Epidural Steroid Injection Vs. Spinal Manipulation

<span class="widget-title__inline">Spinal Injections and Chiropractic care for symptomatic disc herniations</span>

Did you know that there are over 25,000 spinal nerve root injections given in the U.S. each day? This equates to over one million per year in the U.S. alone! These epidural steroid injections (ESI) carry the most common side effects of infections, dural punctures, bleeding, and nerve damage. There is additional research that suggests a 21% increase of vertebral fracture after ESI. A nerve root injection is the injection of steroids, local anesthetic, and/or saline that is performed under fluoroscopy into the epidural space with the intentions to decrease inflammation and improve healing in that region.

Researchers found that both chiropractic manipulation and nerve root injections improved symptomatic MRI confirmed lumbar disc herniations. The groups were split into a chiropractic manipulation group and a nerve root injection group. Pain levels were measured prior to the start of the therapy and again one month post-treatment. After one month, 76.5% of the chiropractic manipulation group found improvement in symptomatology as compared to 62.7% of the nerve root injection group. However, 60% reduction was found with spinal manipulation; whereas, 53% reduction in pain was found with nerve root injections. With nerve root injections, 5.9% of patients found worsening symptoms and with spinal manipulation, 2% of patients found worsening symptoms after one month of treatment.

Already received an injection? Theres more!

A study from 2004 found that chiropractic care following nerve root injections resulted in 76% of these patients having improvement after one treatment procedure. The researchers found that nerve root injections are proposed to address the inflammatory and central components of spinal pain. Spinal manipulation is proposed to address the biomechanical and neural aspects of the pain syndrome. Spinal manipulation is a safe and effective, non-surgical procedure to address low back pain with radiculopathy both before and after nerve root injections.

Sources:Spinal manipulation postepidural injection for lumbar and cervical radiculopathy: a retrospective case series.

Symptomatic magnetic resonance imaging-confirmed lumbar disk herniation patients: a comparative effectiveness prospective observational study of 2 age- and sex-matched cohorts treated with either high-velocity, low-amplitude spinal manipulative therapy or imaging-guided lumbar nerve root injections.

How your neck pain can kill you!

In talking with some patients, I’ve come to realize not many people understand the importance of a chiropractor being a portal-of-entry provider (meaning, you don’t need to have your MD write a script for you to see a chiropractor). This is a valuable commodity, especially if you have insurance, of which you can take advantage.

First of all, let’s talk about why this is an excellent option.

From a chiropractor’s perspective:

We endure the same amount of schooling as a other medical professionals at a doctorate level, except we focus more on the biomechanical aspect. This is important because a chiropractor can rule out red flags or deadly conditions and/or refer you to the appropriate provider.

From a patient’s perspective:

(Most of) You have insurance to take care of any of the health-related problems. Take advantage of it! Why live with neck pain/headaches when you can have your condition treated effectively and be pain-free? Also, it’s always a good idea to have anything that isn’t normal examined by a professional to make sure it’s not a bigger problem than you think.

So how can neck pain kill you?

Essentially there are two ways that we will discuss, which I’m going to call non-diagnosis and misdiagnosis. Non-diagnosis is leaving a neck condition untreated until it is too late. These are the red flag conditions in which chiropractors are trained to diagnose and refer to a specialist such as beginning signs of stroke, tumor, cancer, etc. Misdiagnosis is essentially a condition that is diagnosed wrong. Although misdiagnosis can happen in any office or with any provider, some are more extreme. Of these most extreme, I’ve seen many of patients that had common, successfully treated-with-chiropractic conditions that have undergone risky operations because of misdiagnosis. The American Chiropractic Association created a graphic to depict the risks of death with commonly used prescriptions/surgeries versus the risk of stroke with neck manipulation.

neck pain; neck; pain; chiropractic; risk of death Now, would you rather go to a surgeon and have surgery for something that can be treated by a chiropractor in 4-12 visits, or would you rather go to a chiropractor and be referred to a surgeon for a condition that absolutely needs surgery?

