Osteoporosis need not stop chiropractic visits


Is it dangerous to have chiropractic treatments if you have osteoporosis?

Scientifically, there is little data on chiropractic in people with osteoporosis, said Anthony L. Rosner, a Brookline, Mass., biochemist who is director of research and education for the Foundation for Chiropractic Education and Research. There is also little data suggesting that people with osteoporosis are injured by chiropractic treatment, in which the spine is manipulated to restore proper alignment of vertebrae.

Osteoporosis should not keep people from seeing a chiropractor, he said. Instead of manipulating the spine in a way that produces what laypeople call "cracking" or "popping" sounds (caused by the release of gases between joints), chiropractors can use "low-force techniques" such as massage, Rosner said.

Often, chiropractors take X-rays of patients with osteoporosis so that they can use different techniques on them. But the X-rays used by chiropractors are much less sensitive than the ones used to gauge bone density.

So, by the time osteoporosis shows up on regular X-rays, a patient could have lost 30 percent to 35 percent of bone mass, said Dr. Suzanne Jan de Beur, an osteoporosis expert and chief of endocrinology at Johns Hopkins Bayview Medical Center.

And don't let the chiropractor "crack" your mid-back if you have osteoporosis. "The biggest potential problem is in the thoracic spine," said Dr. Joseph Kornfeld, a chiropractor in Lynn, Mass. "A hard thrust can break the ribs."

That happened to Dr. Jerry Gerrard, a chiropractor in Mesa, Ariz., who is on the board of governors of the American Chiropractic Association.

Once, in 35 years of practice, he said, he broke an osteoporotic patient's rib. He had warned her about the risk, he said, but she wanted to proceed anyway. (She later recovered.) So, if you have osteoporosis, tell your chiropractor. And ask for low-force techniques.

Does mesotherapy really get rid of cellulite? Is it safe?

Mesotherapy is a technique, developed in France decades ago, that involves injecting hormones, enzymes, plant extracts, vitamins, asthma medications and other chemicals (none of them approved by the U.S. Food and Drug Administration for this purpose) into various layers of the skin.

The idea, said Dr. Lionel Bissoon, a doctor of osteopathic medicine in New York, is that some of these chemicals, such as phosphatidylcholine, can melt away cellulite, the lumpy deposits of fat that accumulate on the buttocks and thighs.

The procedure involves many injections per treatment, with three to 10 treatments needed. The cost, which is not covered by insurance, can run to thousands of dollars.

There's lots of hype about mesotherapy - but so little solid research that mesotherapy should be considered an unproven technique.

"Competent physicians would never - and should never - use anything that has not been proved in standardized clinical testing," said Dr. Richard Ehrlichman, a spokesman for the American Society of Plastic Surgeons and a private practitioner in Wellesley, Mass.

Last year, Dr. Alan Matarasso, a plastic surgeon and clinical professor at the Albert Einstein College of Medicine, reported in the journal Plastic and Reconstructive Surgery on a few studies that hint at an improvement in the appearance of cellulite. But so far, he said, "we have nothing, no matter what you read, to permanently take care of cellulite."

The chief side effects reported are minor --- bruising, localized infections and redness. And there have been few reports of complications so far, said Dr. Ricardo Rodriguez, head of plastic surgery at the Greater Baltimore Medical Center.

Still, this one seems a no brainer: Save your money, at least until there's better data.

Send your questions to foreman@baltsun.com.

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