Risks of Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a standard class of drugs. They are used chronically for persistent pain due to osteoarthritis and other musculoskeletal disorders in older adults. Specifically, an estimated 40% of people age 65 and older fill one or more prescriptions for an NSAID each year. Exposing themselves to serious risk. Considering that NSAIDs are also currently available over the counter, it is clear to see that even more significant numbers of older adults expose themselves to NSAIDs in the United States.

NSAID use causes an estimated 41,000 hospitalizations and 3300 deaths each year among older adults.

Some specific ADRs of concern with chronic use of NSAIDs include:

  1. Gastrointestinal (GI)
  2. Renal
  3. Cardiovascular (CV – heart attacks or heart failure) and cerebrovascular (strokes)
  4. Central nervous system (CNS – dementia, cognitive impairment)

Although I only discuss ADRs affecting these four organ systems in this review, it is crucial to recognize that NSAIDs can cause various other adverse effects (e.g., hepatotoxicity (liver damage), cutaneous toxicity).

GI Risks Associated with Chronic NSAID Use

The spectrum of potential NSAID-related GI adverse effects is extensive, ranging from dyspepsia to life-threatening gastric bleeding. A nested case-control study showed that NSAIDs increase the risk of fatal peptic ulcers by nearly fivefold in older adults. Other studies show that the risk of peptic ulcer complications increases by three- to fivefold in older adults using NSAIDs. This risk higher in those taking concomitant systemic corticosteroids and warfarin. In addition, the risk is increased as early as within the first month of treatment and sustains over time. Often, these peptic ulcers are asymptomatic but can lead to significant morbidity and mortality.

Renal Risks Associated with Chronic NSAID Use

Similar to NSAID-related GI adverse effects, NSAID-induced renal dysfunction has a wide spectrum of adverse effects, including decreased glomerular perfusion, decreased glomerular filtration rate, and acute renal failure (ARF). While it is important to recognize that ARF can develop at any point during long-term NSAID therapy, the risk may be highest among those who have recently initiated therapy.

Specifically, in a nested case-control study of older adults, the risk of ARF increases nearly twofold for all NSAIDs within 30 days of initial use/prescribing. This risk is greater in those older adults with pre-existing chronic kidney disease (CKD) and in those who use long half-life NSAIDs.

Cardiovascular/Cerebrovascular (heart attack/stroke) Risks Associated with Chronic NSAID Use

NSAIDs worsen/increase the risk of various CV and cerebrovascular outcomes.

NSAIDs =also cause or exacerbate heart failure (HF) in older adults. Specifically, a cohort study of older adults found that rofecoxib and nonselective NSAIDs (naproxen, ibuprofen, and diclofenac), but not celecoxib were significantly associated with an increased risk of admission for HF as compared to those not taking NSAIDs. Another cohort study found that among patients who had survived their first hospitalization because of HF. Subsequent use of any NSAID (including celecoxib, as well as ibuprofen, diclofenac, naproxen, and other NSAIDs) led to a significantly increased risk of death.

CNS (Central Nervous System) Risks Associated with Chronic NSAID Use

NSAID use is associated with several CNS effects, including aseptic meningitis, psychosis, and cognitive dysfunction. Studies to date have not consistently shown a benefit from chronic NSAID use in reducing the risk of dementia or cognitive impairment. Interestingly, though, several studies have shown that high-dose NSAIDs (i.e., anti-inflammatory doses) may increase the risk of cognitive impairment. In particular, indomethacin appears to cause more CNS effects than other NSAIDs in the elderly.

Conclusion

This review has summarized the potential risks associated with chronic NSAID use in older adults. Including GI, renal, CV/cerebrovascular, and CNS adverse effects. Although I only discuss ADRs affecting these four organ systems in this review, it is important to recognize that NSAIDs can cause various other adverse effects (eg, hepatotoxicity, cutaneous toxicity). Moreover, it is important to note that nonpharmacological approaches (weight reduction, increasing physical activity) may also help patients who are experiencing musculoskeletal pain.

As the aging population rapidly grows over the next few decades, the risks associated with chronic NSAID use will remain a significant public health issue.

