Chiropractic Can Reduce High Blood Pressure: The Study

The US Food and Drug Administration has a standard for determining the efficacy of new hypertension drugs: it requires “a blinded design with a placebo-subtracted reduction in diastolic BP of 5 mm Hg or more and be free of serious side effects to be approvable.”

With that guideline as their standard, a group of researchers from the University of Chicago set out to determine if chiropractic adjustment of the atlas could reduce blood pressure in patients with hypertension. The authors summarize the relationship between the first cervical vertebra (C1) and hypertension:

“Unlike other vertebrae, which interlock one to the next, the Atlas relies solely upon soft-tissue (muscles and ligaments) to maintain alignment; therefore, the placement of C-1 is pain free and thus, remains undiagnosed and untreated, whereas health-related consequences are attributed to other aetiologies.”

The position of the atlas can have an affect on the functioning of the brainstem, and, as shown in this study, can affect blood pressure. Chiropractic manipulation can adjust the position of the spine, relieving the pressure on the spinal cord.

“Minor misalignment of the Atlas vertebra can potentially injure, impair, compress and/or compromise brainstem neural pathways. The relationship between hypertension and presence of circulatory abnormalities in the area around the Atlas vertebra and posterior fossa of the brain has been known for more than 40 years.”

In this study, the researchers took 50 patients with Stage 1 hypertension who had either never been on hypertensive drugs or who had stopped taking hypertensive drugs for at least two weeks.

All of the patients were evaluated by a chiropractor for misalignment of C1 using radiographs and leg-length checks. Half of the patients received spinal manipulation of the C1; the other half received a sham treatment that was indistinguishable from a real treatment by the patient.

The diagnostic procedure was conducted at intake, after the treatment and at eight weeks.

The authors found that the patients who received the chiropractic treatment experienced a dramatic drop in average blood pressure compared to the control subjects:

	Control	Treatment
BP Baseline	145.3/91	147/92.5
BP End of Study	142.1/89.2	129.8/82.2

The drop in blood pressure was so impressive the authors state that it “is similar to that seen by giving two different antihypertensive agents simultaneously.”

Furthermore, 85% of the patients needed only one treatment to realize the improvement in blood pressure.

In addition, the study also documented the degree of pelvic misalignment and the position of the C7 vertebra; these measurements are used with this particular method of chiropractic to diagnose dysfunction of the C1 vertebra. Just as they found with the results for blood pressure, the degree of misalignment was reduced dramatically in the treatment group, but not the control group.

“As discussed in the Methods section of this paper, techniques are now available to screen for atlas misalignment. This type of screening should be the responsibility of the primary care physician and should be performed on patients who have a history of head and neck trauma even if it is deemed insignificant. Those patients who present with pain related to head and neck trauma should not be screened. At a time when the prevalence of hypertension is increasing and its control more difficult due to a variety of factors, linking the correction of C1 misalignment to the subsequent lowering of BP may represent an important advancement in the screening of such patients.”

Bakris G, Dickholtz M, Meyer PM, Kravitz G, et al. Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study. Journal of Human Hypertension 2007;21:347-352.

Side-Effects of Common Blood Pressure Medications

(Source: American Heart Association)

Some of the drugs listed below can affect certain functions of the body, resulting in bad side effects. However, drugs that lower blood pressure have proven effective over the years. The benefits of using them far outweigh the risk of side effects. Most people who’ve taken these drugs haven’t had any problems.

Diuretics — Some of these drugs may decrease your body's supply of a mineral called potassium. Symptoms such as weakness, leg cramps or being tired may result. Eating foods containing potassium may help prevent significant potassium loss. You can prevent potassium loss by taking a liquid or tablet that has potassium along with the diuretic, if your doctor recommends it. Diuretics such as amiloride (Midamar), spironolactone (Aldactone) or triamterene (Dyrenium) are called "potassium sparing" agents. They don’t cause the body to lose potassium. They might be prescribed alone but are usually used with another diuretic. Some of these combinations are Aldactazide, Dyazide, Maxzide or Moduretic.

Some people suffer from attacks of gout after prolonged treatment with diuretics. This side effect isn't common and can be managed by other treatment.

