Neck Pain

SCV News | Thursday COVID-19 Roundup: LA County Starts New Vaccine Sweepstakes; 28,074 Total SCV Cases

Published

4 years ago

June 18, 2021

AmericanChiro

Uploaded: , Thursday, Jun 17, 2021

By Press Release

L.A. County Public Health confirmed today eight new deaths and 249 new cases of COVID-19 countywide, with 28,074 total cases in the Santa Clarita Valley.

Of the eight new deaths reported today, two people that passed away were over the age of 80, four people who died were between the ages of 65 and 79, and one person who died was between the ages of 50 and 64. One death was reported by the City of Long Beach.

Beginning tomorrow, Fri June 18 through next Thurs June 24 at County-run vaccination sites, participating LA City sites, and St. John’s Well Child and Family Center sites, everyone 18 and older coming to get their first vaccine or who brings a first-time vaccine recipient with them to their second dose appointment, will have an opportunity to win one of three prizes: two 17-ticket packages to see Pepe Aguilar at the Staples Center this November, and one VIP Experience for 20 people at Universal Studios Hollywood. Official rules and participating site locations will be posted on the Los Angeles County Vaccination Sweepstakes page online tomorrow. The Clippers, the Rams, or the Chargers season tickets vaccination sweepstakes is currently in effect through the end of the day today.

“We extend our deepest condolences to those of you who have been grieving the loss of a loved one or a coworker to this virus; our love and prayers are with you,” said Barbara Ferrer, PhD, MPH, MEd, Director of Public Health. “Given how much protection vaccinations provide, it will be important to improve the rates of vaccination among young and middle-aged adults, many of whom are part of our essential workforce and who may be participating in more activities now that we are fully re-opened. The most effective strategy to reduce the likelihood that outbreaks will arise due to large numbers of unvaccinated people exposed at worksites or gathering at events, is closing vaccination coverage gaps. We urge everyone, especially those who are not or cannot be vaccinated against COVID-19, to continue to exercise caution and good judgment as physical distancing requirements and capacity limitations are removed. This includes always wearing a mask when indoors at workplaces, public settings, and businesses. If you are unvaccinated and will have sustained close contact with others whose vaccination status is not known or they are unvaccinated, consider using a respirator to protect yourself more effectively from the virus.”

To date, Public Health identified 1,247,032 positive cases of COVID-19 across all areas of L.A. County and a total of 24,428 deaths.

Reopening Guidelines for Vaccinated/Unvaccinated County Residents

Since June 15, workplaces remain under the current Cal/OSHA standards which continue to require distancing and masking for all employees. The Cal/OSHA standards board may vote on proposed modifications to the current standards on Thursday.

Masks are also required for everyone regardless of vaccination status on public transit and in transportation hubs; indoors in K-12 schools, child care and other youth settings; healthcare settings, including long term care facilities; state and local correctional facilities and detention centers; and homeless shelters, emergency shelters, and cooling centers.

People who are not fully vaccinated, including all children between the ages of 2 and 12, are required to wear masks at all indoor public settings and businesses; this includes retail, restaurants, theatres, family entertainment centers, meetings, and state and local government offices serving the public.

Everyone can remove their masks outdoors, except people who are not fully vaccinated attending large outdoor events – they should stay masked. Additionally, everyone has a right to wear a mask; a person may not be prevented from wearing a mask as a condition of participation/entry into a business.

For more information on the County reopening including masking requirements, travel guidance, best practices, and remaining sector protocols, visit: www.ReopeningLACounty.com

Santa Clarita Valley Thursday Update

As of 6 p.m. Monday, the L.A. County Public Health COVID-19 dashboard remains unchanged with 306 deaths among Santa Clarita Valley residents since the pandemic began.

The following is the community breakdown of the 306 SCV residents who have died, according to the L.A. County dashboard:

263 in Santa Clarita

17 in Castaic

6 in Acton

6 in Stevenson Ranch

4 in unincorporated Canyon Country

3 in Agua Dulce

1 in unincorporated Bouquet Canyon

1 in Elizabeth Lake

1 in Lake Hughes

1 in Newhall

1 in unincorporated Saugus/Canyon Country

1 in Valencia

1 in Val Verde

covid-19 roundup tuesday march 23

Of the 28,074 confirmed COVID-19 cases reported to Public Health for the SCV to date, the community breakdown is as follows:

* City of Santa Clarita: 20,556

* Castaic: 3,743 (incl. Pitchess Detention Center & North County Correctional Facility*)

