In healthcare, there are a lot of old wives tales that you need to be careful about. There are some pieces of advice that goes around that isn’t substantiated by testing. Or they are backed up by junk science.
I always thought that the hackneyed advice of telling people to drink more water to stay hydrated was junk. But this study below tells us that if people are slightly dehydrated, or “hypohydrated,” then they don’t respond as well to treatment.
My only question now is: How dehydrated were the patients? Because I don’t think most of us are walking around dehydrated to any appreciable degree. I maintain that if we are walking around hypohydrated, we would all be feeling lousy, and our thirst mechanisms would have long ago kicked in.
Either way, when you come into The Joint, you will have access to plenty of fresh water. We have cups on top of our fresh drinking water fountains, and we will encourage you to drink plenty.
I’d like to hear your thoughts in the comments section below.
Todd Lloyd, DC
Chiropractic Physician in Salt Lake City
Efficacy of Osteopathic Manipulative Treatment for Low Back Pain
in Euhydrated and Hypohydrated Conditions: A Randomized Crossover TrialJ Am Osteopath Assoc May 1, 2012 vol. 112 no. 5 276-284
Abstract
Context: Low back pain (LBP) affects up to 85% of all persons at some time in
life and is a condition for which osteopathic manipulative treatment (OMT) has been
shown to be beneficial. Measures that can improve the efficacy of OMT would further
benefit patients; one such measure, hydration status, was explored in this study.Objective: To determine whether there is a relationship between a patient’s hydration
status before OMT for LBP and the outcome of that treatment.Design: A randomized, single-blind crossover study conducted from March to December 2010.
Setting: Outpatient academic center.
Participants: Eight women and 11 men with LBP of 1 to 12 months duration.
Interventions: Both euhydrated and hypohydrated conditions were achieved in each
participant by modifying water consumption for 36 hours before OMT sessions.
Participants received 2 sessions of OMT, each in a different hydration condition and with
a 1-week washout period in between.Main Outcome Measures: Pre- and posttreatment visual analog scale scores for pain,
number and severity of somatic dysfunction as scored on the somatic dysfunction
severity scale, and number of asymmetric landmarks found on the osteopathic standing
structural examination.Results: Improvements in total and severe number of lumbar somatic dysfunction (P=.001
and P=.013, respectively) and number of asymmetric landmarks on standing structural
examination (P=.002) were found to be greater in the euhydrated vs the hypohydrated
condition. Participants had a mean of 2 fewer areas of posttreatment somatic dysfunction
when euhydrated than when hypohydrated, and they had a mean decrease of 2 asymmetric
landmarks on the standing structural examination when euhydrated but none when hypohydrated.
Osteopathic manipulative treatment improved self-reported pain immediately after treatment
regardless of hydration status.Conclusion: Outcome measures improved for all participants, with greater improvement
observed after participants were treated in the euhydrated condition than when in the
hypohydrated condition. It is reasonable for clinicians to recommend that patients increase
their hydration to optimize treatment.
Hi Dr. Lloyd… I do think most people are dehydrated, especially with the amounts of coffee and other caffeine products people drink. I explain to my patients to think of their tissues like a sponge… if they don’t drink enough water it is like drought in an area of the planet: the ground dries out and starts cracking, plants start to die, or the sponge that is left on the counter top without putting more water on it will stiffen and dry out (then try and bend and twist it.. it will start to tear easier and break).
When I get my patients to cut out caffeine and to increase their water intake to about half their body weight in ounces of water… they can’t believe how much better they feel, flexibility of muscles improves more quickly during therapy, the trigger points break down more easily and less tender.
Drinking water and being optimally hydrated is a key factor in not only helping our patients with their musculoskeletal problems, but in maintaining optimal health without drugs and surgery.
Thank you for reminding me of the importance of water!
Yes proper hydration is key, and I read this article too. I have since been instructing my patients to keep plenty of water around and drink lots especially after an adjustment.
I seems like a no-brainer about drinking water after a massage session. Just about everyone knows about that. But I agree with the others. I suspect that most chiropractic patients are not being told to drink additional amounts of water following their adjustments.