In people with diabetes, diuretic drugs may increase the blood sugar level. A change in drug, diet, insulin or oral antidiabetic dosage corrects this in most cases. Your doctor can change your treatment. Most of the time the degree of increase in blood sugar isn't much. Impotence may also occur in a small percentage of people.

Beta-blockers — Acebutolol (Sectral), atenolol (Tenormin), metoprolol (Lopressor), nadolol (Corgard), pindolol (Visken), propranolol (Inderal) or timolol (Blocadren) may cause insomnia, cold hands and feet, tiredness or depression, a slow heartbeat or symptoms of asthma. Impotence may occur. If you have diabetes and you’re taking insulin, have your responses to therapy monitored closely.

ACE inhibitors — These drugs, such as captopril (Capoten), enalapril (Vasotec), lisinopril (Zestril or Prinivil), may cause a skin rash; loss of taste; a chronic dry, hacking cough; and in rare instances, kidney damage.

Angiotensin II receptor blockers — These drugs may cause occasional dizziness.

Calcium channel blockers — Diltiazem (Cardizem), nicardipine (Cardene), Nifedipine (Procardia) and verapamil (Calan or Isoptin) may cause palpitations, swollen ankles, constipation, headache or dizziness. Side effects with each of these drugs differ a great deal.

Alpha blockers — These drugs may cause fast heart rate, dizziness or a drop in blood pressure when you stand up.

Combined alpha and beta blockers — People taking these drugs may experience a drop in blood pressure when they stand up.

Central agonists — Alpha methyldopa (Aldomet) may produce a greater drop in blood pressure when you're in an upright position (standing or walking) and may make you feel weak or faint if the pressure has been lowered too far. This drug may also cause drowsiness or sluggishness, dryness of the mouth, fever or anemia. Male patients may experience impotence. If this side effect persists, your doctor may have to change the drug dosage or use another medication.

Clonidine (Catapres), guanabenz (Wytensin) or guanfacine (Tenex) may produce severe dryness of the mouth, constipation or drowsiness. If you're taking any of these drugs, don’t stop suddenly, because your blood pressure may rise quickly to dangerously high levels.

Peripheral adrenergic inhibitors — Reserpine may cause a stuffy nose, diarrhea or heartburn. These effects aren't severe and no treatment is required other than to change the amount of drugs taken. If you have nightmares or insomnia or get depressed, tell your doctor. You should stop using the drugs.

Guanadrel (Hylorel) or guanethidine (Ismelin) may cause some diarrhea, which may persist in some people. This side effect usually becomes less of a problem if you continue treatment.

These drugs reduce blood pressure more when you stand. Consequently, you may get dizzy and lightheaded and feel weak when you get out of bed in the morning or stand up suddenly. If you notice any of these reactions — and if they persist for more than a minute or two — sit or lie down and either reduce or omit the next dose of the drug. If symptoms continue, contact your doctor.

When you're taking guanethidine, don't keep standing in the hot sun or at a social gathering if you begin to feel faint or weak. These activities cause low blood pressure. Male patients may experience impotence. Contact your doctor if this occurs. These drugs are rarely used unless other medications don’t help.

Blood vessel dilators — Hydralzine (Apresoline) may cause headaches, swelling around the eyes, heart palpitations or aches and pains in the joints. Usually none of these symptoms are severe, and most will go away after a few weeks of treatment. This drug isn't usually used by itself. Minoxidil (Loniten) is a potent drug that's usually used only in resistant cases of severe high blood pressure. It may cause fluid retention (marked weight gain) or excessive hair growth.

NOTE: If you're taking any of the medications discussed here, don't stop taking them without consulting your doctor.

Latest Research: Chiropractic Lowers Blood Pressure

You may have seen reports of a new study on the effectiveness of a certain type of chiropractic treatment in lowering blood pressure without any drugs, or changes in diet or exercise habits.* It’s been all over the TV news.

The patients in this study simply went to the chiropractor, were carefully examined and x-rayed in a very specific way and then given a precise chiropractic adjustment. Just once. Six months later, the 25 patients in the study who actually got adjustments still had, on average, a 17 point reduction in blood pressure. That is very significant. Take a look at the enclosed list of medications and their side-effects. Eliminating or reducing the amount you take could make a BIG difference in how you feel. Also, if your body is better able to regulate your blood pressure, there will be less fluctuation between doses of medication, which will mean fewer “ups and downs” in the way you feel during the day.