* Stevenson Ranch: 1,167

* Canyon Country (unincorporated portion): 853

* Acton: 487

* Val Verde: 338

* Agua Dulce: 285

* Valencia (unincorporated portion west of I-5): 196

* Saugus (unincorporated portion): 132

* Elizabeth Lake: 82

* Newhall (Unincorporated portion): 69

* Bouquet Canyon: 49

* Lake Hughes: 42

* Saugus/Canyon Country: 40

* Sand Canyon: 17

* San Francisquito/Bouquet Canyon: 15

* Placerita Canyon: 3

*Note: The county is unable to break out separate numbers for Castaic and PDC/NCCF because the county uses geotagging software that cannot be changed at this time, according to officials. Click here for the LASD COVID-19 dashboard.

Henry Mayo Newhall Hospital Thursday Update

As of Thursday, June 17, Henry Mayo Newhall Hospital had zero cases pending, five currently in the hospital, a total of 1,246 patients had been treated and discharged since the pandemic began and no additional deceased, hospital spokesman Patrick Moody said.

The last COVID-related death occurred May 21, 2021.

Privacy laws prohibit Henry Mayo from releasing the community of residence for patients who die at the hospital; residence info is reported by the L.A. County Public Health COVID-19 dashboard, which generally lags 48 hours behind.

California Thursday Snapshot

Yesterday, the state fully reopened and is moving ‘Beyond the Blueprint,’ announced California Department of Public Health officials.

Statewide, as of Wednesday, June 16, CDPH officials confirmed 3,699,455 COVID-19 cases (up 829) with 62,565 deaths from the disease (up 31) since the pandemic began.

Numbers may not represent true day-over-day change as reporting of test results can be delayed.

As of June 16, local health departments have reported 112,241 confirmed positive cases in health care workers and 466 deaths statewide.

The 7-day positivity rate is 0.9%.

There have been 68,098,129 tests conducted in California. This represents an increase of 109,057 during the prior 24-hour reporting period.

As of June 16, providers have reported administering a total of 40,098,803 vaccine doses statewide.

The CDC reports that 47,380,875 doses have been delivered to entities within the state.

Numbers do not represent true day-to-day change as reporting may be delayed.

From now through July 4th, Uber and Lyft are offering 4 free rides (up to 25$ each) to and from vaccination sites.

L.A. County Vaccine Update

To stay in this good place with low COVID-19 transmission after reopening, Public Health will continue to get vaccines and high-quality information to people who aren’t yet vaccinated.

“We remain committed to protecting your health and to closing gaps in health outcomes associated with COVID-19,” said Ferrer. “Case counts and transmission are low because of our shared efforts to implement a layered approach to preventing transmission.”

Public Health is partnering with businesses and community-based and faith-based organizations countywide, with mobile vaccination teams making nearly 270 visits each week to the places where people shop, worship, and gather.

Unvaccinated people need to remain very careful and wear masks when they are around people outside their household, and if in close contact with others, including at worksites, they should consider upgrading their masks to a respirator, such as an N95, or a KN95. These masks do a much better job protecting the wearer from other people’s germs.

“As we reopen, we are mindful that for those not yet vaccinated, protection is highly dependent on our continued actions to take care of each other,” said Ferrer. “Sensible protections for our essential workforce will be instrumental in keeping transmission of COVID-19 in check.”

For anyone that gets sick, you need to take the right steps to prevent further spreading the virus. That means getting tested if you have symptoms, staying home and keeping a distance from people in your households, especially unvaccinated people, and working with the County’s contact tracers to help protect others.

The County is transitioning from the four larger capacity vaccination sites to community sites accessible by public transit.

The California State University Northridge site’s last day of operations was Jun 7; vaccinations will continue to be available to nearby residents at the Balboa Sports Complex vaccination site.

If you received your first dose at the California State University Northridge site, you can receive your second dose at the nearby Balboa Sports Complex site.

The Pomona Fairplex, Forum, and LACOE/Downey large capacity vaccination sites closed June 13 with new community sites set to open on Tuesday, June 15 at Ted Watkins Memorial Park in South L.A., the Commerce Senior Citizens Center in the City of Commerce, and the Norwalk Arts and Sports Complex in the City of Norwalk.