 

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Painkillers

Painkillers

Painkillers, are they bad, or are they good? Yes, they are great for masking pain, but do they do anything? Long term use of painkillers can cause many problems. Taking strong painkillers or just regular painkillers frequently for a long time can cause liver and stomach damage. Additionally, it may not even help the underlying problem. Perhaps after this blog, there will be more awareness about the side effects of pain killers.

Overuse of painkillers can lead to both liver and stomach damage. Let’s start with the most common painkillers that we can find over the counter; Paracetamol. The recommended daily allowance of Paracetamol is 4000 mg, which is equivalent to around eight tablets. However, many other medications already consist of Paracetamol in the formula, so this makes it hard to keep track of the amount that the body is intaking. Going over the recommended daily allowance can lead to long term liver damage or even liver death as well. Even if you stick to 4000 mg daily and do not exceed it, the daily or frequent use of this amount of painkillers is detrimental to your health.

Painkillers cont.

Another common painkiller are NSAIDs (Nonsteroidal anti-inflammatory drugs); iburoprofen, asprin and diclofenac are only a few that falls into this category. This category of painkillers can damage the stomach if it taken for long periods. These should only be taken under the recommendation of a GP. NSAIDs interfere with the production of mucus in the stomach. The mucus in the stomach forms a mucosal layer to prevent gastric acid from eroding and damaging the stomach. With a decrease of mucus production in the stomach, it becomes more susceptible to gastric ulcers. Study has shown that even taking NSAIDs just once is enough to cause irritation and inflammation of the stomach.

Finally, painkillers serve a purpose, but do they get to the root of the problem. By masking the pain, you may make the original problem worse. This is because pain is a way for our body that something is not right and should be looked into more thoroughly. If the painkiller covers the pain, we would have no idea that the area is injured or has a problem, and we would continue our activities. This may further aggravate the injury leading it to become a long term problem. Taking painkillers is like temporarily covering a leaky roof rather than repairing the problem. It will always keep coming back, and over time it’ll just get worse and worse.

So it’s up to whether or not you want to fix the problem and for your body to heal from the inside, or just mask the symptoms.

 

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Brain Health

The human brain is the organ that controls everything in our body. It acts as our engine and provides vital messages to different parts of our body to keep everything moving. Just like the engine in our cars, we keep it oiled, regularly serviced and well maintained. But how well do we maintain the health of our brains? There are several ways we can keep our brains well-groomed. This can be done through regular stimulus and healthy nutrition.

Improving the brain with stimulus

Just like other muscles in our body, our brain grows with constant stimulus. When we exercise our brain becomes stronger, smarter and better. We can stimulate our brain through many means such as reading, solving puzzles, playing challenging board games and regular exercise. Study has shown that if we do some sort of physical mental challenge it can help reinforce brain cell connection. This means we are less likely to suffer from mental diseases like Alzheimer’s and dementia.

Physical mental challenges involve your hands, eyes and brains; this means that these activities should not be done on our devices. In fact, research has shown that due to the amount of time we spend on our devices, our concentration span and our ability to recall information has decreased. So as a recommendation, it is good to stimulate our brain for 30 minutes a day. Whether this is reading a book, enjoying a puzzle or playing board games with family and friends.

Diet and mind

Another way to keep our brains well maintained is through a healthy diet. There are some foods that should be avoided if we want to keep our brains well maintained; sugary drinks (eg. fizzy drinks), artificial sweeteners, highly processed foods and alcohol just to name a few. Instead we should be consuming nutrients that are good for the brain such as omega 3, antioxidants, unsaturated fats and magnesium. All of these can be found in natural food sources such as berries, legumes, nuts, seeds (flaxseeds, linseeds, hemp seeds) and vegetables. A healthy diet can help your brain just as much as helping the rest of your body.

In a technological era that we are in right now, we have now lost the ability to concentrate for long periods of time and recall information that we have just read or seen. It is important to keep our brain well-conditioned at all times as this is the master organ of our body. This can be done through regular stimulus and a healthy diet. So please start taking care of your brain and give it what it needs so you can start excelling in your life.