The technique used in the study is called “Nucca”. It is one of several “upper cervical” techniques. While proponents of a particular upper cervical technique might argue the point, they are all pretty much alike. Careful examination and x-ray techniques are used to determine the direction and degree to which the occiput (base of the skull), the atlas (first vertebra), and axis (second vertebra) are misaligned in relation to each other and the rest of the body. Then, they are realigned either by hand or by one of several different types of adjusting instruments. It is the precision of the x-ray analysis and adjusting technique that gives results where other methods might fail.

While I do not limit my practice to upper cervical adjusting, I am proficient in three very effective upper cervical techniques, two done by hand and one by a hand-held instrument. There is a method of precise x-ray positioning and analysis that I use that has helped me get quick, long-lasting results.

Over my 25 years of practice, I have had many patients report a drop in high blood pressure while being treated for neck pain. This has been a well-known effect of chiropractic adjustments for years. Now, with this study and all of the publicity surrounding it, the time has come to promote it.

Just give us a call and tell Pat that you want to come in for the FREE “Chiropractic Blood Pressure Program” screening. If there are certain indicators present that would make you a candidate for care, you will be accepted into the program. I have set a fee that I’m sure you will find very affordable.

I look forward to helping you.

Yours in Health,

Anthony P. Galzarano, D.C.

*Of course this does not mean that you should abandon healthy eating and exercise habits or stop taking prescribed medication without your doctor’s supervision.)

Village Voice Questions Credibility of "Quackwatch.com"

Whenever you do a search for "chiropractors", somewhere on the first page you invariably see a misleading link entitled "Choosing a Chiropractor". This brings you to the "quackwatch.com" website of the infamous Dr. Stephen Barrett. The article below will give you an insight into the mind of Dr. Barrett what he is really trying to accomplish with this "public service".

Village Voice Questions Credibility of "Quackwatch.com"

The Village Voice, a weekly newspaper that symbolized the "new journalism" when it was founded in New York City in 1955 by Dan Wolf, Ed Fancher and Norman Mailer, still represents an alternative media voice in U.S. journalism. The award-winning publication, with the largest circulation of any weekly newspaper in the U.S. (250,000), continues in its iconoclastic way to report on the cultural and political trends that shape the nation.

Most everyone is aware of the cultural shift toward "alternative" forms of health care. In 1997, an estimated 83 million Americans visited an alternative provider at least once during the year; there were 628,825,000 visits to alternative care providers, compared to only 385,919,000 visits to all primary care physicians.¹

Coinciding with the rise in visits to alternative care providers is the increasing number of people using the internet for health-related information. In June, the Wall Street Journal reported that nearly 40 percent of all American adults on line, roughly 22 million, searched for health information on the internet last year.

Donna Ladd, writing for the Village Voice, took up just this issue in the June 23-29 issue.² Her article begins by relating the consensus of the Science Panel on Interactive Communication and Health, a group of doctors, insurers, HMO representatives and online health providers: that, surprise, health information on the Web can be inaccurate! The panel, which was appointed by the U.S. Dept. of Health and Human Services, recommended that the government not get involved in regulating online health information.

The HHS director of the panel, Dr. Thomas Eng, however, did cause a stir by mentioning in a press conference that Quackwatch.com was a good site for exposing bogus health information. That raised the hackles of those in the alternative care field, because Quackwatch.com (nÐ December 1996) has been operated by retired psychiatrist Stephen Barrett,MD, certainly the most vocal and often-published detractor of alternative health care, including chiropractic. Quackwatch.com's slogan is "Your Guide to Health Fraud, Quackery, and Intelligent Decisions."

Dr. Barrett also administers the Chirobase.org website (nÐ Oct. 1998) that is "A Skeptical Guide to Chiropractic History, Theories, and Current Practices." Chirobase is cosponsored by the National Council Against Health Fraud, Inc., and Victims of Chiropractic. Helping Dr. Barrett operate Chirobase is William Jarvis,PhD, and Charles DuVall Jr.,DC.