Public Health continues to build an extensive network with pharmacies, federally qualified health centers, hospitals, health clinics, and community vaccination sites, including these large-capacity sites:

* Dodger Stadium (operated by the city of Los Angeles)

* College of the Canyons, 26455 Rockwell Canyon Rd, Santa Clarita, CA 91355

* Palmdale Oasis Park Recreation Center, 3850 E Ave S, Palmdale, CA 93550

* California State University, Los Angeles, 5151 State University Drive, Los Angeles 90032 (operated by FEMA)

Vaccination Sweepstakes

Public Health continues to urge unvaccinated people to get vaccinated. Through Thursday, June 17 at County-run vaccination sites, participating LA city and mobile sites, and St. John’s Well Child and Family Center sites, everyone 18 and older coming to get their first vaccine or who brings a first-time vaccine recipient with them to their second dose appointment, will have an opportunity to win a pair of season tickets to the 2021-2022 home season of the Clippers, the Rams, or the Chargers. Official rules and participating site locations are posted online on the Los Angeles County Vaccination Sweepstakes page.

Visit: www.VaccinateLACounty.com (English) and www.VacunateLosAngeles.com (Spanish) to learn how to make an appointment at vaccination sites. If you don’t have internet access, can’t use a computer, or you’re over 65, you can call 1-833-540-0473 for help finding an appointment. Vaccinations are always free and open to eligible residents and workers regardless of immigration status.

L.A. County Public Health’s Reopening Protocols, COVID-19 Surveillance Interactive Dashboard, Roadmap to Recovery, Recovery Dashboard, and additional things you can do to protect yourself, your family and your community are on the Public Health website, www.publichealth.lacounty.gov.

covid-19 roundup

Multisystem Inflammatory Syndrome in Children (MIS-C)

Each week, the California Department of Public Health updates the number of cases of Multisystem Inflammatory Syndrome in Children (MIS-C) reported in the state.

As of June 14, there have been 541 cases of MIS-C have been reported statewide.

MIS-C is a rare inflammatory condition associated with COVID-19 that can damage multiple organ systems. MIS-C can require hospitalization and be life-threatening.

Parents should be aware of the signs and symptoms of MIS-C including fever that does not go away, abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling tired.

Although very rare, COVID-19 cases among children can sometimes result a few weeks later in very serious illness known as Multi-symptom Inflammatory Syndrome in Children (MIS-C).

Vaccine Eligibility Update

As of May 13, vaccination appointments for individuals aged 12+ can be made by visiting myturn.ca.gov. The consent of a parent or legal guardian may be needed for those between the ages of 12 and 17 to receive a vaccination. For more information on the vaccine effort, visit Vaccinate All 58.

Tracking COVID-19 in California

* State Dashboard – Daily COVID-19 data

* County Map – Local data

* Data and Tools – Models and dashboards for researchers, scientists, and the public

* COVID-19 Race & Ethnicity Data – Weekly updated Race & Ethnicity data

* Cases and Deaths by Age Group – Weekly updated Deaths by Age Group data

* Health Equity Dashboard – See how COVID-19 highlights existing inequities in health

* Tracking Variants – Data on the variants California is currently monitoring

* Safe Schools for All Hub – Information about safe in-person instruction

* School Districts Reopening Map – data on public schools and reported outbreaks

California Testing & Turnaround Time

The testing turnaround time dashboard reports how long California patients are waiting for COVID-19 test results.

During the week of May 30 to June 5, the average time patients waited for test results was under one day.

During this same time period, 88% of patients received test results in one day and 97% received them within two days.

Protect Yourself and Your Family: Your Actions Save Lives

Protect yourself, family, friends, and community by following these prevention measures:

* Getting vaccinated when it’s your turn. Californians age 16+ are eligible to make an appointment.

* Avoiding non-essential travel, and practicing self-quarantine for 14 days after arrival if you leave the state.

* Keeping interactions limited to people who live in your household.

* Wearing a cloth face mask when out in public.

* Washing hands with soap and water for a minimum of 20 seconds.

* Avoiding touching eyes, nose, or mouth with unwashed hands.

* Covering a cough or sneeze with your sleeve or disposable tissue. Wash your hands afterward.

* Avoiding close contact with people who are sick.

* Staying away from work, school, or other people if you become sick with respiratory symptoms like fever and cough.

* Staying home except for essential needs/activities following local and state public health guidelines when patronizing approved businesses. To the extent that sectors are re-opened, Californians may leave their homes to work at, patronize, or otherwise engage with those businesses, establishments or activities.

* Getting tested if you believe you’ve been exposed. Free, confidential testing is available statewide.

* Adding your phone to the fight by signing up for COVID-19 exposure notifications from CA Notify.

* Answering the call if a contact tracer from the CA COVID Team or local health department tries to connect.

* Following guidance from public health officials.