 

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The Importance of Exercise: Cardiovascular Training

In our blog ‘Strength Training’, we talked about the importance of strength training and as a recommendation, 40-60 minutes of strength/weight training every week is needed. These exercises could be from something that we can just do with our body weight such as push ups, plank, squats, pull ups and many more. This week, I would like to explore cardiovascular training and how you can include it into your exercise routine.

Please be aware, when I say we need to do endurance training. We are not going to run a marathon or do a triathlon. We actually include cardio/endurance in our daily lives most of the time; when we walk, do chores at home and even while we are doing our weekly grocery shopping. Cardio training are just exercises that challenge our heart and lungs. As a recommendation, we should be doing around 150 minutes of cardio every week. That comes down to around 20 minutes a day. If you include 2 days of weight training exercises, it makes it 30 minutes a day over 5 days.

Cardiovascular training is just as important as doing weight training. There are many benefits from cardio training; increasing strength of heart muscles, lowering blood cholesterol and many more.

Cardiovascular training helps us build and increase the muscles of the heart just like how weight training help us build muscles. By increasing the strength of our heart muscles there will be less pressure in our cardiovascular system. This is because cardiovascular training can increase the efficiency of transporting oxygen around our body. Due to the increase in strength, it can also increase the stroke volume with each beat, which means that with each beat of the heart more blood will be pumped out. As a result, this can help you lower your blood pressure.

Another benefit of doing cardiovascular training is lowering blood cholesterol levels. There are two types of cholesterols; low density lipoprotein (LDL) and high density lipoprotein (HDL). LDL is known as bad cholesterol because it causes fatty build ups in the arteries which leads to narrowing of arteries. With the arteries narrowing, it is harder for blood to flow through causing an increase in blood pressure. HDL on the other hand is the good cholesterol in our body. HDL absorbs the bad cholesterol in your body and stores them in the liver. The liver then flushes the bad cholesterol out of your system. Cardiovascular training raises HDL in the body which induces the decrease of LDL. As a result, the arteries will be less narrow which will also bring down your blood pressure.

Some people think cardio is really boring but you can make if fun. If doing long walk or jogging isn’t your thing, you can try some high intensity interval training (also known as HIIT), go play a sport you enjoy or even go dancing with someone. The great thing about cardio is that it can be done anywhere, it is also a good opportunity to start a new hobby too!

Now you know the benefits of cardio, go out there and move your body. With this, it wraps up our 3 part series on why we should exercise. I hope now you know the importance of exercise and will take out some time from your busy day to keep your body healthy!

 

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The Importance of Exercise: Strength Training

In our blog ‘8 Benefits of Exercising’ we talked about the importance of exercise and as a recommendation, 30 minutes of exercise every day is needed. These exercises could be from something that we already know how to do like walking or mowing the lawns. This week, I would like to dive into something slightly more specific; strength training and how you can include it into your exercise routine.

When I mention strength training, I’m not asking you to become a bodybuilder nor be the next Chris Hemsworth. All you need to start with is 2 days a week for 20-30 minutes each time. So perhaps you can substitute your two days of walking and do this instead.

Effects of strength training

So now we know how often and how much weight training we should be doing every week, do you know why we should make it part of our routine? Weight training can help with many things apart from building strength and muscles, it can help with fat burning and the prevention of osteoporosis too.

Weight training helps with building muscles and increasing strength. Muscle builds and strengthens through repetitive stress. Our muscles are made from many smaller muscle fibers. Every time we do strength training, we actually tear and rip these muscle fibers. Our body knows that each time we tear our muscle fibers we are lifting something heavier than usual and it will find a way to adapt. As a result, our muscles become thicker, larger, and stronger when it recovers.

Strength vs. Cardio

Many studies also show that weight training can help us burn more fat and calories than cardio exercises. This does not mean you should just ditch cardio altogether as there are also unique benefits that only cardio provides. Muscles are metabolically more active than fat therefore muscles burn more calories in a resting state. This is why if you want to burn that fat off your belly, don’t just do cardio and add in some strength training too!