If you decide to choose conservative, choose chiropractic that works and please give us a call at (570) 621-4390.

Why do joints crack when they’re adjusted?

The age old of question of “why do my joints crack/pop when they get adjusted?” is answered with this study! The most popular belief was the theory that tiny gas bubbles are “popped” and the gases are released from the joint. This study demonstrates the reverse! The popping is the rapid development of bubbles inside the joint. Picture a deflated air bag in between each joint. When it is manipulated a certain way, this air bag is rapidly inflated. This makes a lot more sense then “your joints create bubbles that pop when we apply a specific force.” As mentioned by the author, this study supports the other recent study that cracking your knuckles does not cause, and actually helps slightly prevent, arthritis.

So, basically, chiropractors are helping massage the cartilage inside each joint. Although I haven’t found any research to support it, it makes sense why restricted joints are restricted – there’s no “air bag” or extra cushion between the joints.

If you’ve never had a chiropractic adjustment or are suffering from any type of injury or pain, stop by and check us out! We gladly accept walk-ins or feel free to give us a call to set up an appointment today!

systemic inflammation

Inflammation: The Sand Castle Analogy

systemic inflammation

Recent studies are pointing to chronic, systemic inflammation (CSI) as the major cause of chronic diseases. Chronic diseases include, but are not limited to, heart disease, stroke, and cancers. Autoimmune diseases, heart attacks, thyroid conditions, lupus, diabetes, and even “genetic” conditions fall into this group.Have you ever considered why you may know someone who has Type II Diabetes, but their siblings don’t? Their excuse may be “it runs in my family.” With epigenetics we find common links to common diseases. However, the body is more complex than that. Someone may claim that predisposition (increased likelihood of contracting the common disease based upon common genes), but there needs to be a trigger to activate these genes. If the genes are not activated, the body does not respond by allowing the disease process to occur. Now that we’ve laid out epigenetics in response to chronic diseases, let’s talk about the most common trigger: chronic, systemic inflammation (CSI).

CSI is a state in which the body is in constant stress. It is influenced by a number of factors, most importantly: exercise, diet, and toxins ingested. Exercise eliminates deleterious effects of sedentary lifestyle. Next, everything we put into our mouth affects the body. There are foods/supplements that promote health, just as there are foods/supplements that diminish health. Out of the foods and toxins that diminish health, a majority of them cause systemic inflammation. With constant consumption of these foods, the systemic inflammation becomes chronic.
Let’s break this down. Chronic means a long period of time, usually longer than one month. Systemic means wide-spread, throughout your body. Inflammation is a process the body uses repair itself. If it’s a healing process, why is it so bad for the body to be in this state? In CSI, the body is stuck in the initial cycle, like a scratched CD (do you remember that thing that used exist before your mp3 player?). It’s a constant repeat of irritation leading to an increase in the immune response (inflammation) without allowing the second phase of the process to begin.

Picture building a sand castle too close to the water. The castle is your body, the water is inflammation, and you are the immune system. Initially, you have that perfect castle. But wait, the tide is coming in. Initially it may bump the sand castle and, while the tide is low, you can repair the castle as good as new. As time goes on, the body is getting increased amounts of irritation, much like the tide coming in. Eventually you are unable to repair the castle (body) as the wave (inflammation) strikes it and the castle will not be able to be fully repaired. This varies on a large scale of how close your castle is to the water, or how often you are exposed to those irritants to the immune system.With that being said, let’s touch on some of the foods that we eat everyday that have been linked to promote CSI.