California COVID-19 Data and Tools

A wide range of data and analysis guides California’s response to COVID-19. The state is making the data and its analytical tools available to researchers, scientists and the public at covid19.ca.gov.

* The Statewide COVID-19 Dashboard

* The California COVID-19 Assessment Tool (CalCAT)

* State Cases and Deaths Associated with COVID-19 by Age Group

* COVID-19 Race & Ethnicity Data

* COVID-19 Hospital Data and Case Statistics

* View additional datasets at the California Open Data Portal (including Testing Data, PPE Logistics Data, Hospital Data, Homeless Impact and more)

Consolidated guidance is available on the California Department of Public Health’s Guidance webpage.

* * * * *

Always check with trusted sources for the latest accurate information about novel coronavirus (COVID-19):

* Los Angeles County Department of Public Health

* California Department of Public Health

* Centers for Disease Control and Prevention

* Spanish

* World Health Organization

* Johns Hopkins University COVID-19 Dashboard

L.A. County residents can also call 2-1-1.

* * * * *

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AmericanChiro

We understand how important it is to choose a chiropractor that is right for you. It is our belief that educating our patients is a very important part of the success we see in our offices.

Neck Pain

Re: Chronic Pain: Management focuses on the individual, not the pain.

Published

2 years ago

July 17, 2023

AmericanChiro

Dear Editor

Chronic pain management focuses on the individual, not the pain.

I am very pleased with the review by Kang and colleagues [1]. I write as a spinal pain specialist whose patients had an average episode duration of pain pain of 2.5 years [2] for low back pain and 1.3 years for neck pain [3]. These studies confirm that Kang et. al. noted the significant extent of spinal and extraspinal pain, sleep disturbance, and psychological distress. I also recognize the ‘heartsinks’ who have seen many consultants for a variety of complaints, and those with hypersensitivity. I do accept that some patients need further investigations, but it can be done in a way that does not cause further anxiety. To ensure that intensive rehabilitation is not contraindicated. By showing a genuine interest in the family, job and interests of the individual, you can begin to build confidence and hope for the clinical path being recommended.

The review ignores trauma’s effects on some people, causing their pain to begin, and for others, a major factor. Thirteen percent of patients with neck pain who presented to my clinics had a traumatic origin with a missed break and significant psychological comorbidity. Subsequently, it became clear that post-traumatic distress (PTPD), [a term used because post-traumatic stress may require specialist knowledge for diagnosis] can be present in rheumatological practices [4] and with the increasing influx of refugees in the UK [5], more patients are being diagnosed with PTPD. This can have major effects on families [5]. PTPD is commonly seen in medicolegal situations where accidents have caused major destruction to the lives of individuals and their families, including divorce [6]; and is often associated mood disturbances [6].

Kang et. al. correctly mention that sleep disorders are important in the management chronic pain [1], however, two important aspects of a’sleep story’ must be identified. It is important to ask the individual what they are thinking about when they lie awake in bed at night. This may provide clues as to social or family stress. Second, you should ask about their nightmares and dreams, especially if they are unpleasant. These often involve reliving trauma or accidents. When asked about nightmares, people who deny any unpleasant memories during direct questioning may reveal clues. The presence of PTPD can be important because it opens up therapeutic opportunities with psychological support and medications.

My experience in rehabilitation medicine over the years has taught me that to fully assist our disadvantaged clients, social issues must be resolved before psychological issues, and psychological issues must be resolved before physical issues!

References

1. Kang Y et. al., Chronic Pain: Definitions and Diagnosis. BMJ (Clinical Research ed. ), 2023. 381: p. e076036.

2. Frank A. et al. A cross-sectional study of the clinical and psychosocial features of low back injury and the resulting work handicap: Use of the Quebec Task Force Classification. Int J Clin Pract, 2000; 54(10) p. 639-644.

3. Frank A, De Souza L and Frank C. Neck Pain and Disability: A Cross-sectional Survey of the Demographic and Clinical Characteristics of Neck Pain Seen in a Rheumatology Clinic. Int J Clin Pract 2005; 59(doi: 10.1111/j.1742-1241.2004.00237.x): p. 173-182.

4. McCarthy J. and Frank A. Posttraumatic psychological distress can present in rheumatology. BMJ 2002. 325(27 July): p. 221-221.

5. Frank A. Refugee status: a yellow-flag in managing back pain. BMJ 2007;334(13 Jan): p.58-58.

6. Frank A. Psychiatric effects of road traffic accidents: often disabling, and not recognised (letter). BMJ 1993, 307(13th Nov): p.1283.