Ms. Ladd noted in her article in the Village Voice that if a study shows that alternative therapies do not work, Dr. Barrett has no problem with it, but if a study shows positive results, he labels that study as unreliable.

"It's easy to look at something like chiropractic, see what they're doing, and describe what they're doing wrong," Dr. Barrett told the Village Voice.

It's a curious condition that allows Dr. Barrett to assess the chiropractic profession, in which he has no professional training, yet not take the medical profession to task for any of its shortcomings. Criticism of the medical profession, he said, is "way outside my scope."
Dr. Barrett told the Village Voice that most alternative therapies should be disregarded without further research. Why? "A lot of things don't need to be tested (because) they simply don't make sense."

Mary Jo Deering, the Health Communication and Telehealth staff director at HHS, made a good point to the Village Voice. She said consumers "really need to be able to avoid quackery and bias. Bias can be as damaging as outright quackery."

Peter Barry Chowka, a consultant to NIH's Office of Alternative Medicine, former national affairs editor of New Age Journal, a writer, editor and lecturer on the limitations of conventional medicine and the promise of alternative therapies, added his commentary to the Village Voice article: "He (Barrett) seems to be putting down trying to be objective." Mr. Chowka said Quackwatch.com was "consistently provocative and entertaining, and occasionally informative," but said that Dr. Barrett was "running against the tide of history."

Mr. Chowka, observing the medical profession's efforts to thwart alternative therapies, called for an end to "medical McCarthyism." He has confidence in people to make decisions about health care. "We no longer need a nanny state or a government-appointed watchdog to filter information for us," he told the Village Voice.

The Web is opening a whole new world of information. People are ordering supplements on line, asking their doctors questions, and even getting their prescriptions filled. Chiropractic patients can get referrals to DCs and access to thousands of chiropractic articles (ChiroWeb.com).

The trend toward alternative forms of health care will continue to grow, and the internet will be a driving force behind it. Meanwhile, while some in the medical profession are creating websites to discourage and disparage alternative health care, the AMA has made the astounding decision to unionize! It would seem a decision that will be a boon to alternative therapies and drive even greater numbers of people away from the MD's office.

You'll recall Peter Chowka characterizing Dr. Barrett's Quackwatch.com as "running against the tide of history." It would seem that the AMA is rowing against the same tide.

References

1. Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Rompay MV, Kessler RC. Trends in alternative medicine use in the United States, 1990-97. JAMA 1998;280:1569-75.

2. Ladd D. Doctor who? Diagnosing medical fraud may require a second opinion. Village Voice June 23-29, 1999.

Chiropractors don't raise stroke risk, study says

Chiropractors don't raise stroke risk, study says

A research report published in Spine journal confirms what chiropractors have said for years: chiropractic care does NOT cause an increased risk of strokes due to arterial dissection.

"We didn't see any increased association between chiropractic care and usual family physician care, and the stroke," said researcher Frank Silver, professor of medicine at the University of Toronto and director of the University Health Network stroke program. "The association occurs because patients tend to seek care when they're having neck pain or headache, and sometimes they go to a chiropractor, sometimes they go to a physician. But we didn't see an increased likelihood of them having this type of stroke after seeing a chiropractor."

During the past several years, chiropractic has come under intense attack by anti-chiropractic organizations, including several that claim to represent chiropractic "victims." Despite a wealth of evidence to the contrary – including a 2001 study published in the Canadian Medical Association Journal that the risk of suffering a stroke due to chiropractic adjustments was less than one in nearly 6 million -- critics have kept up their attacks and tried to persuade the public that chiropractic adjustments were dangerous.

For this latest project, a Canadian research team studied nine years of patient data and found that, of the 818 cases involving this kind of stroke, patients were just as likely to have visited their family medical doctor as they did a chiropractor. There was no increased risk from having received chiropractic care.

Dr. Silver admitted that he and his team were specifically looking for an increased association between chiropractic care and stroke but found none. According to the report's conclusion, "The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care."

Risk of Vertebrobasilar Stroke and Chiropractic Care: Results of a Population-Based Case-Control and Case-Crossover Study. Spine. 33(4S) Neck Pain Task Force Supplement:S176-S183, February 15, 2008. Abstract

My Laser

“I was ready to take the #$@&$#& gas pipe!”, exclaimed Manayunk community leader, John Bernard,
turning to us on his way out the door. “I mean it! I couldn’t even stand up and take a step. This hip was killing me! I’m telling you, I was headed for surgery. I’m gonna’ tell everybody I know about this laser.”