Before we mention these foods, and I cannot stress this enough: check out It Starts with Food by Dallas and Melissa Hartwig. This book thoroughly explores both sides: health promoting and health diminishing foods. Also, it includes easy to understand explanations for the processes in the body affected by food. Finally, they include a 30 day challenge to clean up your diet and improve your health. The beginning of each chapter has quotes from success stories of individuals trying the Whole30 challenge which helps grab your attention. Alright, now for some foods that we eat everyday that deteriorate our health:

  • Sugars, sweeteners, and alcohol
  • Seed oils
    – canola – corn
    – peanut – safflower
    – soybean – sesame
    – sunflower – etc.
  • Grains
    – flour – breads
    – wheat – oats
    – cereals
  • Legumes
    – beans – peas
    – lentils – peanuts

Please remember this list is not all-inclusive and is a brief review of food groups that appear to promote CSI. It Starts With Food heavily breaks everything down in simple terms and lays out an excellent 30 day program to help you avoid the majority of these food to promote a healthy lifestyle. Once again, It Starts With Food should definitely be a book on your conquered checklist and is a great book to keep on your bookshelf to reference and review from time to time after implementing the Whole30 program. For any additional information regarding dietary changes, please feel free to check out www.whole9life.com and once again, check out It Starts With Food. For those individuals in the Pottsville area in Schuylkill County, Pennsylvania looking to make a change in diet, feel free to talk to Dr. Brandon Aucker at Revive Chiropractic.

Sources: Hartwig D, Hartwig M. It Starts With Food. Las Vegas: Victory Belt Publishing, Inc.; 2012.

nutrition; tobacco; heart health

The Truth about Heart Disease!

nutrition; tobacco; heart health
Dr. Lundell, a heart surgeon with 25 years experience is now basically saying “Hey, these chiropractors may have it right all along.” To quote Dr. Lundell: “However, if we chronically expose the body to injury by toxins or foods the human body was never designed to process, a condition occurs called chronic inflammation.” Many studies point to chronic, systemic inflammation (CSI) to be the root of all evil. (For more information on inflammation, please read the sand castle analogy.)

In western medicine, there was an early concept that seemed to make sense: if you eat cholesterol, the cholesterol in your blood is going to rise. This rise in blood-cholesterol (fatty materials) increases viscosity (thickness) of blood which then can cause clogged arteries leading to strokes and, the big one, heart attacks! However, multiple studies have overturned this concept. The most recent discovery is that inflammation in the wall of the artery is the real cause of heart disease.

So that means that approximately 25% of the population are being misled and the 12 billion dollars being spent on statin drugs to lower cholesterol and prevent heart disease are pointless. Digested cholesterol does not immediately spike blood levels of cholesterol. In fact, the body has an endogenous (internal) process that creates cholesterol because cholesterol is very important for physiological processes in the body.

The most common source the body utilizes to make cholesterol is refined carbohydrates, most commonly flour products (breads, cakes, pastas, etc.) and sugars (high-fructose corn syrup found in everything from imitation “pancake syrup” to sodas). The simple process: the body stores excess calories for energy in the liver and muscles. When these stores get full, the liver turns the carbohydrates into fat, specifically palmitic acid (the saturated fat linked to elevated triglycerides/cholesterol, insulin resistance, and inflammation).

Directly from the heart doc: “The injury and inflammation in our blood vessels is caused by the low fat diet recommended for years by mainstream medicine.” So he is reiterating what I just mentioned. An overabundance of refined carbohydrates are the biggest culprit of excess stores of cholesterol AND the cause of injury and inflammation! So the low-fat diets that increased consumption of refined carbs and omega-6 vegetable oils (canola, vegetable, corn, soybean oils, etc.) put us at greater risk of heart disease.
Why do the omega-6 fatty acids found in vegetable oils and low-grade animal meats increase inflammation? The body needs to keep a 3:1 ratio of omega 3 to omega 6 fatty acids. With the over-consumption of omega 6 fatty acids, the balance is thrown off and allows the body to choose one pathway over the other. In this pathway, it creates cytokines (cell-messengers) that signal to increase inflammation to surrounding areas.

Yes, cholesterol is being deposited into the wall, but it cannot take place without the irritation from the toxins or foods exposed to the body causing the CSI. What makes more sense: lowering cholesterol that is very important to physiological processes in the body or preventing the chronic systemic inflammation from ever happening?