AmericanChiro

We understand how important it is to choose a chiropractor that is right for you. It is our belief that educating our patients is a very important part of the success we see in our offices.

Neck Pain

Landmark Trial: Opioids No Better Than Placebo for Back Pain

Published

2 years ago

July 16, 2023

AmericanChiro

The first randomized controlled study testing the efficacy of a short course opioids for acute nonspecific neck/low back pain suggests that opioids do not relieve acute neck or low back pain in the short-term and can lead to worse outcomes over the long-term.

After 6 weeks there was no significant difference between the pain scores of patients taking opioids and those who took a placebo. After one year, the pain scores of patients who received placebos were slightly lower. After 1 year, opioid users were also at a higher risk of opioid abuse.

Senior author Christine Lin, Ph.D., from the University of Sydney told Medscape Medical News that this is a “landmark trial” with “practice changing” results.

Lin explained that “we did not have any good evidence before this trial on whether opioids are effective for acute neck or low back pain, but opioids are one of the most commonly prescribed medicines for these conditions.”

Lin stated that based on these results “opioids shouldn’t be recommended at any time for acute neck and low back pain,”

The results of the OPAL study have been published online in The Lancet on June 28.

Rigorous Test

The trial was conducted at 157 primary care and emergency departments in Australia, with 347 adults who experienced low back pain or neck pain for 12 weeks or less.

They were randomly allocated (1:1) to receive guideline-recommended care (reassurance and advice to stay active) plus an opioid (oxycodone up to 20 mg daily) or identical placebo for up to 6 weeks. Naloxone is given to prevent opioid-induced constipation, and to improve blinding.

The primary outcome was the pain severity at six weeks, as measured by the pain severity subscale (10-point scale) of the Brief Pain Inventory.

After 6 weeks of opioid therapy, there was no difference between placebo and opioid therapy in terms of pain relief or functional improvement.

The mean pain score was 2.78 for the opioid group at 6 weeks, compared to 2.25 for the placebo group. (Adjusted median difference, 0.53, 95% CI -0.00 – 1.07, P=.051). At 1 year, the mean pain scores of the placebo group were lower than those of the opioid group (1.8 and 2.4).

The risk of opioid misuse was doubled at 1 year for patients randomly assigned to receive opioid therapy during 6 weeks as compared to those randomly assigned to receive placebo during 6 weeks.

At 1 year, the Current Opioid Use Measure (COMM), a scale that measures current drug-related behavior, indicated that 24 (20%) patients from 123 patients who received opioids, were at risk for misuse. This was compared to 13 (10%) patients from 128 patients in a placebo group ( p =.049). The COMM is a widely-used measure of current aberrant drug related behavior among chronic pain patients who are prescribed opioid therapy.

Results Raise “Serious Questions”

Lin told Medscape Medical News that “I think the findings of the research will need to be distributed to doctors and patients so they receive the latest evidence on opioids.”

“We must reassure doctors and their patients that the majority of people with acute neck and low back pain recover well over time (normally within 6 weeks). Therefore, management is simple – stay active, avoid bed rest and, if needed, use a heat pack to relieve short term pain. Consider anti-inflammatory drugs if drugs are needed,” Lin added.

The authors of the linked comment state that the OPAL trial raises serious questions regarding the use of opioids for acute neck and low back pain.

Mark Sullivan, MD PhD, and Jane Ballantyne MD, from the University of Washington in Seattle, note that clinical guidelines recommend opioids to patients with acute neck and back pain when other drugs fail or are contraindicated.

As many as two thirds of patients may receive an opioid for back or neck pain. Sullivan and Ballantyne say that it is time to reexamine these guidelines.

The National Health and Medical Research Council (NHMRC), the University of Sydney Faculty of Medicine and Health (University of Sydney Faculty of Medicine and Health) and SafeWork SA funded the OPAL study. The authors of the study have not disclosed any relevant financial relationships. Sullivan and Ballantyne have served as board members of Physicians for Responsible Opioid Prescribing (unpaid), and paid consultants for opioid litigation.

Lancet. Online published June 28, 2023. Abstract

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AmericanChiro

We understand how important it is to choose a chiropractor that is right for you. It is our belief that educating our patients is a very important part of the success we see in our offices.

Neck Pain

‘I tried acupuncture for back and neck pain even though I’m afraid of needles–and it’s literally the only thing that’s ever worked’

Published

2 years ago

July 15, 2023

AmericanChiro

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AmericanChiro

We understand how important it is to choose a chiropractor that is right for you. It is our belief that educating our patients is a very important part of the success we see in our offices.