Weight training can help with the prevention of osteoporosis. Osteoporosis is the weakening of bones. This process happens as we age and as our bones become weaker, it can no longer withstand as much pressure and stress. This makes us more susceptible to fractures. Every time we strength train, we actually stress the bone by pulling and tugging it. So once we put stress on the bone, it stimulates the bone-forming cells into action causing more bone growth.

A common misconception about strength training is that we have to go to a gym or lift something really heavy. But in reality, when we are first starting off, bodyweight exercises are more than enough. Some simple bodyweight exercises include push-ups, squats, crunches, planks, lunges, and many more. We actually have plenty of videos on our YouTube channel and Instagram. If you are interested, we are also posting up new videos on basic bodyweight exercises this week that you can check out!

Now you know the amount of exercise you need to do, start incorporating some weight training, and become the best version of yourself!

 

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Strength training 101: HAWC classes help improve fitness > Kunsan ...

 

 

8 Benefits of Exercising

We all have an extremely busy lifestyle and quite a few of us may not have the time to exercise. Additionally, summer is coming up and most of us would want to get ready for the beach body. But as a health practitioner, it is my duty to emphasise the importance of exercise, how it changes the body and how much of an impact it has other than just looking good.

Here is a list of some reasons why we know exercising consistently is important:

  • Reduces the risk of osteoporosis.
  • Increases bone and muscle strength.
  • Lowers blood cholesterol levels.
  • Lowers blood pressure.
  • Decreases the risk of type 2 Diabetes.
  • Increases endorphins which makes us feel good.
  • Decreases the risk of dementia.
  • Improves posture.

We have special little things in our body’s mitochondria. These mitochondria act as the power generator. They generate energy in our body, also known as ATP, from oxygen, fats, sugar and protein.  These ATP are what fuels the body to do what it needs to do, anything from muscle contractions and conducting nerve impulses is generated by ATP. Exercise promotes a process called mitophagy. Mitophagy is the removal of damaged or defected mitochondria after a period of stress. This promotes new and healthy mitochondria to take over providing a more efficient system to burn fat and sugar. As a result, this leads to bigger and stronger muscles.

I’m not asking you to be an athlete and exercise over 2 hours a day. but, as a recommendation, doing 30 minutes of exercise every day is enough. We may already be exercising every day without knowing it such as mowing the lawns and walking to work. If you are not regularly exercising, I’m going to ask you to go for a brisk walk for 30 minutes after dinner around the neighbourhood!

There are plenty of different types of exercises but the main two are cardio and weight training. In the next two weeks, I’ll be covering the benefits of each. Just remember we should all go for a 30 minute walk after dinner this week!

Chiropractor Auckland

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File:Man Doing Warm Up Exercise Cartoon.svg - Wikimedia Commons

Heavy Lifting For a Stronger Body 

Is lifting heavy objects good for you?

This week I’m going to talk about a movement category that you may be missing from your gym routine and give you a few examples of how to implement heavy lifting This is something I have done on and off for many years in my strength training. 

Lifting heavy barbells and dumbbells and doing bodyweight exercises in the gym is a great thing, in fact it is essential for the health and maintenance of your body. But what you may be neglecting is the basic human movement of carrying heavy things.  

What is the benefit of lifting heavy objects?

Carrying heavy objects recruits muscles in a different way than performing the basic push, pull, squat and hip hinge categories of movements that make up the majority of modern training. I’m not saying not to do these movements by the way, they MUST be done to create a strong and resilient body. Just don’t neglect heavy carries!  

Carries can serve as a great warm up for the trunk muscles before heavy squats and deadlifts, for some conditioning work or as the main lift of the day. 

Types of Lifting Heavy/Carries

Farmer’s carries 

Unless you have access to specialty farmers carry bars you can simply grab a heavy dumbbell or kettlebell in each hand and go for a walk. These can be done for time or for distance.  

See how far you can go or how many lengths you can do in a given time frame (eg. 20-60 seconds) and then increase the weight the next week.  