For more information and to read Dr. Lundell’s original article, please check the source listed below. Please check back next week to learn about some dietary changes you can make to prevent heart disease.

Source: Lundell D. WORLD RENOWNED HEART SURGEON SPEAKS OUT ON WHAT REALLY CAUSES HEART DISEASE. 2012 August 19. Available from: http://myscienceacademy.org/2012/08/19/world-renown-heart-surgeon-speaks-out-on-what-really-causes-heart-disease/

New Year, New You

Along with the New Year, most people make resolutions to eat healthier, lose weight, or just become more active. Unfortunately, these efforts frequently remain efforts rather than evolving into results. So why do most efforts fail?Here are some tips and tricks to help you with your diet and exercise goals.


Let’s start by talking about the major two things to avoid during this time. Then, check out the additional pointers to help you change your diet and avoid falling off the wagon!


These foods include canned foods, foods with a laundry list of ingredients that you cannot pronounce, anything with high fructose corn syrup, and anything with bleached flour. Some might call these all the stuff that tastes good. The reason we try to avoid these foods is because they are composed of harmful ingredients that can create inflammation in your gastrointestinal tract which increases inflammation throughout the body. The other reason is because they are usually simple carbs and empty calories. This means you’re taking in a lot more calories than you can use, so the body stores these calories into the fat cells.


One of the best things you can do when trying to lose weight is by just eliminating sugar intake. I know some of you are saying, hey, shouldn’t that be considered processed foods? I wanted to separate it to talk about how just eliminating excess sugars can help you LOSE WEIGHT. This is the same premise as the processed foods, which are chock full of sugars and simple carbs. Some condiments have sugars added to them. Generally, if it has less than 5g of sugar per serving, you should be okay to use it. If you want to lose weight, eliminate excess sugar. After about two weeks you will notice you’re not craving it anymore and you will notice an increase in energy and mood!

Some additional pointers:

Small changes go the distance– when trying to remodel your diet, small changes make the biggest impressions and last longer.

Keep a diet diary– just by writing down everything that enters your mouth, you can easily see that you may not be eating as healthy as you thought!

Fruits are naturally sweet desserts– having a craving for something sweet? Try fruits as a snack. They are made up of complex carbs that don’t digest as easily and are naturally sweet. This helps curb the sweet tooth.

Still hungry? Add more veggies, protein, or good fats– fiber in veggies and complex macromolecules like proteins and fats can help you feel full longer.

If you have any additional questions or concerns, feel free to contact me.


So what things will help you meet your exercise goals and prevent you from falling off of the wagon?


This may seem like a no-brainer, but, without fail, many people cut their resolutions short because of injury. We tend to fall into a sedentary lifestyle, especially, around the holidays. Muscles tighten, joints get achy, and our bodies adapt to these changes. Then we make a resolution and the next day we’re out there training for a marathon or training to lift a bus. We forget that before you can run, you need to (re)learn how to walk. Some keys to injury prevention are warming up before work outs, working on mobility and stretching, and a progressive workout regimen.

See your chiropractor

We spend 4 years (after college) studying movement patterns, injury prevention, and treatment methods to improve function and pain. Chiropractors are the biomechanical specialists in the medical world and can make sure the joints are moving properly, muscles aren’t inhibiting your efforts or at risk of injury, and your movement patterns aren’t altered. Pain is often the last indicator your body gives when something is wrong. Ignoring that is like ignoring your smoke detector even after you smell smoke – it doesn’t make sense!

Some additional pointers:

Set minor goals and major goals for the future – I love to sign up for 5K races for the spring, summer, and fall because it helps me train. Setting minor goals gives you something to work towards and keep you on track.

Don’t forget to lift weights – Compound movements mimic our natural movements so it makes sense to train that way. Furthermore, muscles burn calories. By lifting weights, you won’t get bulky or big (unless you train that way and intake huge amounts of calories), but you will look and feel better.

Mobility!– Don’t forget to stretch and warm-up. This is key for injury prevention. I prefer to use a foam roller to work out my tight muscles, especially on my rest days.

