The spine has its own normal curvature or kyphosis. Most of us don’t think about these curves, their normalcy or function, until there is a problem caused by a curve that becomes overly curvy. Take for example the thoracic spine, the upper back part of the spine, whose normal kyphosis ranges from 20° to 40° in young people.For 20% to 40% of over-60-year-olds, this kyphosis grows beyond 40°. This “age-related kyphosis” (aka ‘hyperkyphosis’) affects both men and women but is more frequently seen in women who experience more functional disorders like decreased back extensor muscle strength and use of erector spinae muscles in addition to poor health conditions. (1,2) Spinal manipulation and mobilization (SMM) of the thoracic spine are common ways chiropractors treat musculoskeletal issues in older adults with issues like hyperkyphosis. Older spines effectively experience the SMM forces similar to younger spines. (3) Luckily, manual therapy like SMM has been researched and described as effective to reduce and prevent musculoskeletal problems due to thoracic hyperkyphosis. A recent study noted that such therapy improved the thoracic kyphosis angle, thoracic extension range of motion, and thoracic extension strength. (4) And a bonus:Thoracic mobilization is shown to increase diaphragmatic excursion and respiratory function to manage and prevent respiratory dysfunction in patients with thoracic hyperkyphosis. (5) Your chiropractor delivers gentle, effective, distractive thoracic spine manipulation that is both hyperkyphosis-relieving and comfortable. Once you feel it, you’ll want more!

Listen to this PODCAST with Dr. Joseph D’Angiolillo on The Back Doctors Podcast with Dr. Michael Johnson as he describes gentle distraction treatment of upper spine pain with the Cox® Technic System of Spinal Pain Management.

TIP OF THE MONTH: Get Care for Spinal Stenosis Sooner Than Later!

Lumbar spinal stenosis is a common diagnosis for older adults. It’s related to higher utilization of healthcare services. And surgery isn’t always the answer according to a study that reported how 1 in 3 lumbar spinal stenosis patients experienced a poor clinical outcome with surgery. Moreover, 36.1% of 529 patients had a poor leg pain outcome while 27.6% had a poor overall outcome. Promisingly, patients who exercised regularly and those who received pre-operative non-operative chiropractic or physiotherapy care were less like to report a poor overall outcome. (6) A recent study reported that getting such non-operative care starting within the first 30 days of diagnosis reduced the use of riskier and more costly health care services in the following year. Less than 2% of Medicare beneficiaries receive such care in a timely fashion. (7) Lastly, manual manipulation for 8 weeks was reported to be effective for patients with lumbar spinal stenosis by reducing their pain and improving their function. (8) Let’s get started caring for your spinal stenosis today, non-surgically and safely.

Set up your next chiropractic visit soon. 
We look forward to seeing you.
Thank you.

References for HEALTHY NEWS – November 2021

1. Roghani T, Zavieh MK, Manshadi FD, King N, Katzman W. Age-related hyperkyphosis: update of its potential causes and clinical impacts-narrative review. Aging Clin Exp Res. 2017 Aug;29(4):567-577. doi: 10.1007/s40520-016-0617-3. Epub 2016 Aug 18. PMID: 27538834; PMCID: PMC5316378.
2. Roghani T, Khalkhali Zavieh M, Talebian S, Akbarzadeh Baghban A, Katzman W. Back Muscle Function in Older Women With Age-Related Hyperkyphosis: A Comparative Study. J Manipulative Physiol Ther. 2019 May;42(4):284-294. doi: 10.1016/j.jmpt.2018.11.012. Epub 2019 Jun 27. PMID: 31257003.
3. Funabashi M, Son J, Pecora CG, Tran S, Lee J, Howarth SJ, Kawchuk G, de Luca K. Characterization of thoracic spinal manipulation and mobilization forces in older adults. Clin Biomech (Bristol, Avon). 2021 Oct;89:105450. doi: 10.1016/j.clinbiomech.2021.105450. Epub 2021 Aug 14. PMID: 34450432.
4. Jung SH, Hwang UJ, Ahn SH, Kim JH, Kwon OY. Effects of Manual Therapy and Mechanical Massage on Spinal Alignment, Extension Range of Motion, Back Extensor Electromyographic Activity, and Thoracic Extension Strength in Individuals with Thoracic Hyperkyphosis: A Randomized Controlled Trial. Evid Based Complement Alternat Med. 2020 Nov 23;2020:6526935. doi: 10.1155/2020/6526935. PMID: 33299454; PMCID: PMC7707944.
5. Jung SH, Hwang UJ, Ahn SH, Kim JH, Kwon OY. Does mobilisation of the thoracic spine using mechanical massage affect diaphragmatic excursion in individuals with thoracic hyperkyphosis? J Back Musculoskelet Rehabil. 2021 Oct 12. doi: 10.3233/BMR-210143. Epub ahead of print. PMID: 34657875.
6. Hébert JJ, Abraham E, Wedderkopp N, et al. Preoperative Factors Predict Postoperative Trajectories of Pain and Disability Following Surgery for Degenerative Lumbar Spinal Stenosis. Spine (Phila Pa 1976). 2020 Nov 1;45(21):E1421-E1430. doi: 10.1097/BRS.0000000000003587. PMID: 32541610; PMCID: PMC7547903.
7. Schmidt CT, Ogarek J, Resnik L. Physical Therapy and Health Care Utilization for Older Adults With Lumbar Spinal Stenosis. J Geriatr Phys Ther. 2021 Sep 24. doi: 10.1519/JPT.0000000000000328. Epub ahead of print. PMID: 34570040.
8. Oh H, Choi S, Lee S, Lee K, Choi J. The effects of manual manipulation therapy on pain and dysfunction in patients with lumbar spinal stenosis. J Phys Ther Sci. 2020;32(8):499-501. doi: 10.1589/jpts.32.499. Epub 2020 Aug 8. PMID: 32884169; PMCID: PMC7443540.