OR 

Try and improve your time to carry a given weight for a given distance eg50 meters, or the length of your gym. 

Suitcase carries 

These can be done the same way as the farmers carry but you are only carrying weight in one hand. These will really tax the lateral stabilising muscles of the trunk and are a great way to get ready for heavy squats and deadlifts. Pick up a dumbbell or weight plate in one hand and pace the gym in between your warmup sets. 

Waiters carries 

These can be done with a weight in one or both arms raised overhead and are a great option to warm up the shoulder stabilisers before pressing movements (bench press, dumbbell presses) or overhead work (overhead squats, snatches, jerks). 

 

Contact Revolution Chiropractic – Leading  Chiropractor Auckland

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Heavy Lifting - Chiropractic Auckland

Chiropractic for Running Injuries

At Revolution Chiropractic, we equip our structural chiropractors with the tools necessary to help you run better. And in addition, to recover from your running injuries faster, and prevent running injuries before they even start!

During the assessment, the structural chiropractor will obtain information about your running habits. They’ll look at your gait, biomechanics, footwear, strength, mobility, and spinal health. Since the tissues in your body interconnect and depend on each other for a function like gears in a machine. The structural chiropractor must look at all of these components to address your body as a whole.

They will take all this information to develop a care plan. As a result, that will help you recover and provide you with the necessary education and tools to prevent re-injury.

Your care plan may include adjustments, active rehabilitation, and exercises. You may also receive nutritional advice to reduce inflammation in your body and facilitate tissue healing.

If required, your Structural Chiropractor may advise on footwear and other external factors. Such as running surfaces and frequency. They will teach you exercises to address muscle imbalances and improve your technique.

If necessary, they will refer you to other professionals that will complement your care and get you better faster.

If you’re a runner, then you know that going through an injury can be a huge nuisance. It can also interfere with your regular running routine. That’s why we recommend strategies that promote prevention and optimization.

Call us today to book your complimentary consultation with one of our experienced practitioners who will assess your mechanics, analyze your running habits and provide you with an individualized care plan to prevent injuries.

 

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How to Deal with Shin Splints

Shin splints present as a dull ache along the inner shin. There can be some possible swelling in the area. Although it’s usually nothing to worry about, they may lead to stress fractures in the tibia if not addressed properly.

Shin splints often present when runners (especially beginners) try to run too much too quickly. Running causes a lot of repetitive impact on the body. The muscles and bones need time to sense the demand being placed on them and rebuild accordingly to better handle that load/demand. Therefore, if a runner tries to increase the volume and/or intensity of their training too quickly it can overstress those tissues.

It’s also not just found in runners. It’s common in any sports that require jumping or sharp cutting, such as basketball and tennis.

The best way to avoid shin splints altogether is to increase the intensity, frequency and duration of your training sessions GRADUALLY. However, it’s hard to quantify how to go about gradually increasing these factors as every human body is different and some are more resilient than others.

So if you do end up with shin splints you can do any or all of the following to treat it.

  • Strengthen your glutes (shown below)
  • Stretch your calves/feet (shown below)
  • Foam roll your legs (shown below)
  • Rest
  • Visit a Structural Chiropractor for individualized assessment and program

EXERCISES FOR SHIN SPLINTS: PERFORM 3 SETS OF 10 OF THE FOLLOWING ON EACH SIDE.

Related image

Image result for donkey kicks

Image result for single leg deadlift

Image result for calf strengthening

PERFORM THESE STRETCHES FOR 1-2 MINUTES ON EACH SIDE.

Image result for foot stretches for shin splintsImage result for foot stretches for shin splintsRelated image

FOAM ROLL FOR 1-2 MINUTES EACH.

Image result for foam roll calvesRelated imageImage result for foam roll quadsImage result for foam roll glutesRelated image

Shin splints can take anywhere from a couple of weeks to several months to heal. So you’ll have to be patient and be sure to stop any activities that trigger it. The faster you begin treating it, the faster it heals.

Feel free to contact us with any questions you may have!

 

Chiropractor Auckland

Contact Revolution Chiropractic – Leading  Chiropractor Auckland

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