Pain alters movement -Soaking in Epsom salts can help reduce muscle tension and relieve delayed onset muscle soreness. Biofreeze is also a great product for pain relief. When topically applied, it helps create a cool sensation over the area which helps you reduce pain and prevent altered movement patterns.

If you have any additional questions or concerns, feel free to contact me.

Spine, Low back pain

Do I need an MRI?

Since starting practice, I’ve seen a lot of patients with low back pain and neck pain (some with radiation into the arms or legs). A popular question by those that are concerned about their condition is: do you think I need an MRI? Luckily, my second job gives me access to widely accepted, best available guidelines. Here are the guidelines regarding low back pain and MRI:

Spine, Low back painLumbar Spine:
Unequivocal objective findings that identify specific nerve compromise on the neurologic examination are sufficient evidence to warrant imaging in patients who do not respond to treatment and who would consider surgery an option. When the neurologic examination is less clear, however, further physiologic evidence of nerve dysfunction should be obtained before ordering an imaging study. Indiscriminant imaging will result in false-positive findings, such as disk bulges, that are not the source of painful symptoms and do not warrant surgery. If physiologic evidence indicates tissue insult or nerve impairment, the practitioner can discuss with a consultant the selection of an imaging test to define a potential cause (magnetic resonance imaging [MRI] for neural or other soft tissue, computer tomography [CT] for bony structures).
ACOEM Guidelines, Chapter 12 (Low Back Complaints) (2004), pg 303

Simply put, not necessarily. In our thorough examination, we determine our clinical opinion of whether or not an MRI is needed. The guidelines suggest that neurological examination (muscle strength, sensation testing, reflex testing, and orthopedic tests) is sufficient to determine necessity of an MRI AFTER a trial of (conservative) treatment. Conservative treatment includes medications, physical medicine (chiropractic, physical therapy), and a therapeutic exercise treatment plan. The guidelines also warn of imaging resulting in false-positive findings, such as disc bulges, that are NOT the source of painful symptoms. Too many times, MRIs are performed that reveal degenerative disc disease or disc bulges. It is important to note that these are secondary findings and do not indicate the source of the pain.

With this being said, there are specific criteria that may indicate an immediate MRI or referral to orthopedist for a consult. These criteria include: red flag conditions, subacute and chronic radicular syndromes, and nonspecific low back pain. Red flag conditions are acute LBP during the first 6 weeks if they have demonstrated progressive neurologic deficit, cauda equina syndrome, significant trauma with no improvement in atypical symptoms, a history of neoplasia (cancer), or atypical presentation (e.g., clinical picture suggests multiple nerve root involvement)-a mouthful! So simply put: any history of cancer, presentation of symptoms not commonly seen in our practice, rapidly decreasing strength, numbness in the entire groin area from low back to lower stomach, or bowel/bladder changes. Subacute and chronic radicular syndromes are pains shooting to the legs for at least 4 to 6 weeks in whom the symptoms are not trending towards improvement. And nonspecific low back pain is select chronic LBP patients in order to rule out concurrent pathology unrelated to injury. Basically, that means patients with long-standing low back pain that have no idea how it came about and may have history of infection, family history of cancer, etc.

So you have low back pain that may be sending pain down one or both of your legs; what do you do? First and foremost, don’t panic! At Revive Chiropractic, we commonly see patients that had pain for a long time that are waiting for it to go away and it doesn’t After a thorough diagnosis, we determine if the patient is a candidate for chiropractic care. In the rare occurrences of something that raises a red flag or fits the criteria, we gladly help the patient take the next step into their road to recovery by referring to the appropriate physician or for further imaging (MRI, CT scan, X-Ray). For the majority, we will start care on the first visit. Generally, we will see a change within the first week of treatment, which lets us know we’re on the right track.

The criteria for treating neck pain are very similar to low back pain. If you have low back pain or neck pain with or without radiation into the extremities, we can help! If you’re in the Pottsville area of Schuylkill County, call today to schedule an appointment at Revive Chiropractic (570) 621-4390.

