Stand Taller ~ Live Longer

Simple treatments work better than expensive surgery and hi-tech toys like MRIs, according to Forbes magazine(April 21,2008 Back Pain:What Works).

America spent $86 million on back pain in 2005, up 65% in real terms from 1997. And according to Forbes, most of the money went to "brand name narcotics and all sorts of new gadgets". Forbes reports that studies now clearly show the best treatments are low tech. Their recommendation to stay active especially pleases me because it is what I have promoted for years, and fits with the message in my book, Stand Taller~Live Longer. Staying active is great, but you can only exercise in the ways you can move. Strengthening posture means you can get the most from your exercise because you learn to you move with greater symmetry, stronger balance, and better control---in other words, more effectively.

In addition, as a doctor of chiropractic, I am delighted with this observation re back pain--"regimens with strong statistical evidence for their use: spinal manipulation from a chiropactor". However, I wonder why they follow up the sentence with a backhanded "(why this works isn't clear)". I have never seen such a parenthetical question next to any of the very expensive and very pretty full page ads for drugs (of dubious effectiveness, per their article) appearing in the magazine--Why is that?

According to this MSNBC article, the effectiveness of many popular and widely prescribed drugs are in strong doubt. On the heels of the widely watched problems with Vioxx caused heart problems (marketed as drugs like naprosyn came off prescription and became over the counter), new studies show many drugs are no better than alternatives (INCLUDING EXERCISE and other natural remedies).

According the MSNBC:

"Avandia, may raise the risk of heart attack, and that antidepressants, the most widely prescribed drugs in America, may work no better than placebo."

"the federal Food and Drug Administration expanded use of a top cancer drug, Avastin, to treat breast cancer, on basis of a trial that showed that while the drug slowed the disease, it didn’t impact overall survival."

"millions of...Vytorin users learned that it and its component drug, Zetia, failed to work as widely expected"

I know many drugs are wonderful and help millions, but perhaps spending $30 billion a year by the pharm industry marketing drugs in ever increasing numbers to the general public doesnt translate into clinical effectiveness. And perhaps more people moving the joints of their body fully, on a daily basis, is a better solution than drugs for many problems.

Another datapoint in the trend towards the retailing of healthcare: Walgreen Buying Health Centers, Wall Street Journal, March 18, 2008.

Walgreen-the nation's largest drugstore chain(by $)- bought I-trax Inc ($259.7 million cash) and Whole Health Management ($???). The purchase gives Walgreen over 500 worksite (in businesses like Lowe's, Toyota Motor Corp, Continental Airlines, Sprint Nextel, and more) and instore Take Care Health Clinics health centers in 40 states.

This is another blip in trend towards big boxes entering the healthcare niche. In 2007 Wal-Mart set a goal to be the nation's largest healthcare provider by 2014, and in January Wal-Mart's CEO told store managers about a PILOT program to help "select employers save employers $100 million this year by removing unnecessary costs."

IMHO, Patients and providers will likely disagree with the company's definition of "unnecessary", and the trend towards reducing coverage and reimbursements will continue to accelerate.

Healthcare quality and service will change for many, and likely not for the better. The challenge for consumers will be finding providers who can economically empower them to economically care for themselves. And the opportunity for providers will be creating organizations and patient relationships geared towards empowering patients so care can provided economically.

Wall Street Journal-February 13th 2008-

Spending to treat back pain in the US rose 65% in the past decade. Spine patients say they feel worse according to a huge study reported in the Journal of the American Medical Association. So if spending on low back surgery is going up, and spending (reimbursement) for chiropractors is going down, is it possible that we're treating this problem backwards?

Another datapoint pointing to my contention that the solution to back pain is less surgery and less drugs, but more consistent chiropractic and posture exercise.

The author of the popular South Beach Diet, Arthur Agatson, endorsed functional exercise targeted at building a strong core (like Pilates and StrongPosture exercises). In a recent MSN report (http://health.msn.com/fitness/articlepage.aspx?cp-documentid=100194940&GT1=10906) Dr. Agatson advises replacing machine workouts with whole body exercises which engage a fuller kinetic chain, and recommends that "if you take just one gym class a week, make it Pilates".

We agree to the point of using the same words in advising against working what we both call ""mirror" muscles—ones that look good in the mirror or on the beach." The problem lies in that by isolating one muscle other links in the kinetic chain are supported by the machine and so a muscle imbalance is generated.

It's fun seeing ideas once thought of as radical entering mainstream.