After months of agony, John’s hip pain is just about gone after only a few treatments with the laser. So is his shoulder pain. And – amazingly – chronic pain from a forty three year old severe knee injury, for which he had recently consulted an orthopedic surgeon, has also vanished. (By the way, don’t worry about John gassing himself. He has an electric oven.)

Victoria Panasevicz was told by “one of the best neurologists in the city” that she “had no hope of ever feeling normal without surgery to my two lower discs.” It took quite a few laser treatments because of the severity of her condition, but she is back to work and, except for a setback from a fall from which she has recovered, she is back to normal – without surgery!

Then there's Mrs. Joanne McGuigan who works as a secretary for Channel 6. Mrs. McGuigan had also received a great deal benefit from chiropractic adjustments. However, she was still partially disabled from pain and we couldn't seem to get past a certain point with her condition. She had had back surgery years before and couldn't stand or walk for very long.

As she tells it: “After the first treatment with the laser device I immediately felt the difference. I went faithfully three times a week and I have felt 85% better. I walk straight with no pain in my hip or my lower back. I still can't stand in one place for long, but I can walk a half-mile around the high school field which I had attempted before and couldn't do."

Watson Straub loves golf. He came to me as a last resort after unsuccessful medical treatment and physical therapy. He wasn’t even able to shake hands without debilitating pain in his right elbow. After a few weeks of laser therapy, he’s back on the golf course, vigorously shaking hands all he wants. WITHOUT PAIN!

Speaking of elbows, Margie DuBrow is very pleased to have her nagging elbow pain almost gone after a four laser treatments. It may take two or three more to get rid of it altogether.

Paula Straka’s foot pain had been interfering with her fencing for months. When someone is coming at you with a sword, you have to be able to move quickly! ONE laser treatment was all it took to eliminate the pain!!

Olivia Gilinger injured her big toe years ago. Long ago, it got to the point where she couldn’t move it. After just a few laser treatments, she can wiggle it as well as the others.

Susan Roxandich, an operating room nurse, didn’t know whether or not her knee pain would ever go away. She was not at all happy with the treatment she had received elsewhere. After being treated with the laser, the pain is just about gone.

This is NOT just temporary relief. Except in cases of re-injury or severe degenerative changes to the affected part, THE RELIEF IS PERMANENT!

(By the way, the laser isn’t actually cold. It just isn’t hot like a surgical laser. Surgical lasers cut or vaporize tissue. This laser doesn’t need all that power. It uses the energy of laser photons to stimulate healing and kill pain. You don’t feel anything at all during the 8 to 12 minute treatment.)

Skeptics want to know: “Why in a city of world-class medical facilities, can the only cold laser of its kind in the entire state of Pennsylvania only be found in a little home chiropractic office in Roxborough?”

As a skeptic myself, I think that’s a perfectly reasonable question. I can answer it, too.

When I came across “cold laser” therapy, I was, indeed, skeptical. It didn’t make sense to me how laser light could stimulate healing. As time went on I read about it in journals and heard about it from other doctors. I became more interested.

I did a Web search and printed out page after page of information and research about "cold lasers". I joined online discussion groups. I checked out the web sites of every brand and type of therapeutic laser. I started e-mailing the support staff at several laser companies. I sent away to Sweden for a textbook on laser therapy written (in English) by the two top experts in the field. I exchanged e-mails with one of the authors.

I narrowed my search down to one particular type of laser.

Then I hit a dead-end.

There was no laser of this type approved for use in the United States. Now, this is one of the several types of lasers that have been used for 30 years in Europe. In fact, it is the laser of choice of the doctor who is considered the expert in the field - one of the authors of that textbook that I mentioned. But, as I said, getting any type of medical device through the FDA is a long and very expensive process. The one company that I knew of that did make this type of laser, a Swedish company, apparently didn't think it worthwhile to jump through the FDA hoops.

By now though, I was past the point of no return. My months of research had convinced me that this was an extraordinarily valuable tool. I had already decided. I had to have one. And I knew which one was going to work best for my patients. But they were not available in the USA.