Benefits of Chiropractic Care

Seven Year Study about the Benefit of Chiropractic Care

Benefits of Chiropractic Care

Two chiropractors and one medical doctor performed a study to analyze clinical and cost utilization data from 1999 to 2005. These physicians compiled random patient surveys and independent physician association-incurred claims and descriptively analyzed them for clinical utilization, cost offsets, and member satisfaction. They compared patients with a medical doctor as a primary care physician (PCP) to patients with a chiropractor as a PCP. Overall, 70,274 member-months (the total number of participants who are members for each month) were examined, and patients using a chiropractor as a PCP yielded the following results (as compared to patients using a medical doctor as a PCP):

  • 60.2% decreased in-hospital admissions
  • 59% decreased hospital days
  • 62% decreased outpatient surgeries and procedures
  • 85% decreased pharmaceutical costs

Importantly, the data compared between chiropractor PCP patients and medical doctor PCP patients shows drastic differences in the previously mentioned areas. The decreases noted in all these areas means decreased out-of-pocket expenses as well as decreased expenses for insurance companies. The incentives to decreasing costs to the insurance companies may mean lower premiums or extended coverages with the current premiums. Additionally, the data indicate improved health in the patients seeing chiropractors in that there are less prescribed drugs being taken, surgeries performed, hospital stays, and admissions to hospitals.


For more information, visit our Contact page or give us a call!

Chiropractic Manipulation or Pain Medication for Low Back Pain

So you just pulled your back out now what? Some will reach for the pain pills, some will go lay down, but our patients will grab the phone and call Revive Chiropractic in Pottsville, PA at (570) 621-4390. But, why?

An April 2013 study, Spinal High-Velocity Low Amplitude Manipulation in Acute Nonspecific Low Back Pain: A Double-Blinded Randomized Controlled Trial in Comparison With Diclofenac and Placebo, compared the effectiveness of three therapies on low back pain that has occurred within the past48 hours. The authors split 93 patients into three groups: spinal manipulation (with placebo pain medication), pain medication (with placebo spinal manipulation), and both placebo pain medication and placebo spinal manipulation. The pain medication used was 50mg 3x/dayof diclofenac, a medication shown to be more effective than ibuprofen at managing low back pain.

The results after 12 weeks suggested two things. The spinal manipulation and diclofenac groups were more effective at pain control than the placebo group. The placebo group was actually closed prior to the end of the study due to the large drop out from uncontrolled pain. Additionally, the spinal manipulation group experienced significantly better outcomes than the diclofenac group. Let me repeat that: spinal manipulation lead to significantly better outcomes than NSAIDs.

If you are experiencing acute or chronic low back pain and are in the Pottsville area of Schuylkill County, schedule an appointment at Revive Chiropractic today!

Chiropractic Manipulation or Medication for Low Back Pain? http://www.spine-health.com/blog/chiropractic-manipulation-or-medication-low-back-pain. Walsh, 2013.

Zelienople/Harmony Shamrock Shuffle


As the weather is starting to get warmer, people are becoming more active. In fact, there’s an upcoming race called the Shamrock Shuffle in the Zelienople and Harmony area! Now is the time to get yourself ready and prepare you body to prevent injuries.

Chiropractors were heavily involved in the last couple of Olympics and remain to treat athletes competing in all major sports. Because chiropractors are trained to diagnose and treat biomechanical (body movement) injuries, it only makes sense to be integrated in the medical staff. In fact, popular athletes such as Aaron Rodgers, Jerry Rice, Michael Jordan, Michael Phelps, Evander Holyfield, Arnold Schwarzenegger, and Tiger Woods have all been proud patients of chiropractors. Chiropractors can make a difference by realigning tissues and improving muscular imbalances which leads to prevention of injury and improved performance. Additionally, with the techniques a chiropractor uses, injury recover time is decreased.

From athletes to weekend warriors, Revive Chiropractic can help you! Give us a call at (724) 453-4033 or contact us through alternate forms.