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Several public service items which appeared this week on the AOL (America On Line Internet Service Provider) Health News column are quoted below for your interest. ITEM 1 Comment: Though the advice about the use of ice in acute inflammatory conditions generally may be sound, its routine application to "back pain" in general, however harmless it may be, needs more adequate comment about its scope and limitations. Firstly, attribution of all acute back pain to inflammation is simplistic, especially since there are a multitude of causes of acute back pain, only some of which are inflammatory or pathological. Moreover, back pain caused by protective muscular spasm may well be attenuated more effectively by warmth. The statement that "I have seen heat do more damage in acute injuries than anything else" is rather overdramatised and conjectural, because I doubt if he has performed biopsies or carried out MRIs etc to clinically assess the extent of damage before and after the application of heat. Possibly more noteworthy is the comment: "When in doubt, call your chiropractor for advice." Noting that AOL serves something like 12 million customers, this message reaches a huge audience and any medical columnist carrying out his duties objectively would rather have written "consult your doctor, physical therapist or chiropractor." ITEM 2 Comment: The quotation that "A recent Harris Poll survey found that patients with back problems were more satisfied with chiropractic treatment than other types of care" surely is intended to sell chiropractic more than to inform the public. The same AOL column gives advice from "kinesiologists" and Alexander Technicians, but nothing from physical therapists - apparently the latter have nothing to do with back pain and disability. This type of biased journalism does AOL no credit whatsoever; nor does it do credit to the numebr of highly informed and comradely chiros who belong to this list. Health care is meant to involve all who can help the patient, not only those who want to capture the market or media headlines. Although I am not a physical therapist, I find this type of propaganda on AOL very distasteful and I hope that future Health News items present a far more balanced approach to medical topics. How do others feel about this issue? Mel Siff ---------------------------------------------------- << ITEM 1: Quick Relief for Back Pain by Dr. Malcolm Conway Let's review a few quick remedies to help you if you are presently experiencing acute low back pain. If the pain just came on, the rule of thumb is to use ice. Why ice? Because ice is a vasoconstrictor (reduces the size of the blood vessel) and will help keep the inflammation down to a minimum. By reducing the inflammation, you will reduce the amount of scar tissue coming into that area. Ice also produces a temporary analgesic effect on the pain. With the proper use of the ice you can possibly decrease the use of medication. Heat on a new injury usually isn't good because it becomes a vasodilator (opens blood vessels) and will let more inflammation into the damaged area. In my treating experience, I have seen heat do more damage in acute injuries than anything else. If the injury is new, you're much better off using ice on a new injury instead of heat. . . . . . . How long should you use ice? The textbooks say no more that 72 hours, but I have used ice successfully for over one week. How to use it with success all depends on the situation. When in doubt, call your chiropractor for advice. Remember, this is only a temporary solution to a possible injury that may need professional assistance. If the pain continues, call your health professional for an appointment. Copyright 1999 Malcolm Conway Dr. Malcolm Conway is a practicing chiropractor in Pennsylvania. . . . >> ----------------------------------------------------------- ITEM 2: <<Spinal Manipulation by <A HREF="aol://4344:1679.AUTH_015.13642859.530311650">Jane Dusek, DC</A> After intensive study and evaluation, government researchers have concluded what millions of chiropractic patients have known for years: Spinal manipulation is a safe and effective form of initial treatment for one of the most common health complaints -- acute low back problems. For nearly a century, spinal manipulation has been what chiropractors do best. It provides relief from pain without drugs or surgery. . . . . A recent Harris Poll survey found that patients with back problems were more satisfied with chiropractic treatment than other types of care, and 70 percent of Americans surveyed believe that chiropractic should be included as a basic benefit in their health plans. In another study, the prestigious Rand Corporation concluded that spinal manipulation was an appropriate treatment for acute low back pain, and reported from its analysis that 94 percent of all manipulations are performed by doctors of chiropractic.>> -------------------------------------------------------- Dr Mel C Siff Denver, USA [log in to unmask] %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%