic risk were significantly associated with higher dementia risk. A favorable lifestyle was associated with lower dementia risk among participants with high genetic risk.”
So, just to keep you all smart, in summary, no matter where you fall on the genetic risk continuum, don’t smoke, eat healthily, drink in moderation, and get some exercise. And tell your patients to do the same.
OK, Item #2
This one is called “Feeling stiffness in the back: a protective perceptual inference in chronic back pain” by Stanton, et. al. and was published in Scientific Reports in August of 2017(Stanton TR 2017). Not smoking hot but only a couple years or so old.
Why They Did It
The authors were looking to test the idea or notion that have a back that FEELS stiff actually means you have a stiff back. They wanted to propose a new hypothesis and that is that feelings of back stiffness are a protective perceptual construct, rather than reflecting biomechanical properties of the back. This new theory, if proven, would have far-reaching implications for the treatment of pain and stiffness going forward.
How They Did It
They used three different experiments to challenge the view by demonstrating that feeling stiff doesn’t actually relate to the objective measure of actually being stiff. In addition, objective back stiffness doesn’t differ any between those who report FEELING stiff vs those who do not.
What They Found
Those reporting a feeling of stiffness actually are showing self-protective responses and they significantly overestimate force applied to their spine.
Wrap It Up
Here we show that conscious experience of feeling stiff does not reflect true biomechanical back stiffness, but may rather represent a protective perceptual inference that may serve to reduce movement and re-injury. By showing that feelings of stiffness do not relate to biomechanical stiffness measures and that biomechanical measures of stiffness do not differ between those with and without feelings of stiffness, this suggests that information other than actual joint stiffness is influencing this perceptual inference
Correct me if I’m wrong but, to an extent that sounds similar to what we commonly hear called ‘fear-avoidance’. What would you say is a common way to deal with fear-avoidance? I would be bold enough to suggest that an effective means is a concept of ‘hurt vs harm.’
Fear-avoidance can keep patients in chronic pain syndrome but if they start moving and start exercising, they start trusting their bodies more and more. We are clear to them that some movements may hurt a little bit and that’s OK. It’s part of the process. But, if the movements feel ‘harmful’, they should stop and let’s take a closer look at what’s going on.
We all know that most exercises for most people are not actually harmful. Once they get moving and making progress, they get excited, don’t they? Fear-avoidance goes down, activity level goes up, and health gets a boost.
The patient is a winner and the doctor is a winner. Hell, the patient’s family is a winner. Have you ever had to be around a chronically painful or ill patient? It’s misery for all involved. Plus, what if the person in chronic pain typically cooks for the family? Obviously, everyone here is the winner because I like some biscuits.
I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.
When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.
It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient.
And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!
At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….
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We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.
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About the Author & Host
Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & VloggerBibliography
Lourida I, H. E., Littlejohns TJ, (2019). “Association of Lifestyle and Genetic Risk With Incidence of Dementia.” JAMA 322(5): 430-437.
Stanton TR, M. G., Wong AYL, Kawchuk G, (2017). “Feeling stiffness in the back: a protective perceptual inference in chronic back pain.” Sci Rep 7(9681).