I couldn't quit now though.

I went back on the Web and tried a variety of different queries. Then, on one of the searches, a new name popped up. It was a Canadian company that had just put up a website, even though they had been manufacturing and distributing their lasers to hospitals, pain centers, and chiropractic offices in Canada for more than 10 years. In fact, the company runs its own clinic and has tested the device on a wide range of conditions.

The reason that they finally got around to putting up a website is that they had just gotten FDA “second level approval” for their laser and were beginning to market it in the United States.

It was the exact laser that I was looking for. No..... not exactly. This was even better.

This laser has a very unique delivery system that clusters five of the lasers which I had determined would be the most effective for the types of deep muscular, disc and nerve conditions that I see PLUS four of the more commonly used lasers that are effective for joint problems closer to the surface.

BUT it had not gotten through the final stage of FDA approval at that point. The only way I could use the laser was as an “investigational tool”. I would have to fill out a ton of paperwork on each patient I treated and submit it to the FDA, documenting the effectiveness of the device. I hate paperwork!! And for the privilege of doing all this extra work I would have to pay more than $12,000 for the unit. No, I should say gamble it.

You see, years ago when I practiced in New York City, I bought a simple electronic device for pain relief. It cost a couple of hundred dollars. It gave some relief to most patients, but it was not anything special. I would use it every so often on minor sprains or strains. One day I got a letter from the FDA saying in big, bold red letters: THIS DEVICE MUST BE DESTROYED! Although it was a harmless device that worked by using small amounts of static electricity, the company must have somehow run afoul of the FDA.

To have that happen with a $12,000 device would be a disaster!

But I what I had read over the previous 6 months convinced me that this device was perhaps the most valuable tool I had come across in all my years of practice. If it worked as well as the research indicated, I might be able to help people who I couldn’t help otherwise. People who would have to risk all of the downsides of medication or surgery. Or go on suffering. Or, as often happens, suffer the side-effects of medication AND go through a surgery that either failed or made them worse.

I knew that there are over 2,000 research papers supporting the effectiveness of “cold laser” treatment for a wide variety of conditions. I also knew that in over 30 years of continued use in Europe and Canada, there has never been one documented side-effect.

So……..I went for it!

I am happy to say that the device did get final FDA approval.

You can see that one reason that I have one of these units and a big outfit like Moss Rehab or NovaCare does not is that I happened to “be at the right place at the right time”. I got one at the earliest time possible. Also, I was willing to gamble on FDA approval and use my practice as a testing facility.

My practice has a distinct advantage over hospitals and large rehab facilities. I don’t have deal with hospital bureaucrats. Getting approval for a new therapy at one of the large, prestigious institutions is a long, drawn out, complicated affair. “Cutting edge” therapies are seldom cutting edge by the time they get through the process. I have the advantage of researching a new therapy, making up my own mind, and just going out and getting it.

The biggest reason that the “Big Boys” do not have one of these units is economic. They are totally geared toward insurance reimbursement. For the most part, only insurance companies can afford to pay the fees that hospitals and other large facilities have to charge. Their overhead is tremendous! And insurance companies are even worse than hospitals when it comes to accepting new therapies. With a few exceptions, insurance companies will not pay for cold laser therapy.

So, what it comes down to is this: I can charge an affordable fee for this therapy. Hospitals and rehab centers cannot.

That’s my story. What’s your story?

Is it a long and dreary one about a pain that just won't go away? Are you just not able to do at least some of the things you like to do? Or have you been listening to someone else's story of pain and limitation?

If you ask me, I'd say you or that other person deserves a happy ending.

So, if you or someone you know has a problem that no one has been able to help with so far…… Don't throw in the towel!

The Facts:

· Treatment is totally safe, with no side effects.

· It may eliminate a condition that has been causing you pain and limitation for years.

· It’s affordable.

Your Choices:

· Do nothing or whatever other ineffective thing you've been doing and just live with

(i.e. suffer with) it.

· Become a guinea pig for the "next Vioxx".

· Go under the knife.

· OR the only logical next step: Give it a try!

I know what I would do.

Yours For Improved Health And Happiness,

Anthony P. Galzarano, DC