National Task Force Urges Depression Screenings for Adults

By Miranda Wilcox
Herald Democrat

…doctors should screen all adults
for depression…

Depression Screening
The U.S. Preventative Services Task Force announced their newest recommendation on Tuesday, that doctors should screen all adults for depression.

Get e-CESD Depression Screening App for Your Practice

“If you don’t screen then you don’t find out that the person has depression, and the result of that is, if you look at population-based data, half of the people with depression in the United States never get diagnosed,” said University of Texas Southwestern Medical Center Professor of Psychiatry Madhukar Trivedi.

Trivedi cited the sweeping impacts of depression, including:

Doctor with patient forms

  • the fact that people with depression live 13 years less than people without depression;
  • an average of 41,000 people kill themselves every year by suicide; and
  • three to four hours per week of productivity is lost for people who have depression compared to those who don’t.

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Can Chiropractic Care Help
Your Neck Pain?

By Micah Hamilton, DC

Approximately 70% of the population will experience neck pain in their lifetime (3). Neck pain can happen for many reasons, but what is the best option for getting rid of neck pain?

If you find yourself not getting anywhere with that nagging neck pain, it may be time to take a look at some alternative solutions.

Many Americans will try and decrease their pain with non-steroidal anti-inflammatory drugs (NSAIDs), which include names such as Advil, Aleve, Motrin, ibuprofen, naproxen, etc. Yet is that the safest option to treat your neck pain?

Research has shown that NSAIDs increase the risk of heart disease, cause over 200,000 hospitalizations and between 10,000-20,000 deaths each year (2). With these alarming statistics many people are seeking a natural alternative, rather than medications, for treating their pain.

To understand how chiropractic can help with neck pain it is important to understand what chiropractic is.

Chiropractic is the largest drug-free health care profession in the world.

Chiropractors focus on the relationship between structure and function, meaning that they detect and correct specific misalignments of the spine and extremities that can be causing irritation, inflammation and malfunction of the nervous system. Many times this is done through a specific chiropractic adjustment, also known as manipulation. By applying a skilled adjustment to spinal vertebrae, the objective is to restore normal biomechanics while stimulating mechanoreceptors (sensory receptors) deep in the joint, which decreases the response of nociceptors (nerve cells) that are responsible for sending pain signals to the brain. These adjustments can increase joint range of motion and reduce pain.

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Chronic Pain and Poor Sleep: A Vicious Cycle

By Gerard J. Meskill, MD

 

Chronic pain is extremely common in America, and it can affect sleep quality. According to the 2015 Sleep in America Poll (1),
21 percent of Americans experience chronic pain, while another 36 percent have experienced acute pain in the past week.

Most people with chronic pain find their symptoms worse while lying in bed trying to sleep, when the external stimuli of the world are no longer providing distraction from their ailments.

Poor sleep can make pain syndromes worse, and worsening of the pain syndrome can feed into perpetuation of poor sleep quality.

Sleep deprivation is an enormous problem in this country as it is. One in three individuals without pain report in the past week that they don’t always or often get a good night’s sleep, the sleep they need to feel their best, or have had trouble falling or staying asleep. In the sub-population of those suffering with pain, it is even worse. According to the National Sleep Foundation (2), people with chronic pain average 42 minutes of sleep debt nightly. Furthermore, only 45 percent of those with acute pain and 37 percent of those with chronic pain report good or very good sleep quality. More than half of those individuals with sleep difficulties and pain report that their poor sleep interfered with their work. This can jeopardize employment and further deteriorate quality of life.

Mature Man having trouble Sleeping

CHRONIC PAIN IMPAIRS SLEEP QUALITY

There are many reasons why chronic pain can impair sleep quality. The obvious one is that dealing with pain while trying to fall asleep makes sleep initiation more difficult. Once sleep finally is achieved, any arousal out of sleep allow for perception of the pain phenomenon again, thus prolonging the time it takes to fall back asleep. Since sleeping lowers our overall sleep drive, it is more difficult to fall back asleep with each awakening. As this pattern continues, the way the brain perceives the bed and sleep changes. Much like the Russian psychologist Pavlov taught his dog to associate the sound of a bell with food, the brain starts to anticipate difficulty sleeping every time an individual suffering from insomnia gets into bed. This leads to increased adrenaline levels (“The Fight or Flight” response), which makes it even harder to fall asleep.
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A Holistic View of Evidence-Based Medicine

By David L. Katz, MD; Chief Medical Officer of the Community Pain Center

 

On April 29, 2014, I was on the Katie Couric Show to discuss Integrative Medicine. Somewhat ironically, I returned from Manhattan that same day to a waiting email from a colleague, forwarding me a rather excoriating critique of integrative medicine on The Health Care Blog, and asking me for my opinion. The juxtaposition, it turns out, was something other than happenstance. The Cleveland Clinic has recently introduced the use of herbal medicines as an option for its patients, generating considerable media attention. Some of it, as in the case of the Katie Couric Show, is of the kinder, gentler variety. Some, like The Health Care Blog—is rather less so. Which is the right response? One might argue, from the perspective of evidence-based medicine, that harsh treatment is warranted for everything operating under the banner of “alternative” medicine, or any of the nomenclature alternative to “alternative”—such as complementary, holistic, traditional, or integrative.

One might argue, conversely, for a warm embrace from the perspective of patient-centered care, in which patient preference is a primary driver.

I tend to argue both ways, and land in the middle. I’ll elaborate.

Scientist using pipette in laboratory

First, I am a card-carrying member (well, I would be if they issued cards) of the evidence-based medicine club. I am a conventionally trained Internist, and run a federally funded clinical research laboratory. I have taught biostatistics, evidence-based medicine, and clinical epidemiology to Yale medical students over a span of nearly a decade. I have authored a textbook on evidence-based medicine.

But on the other hand, I practice Integrative Medicine, and have done so for nearly 15 years. And I represent Yale on the steering committee of the Consortium of Academic Health Centers for Integrative Medicine.
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