Thursday, June 30, 2011

Chronic Pain Abundant Among Americans!

In the past few days, the Institute of Medicine (IOM) came out with a report stating that approximately 116 million Americans suffer from chronic pain. The estimated cost to treatment of their pain is around $600 million per year! That represents about of third of all United States citizens living with pain. That's astonishing!

The recommendations by the IOM actually talk about prevention of disease and pain. This is a very different approach than our current system of disease management. While this is a good first indicator that preventative measures beginning to gain steam, it is a far stretch from where we need to be as a society.

The recommendations are that primary care doctors need to be in charge of managing their patients' pain and specialists should only be referred to in "complex cases." While this sounds like a grand idea, a major problem exists. Medical school and residency for PCPs teach very little about disease prevention in regards to musculoskeletal pain (one of the major contributors to chronic pain). While medical doctors are great at recognizing illness and disease, there is almost no emphasis in allopathic medicine in preventing pain in these types of cases.

As a chiropractor, I am consistantly talking to patients about things they can do to stay healthy and prevent disease. One of the foundations of chiropractic is disease prevention. Unfortunately, I think that placing care of chronic musculoskeletal-driven pain patients in the hands of many PCPs would only result in those patients receiving prescriptions for medications to deal with their pain. While some patients do indeed need medicine, many times they need other forms of care to actually rid themselves of the causitive factors leading to the pain.

I feel that chronic pain generated by issues dealing with the musculoskeletal system, such as back pain, is best managed by physical medicine practitioners. Included in this group would be chiropractors, physical therapists, naprapaths and massage therapists. Once the pain-generating problems are address, these patients can lead a much healthier, pain-free lives.

For more on the IOM report, follow this link:

If you have any questions about this topic, feel free to call our office at (847) 673-6600 or visit us on the web at!

Friday, June 10, 2011

FDA warns about high doses of popular cholesterol medication!

Zocor (also known generically as simvastatin) is a widely used cholesterol-lowering drug. It is part of the statin group of drugs (also including the popular drug Lipitor). These drugs have produced amazing results in lowering bad cholesterol and total cholesterol in patients. With there great success, however, there are shortfalls!

In order to effectively lower cholesterol, statin drugs must affect many processes in the body. Whenever one aspect of the bodies' complex system is disturbed, there are going to be unwanted effects on other parts of the body. Sometimes these negative effects are seen as aches and pains, while often times they are silently occurring.

Statin drugs are notorious for causing the side effect symptoms of muscle fatigue and weakness. Why is this? Basically, statins cause deterioration of the muscle fibers, especially at higher doses. The kidneys then have to process all of the leftovers from this muscle breakdown. This process places a great deal of stress on the kidneys and, at high enough levels, can lead to kidney disease and even kidney failure.

The effect on both the muscles and the kidneys of high-dose simvastatin (80mg) has led the FDA to warn against long-term use of high dosages. Why are patients taking such high doses to begin with? Well, physicians are constantly trying to reduce their patients cholesterol levels to lower and lower levels. At some point, a doctor must say that the level is low enough as to not have such negative side effects on other body parts.

Perhaps a better approach to lowering cholesterol is to actually counsel patients on nutrition and proper diet before prescribing them drugs. If diet changes are not enough, then start the patient on low dose statins. Unfortunately, this approach is much tougher and takes a bigger commitment from both the patient and the doctor. But, I think it's worth the effort!

If you have any questions about your cholesterol levels or health in general, please call us at (847) 673-6600 or visit us at!