Can Statins Cause Back Pain? | Podcast Ep. 76

Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langme. This week we are talking about statins and the challenge. If you thought statins were bad before, things may have just gotten worse with some new research that came out a couple tidbits before we dive into that content. Last weekend was the Kairosushi Summit. If you were there, I'm sure you had a great time. The feedback has been awesome. I had a great time intermixing, mingling, chatting it up with a variety of chiropractors from really around the globe. So it was an awesome event. Definitely check it out. Next year I talked about Facebook retargeting. I'm also going to have a little bit more about that coming soon because the information was really, really well received. So Kairosushi Summit, big thanks, Tristan, Dan and Tim for getting me out there and Ryan of course as well. But for this week, as I said, we are gonna talk about statins and it kind of brought me back. I posted something on Facebook about this and it caught like wildfire. And I'm gonna take the story back a little bit and then give the context for what we're talking about today. So in 2014 I put out a blog that was titled Statins for Every man in America. And really it was because at the time there was an unbelie, unbelievably remarkable and truth be told, frightening new set of guidelines that were released by the American Heart association and American College of Cardiology. And they decided to expand the treatment of cholesterol by including an additional 13 million people who could or should be recommended statin therapy. And I use that very loosely. So when I looked, I did a little due diligence and looking closely at the guidelines, it appeared as though 90% of men between 60 and 75 years old would now be recommended in prescribed statin medications. That's crazy. So again, they expanded who should take statins by 13 million people and that equated to basically 90% of men above 60 years old. Women in that age group who would qualify for statins under those new guidelines were over 50%. And eligibility was then gonna be determined on a quote, unquote, 10 year risk for cardiovascular disease instead of, instead of LDL and HDL levels. So I mean, again, despite the lack of RCTs and grade one evidence, the new guidelines were being adopted by exceptionally powerful organizations. And the guidelines were gonna be adopted by Medicare. So primary care physicians were gonna be pressured into prescribing the medications. And as we know, by not following the guidelines, those physicians may have been placing themselves at risk for penalties. So to me, there is no doubt that the guidelines were heavily supported by the pharmaceutical companies in the United States. And the side effects of statins are well documented. And at the time, I said, hey, it's imperative that our patients, neighbors and friends are well informed regarding cholesterol levels and various treatment options available to them. Now, us as chiropractors, of course, the caveat for this episode is we're not in a position that's outside of our scope to take somebody off of medication or recommend that they stop taking medication. Well beyond the scope of a chiropractor. But. But for us, these are the patients that we're seeing each and every day, and they need to have a better understanding of their health than with their wellness so they can ask a little bit more poignant questions when they go visit their primary care doctor. The primary care doctor says, hey, take statins, your cholesterol's high. Well, you know, what's considered high today is a lot different than what was considered high 20 years ago or 10 years ago. That seems to keep what's considered high keeps trickling down the mountain to a lower and lower number. That, as we've seen now takes about 90% of men. Men are quote, unquote, in the bracket of needing statin. Now, as far as that's concerned, the secondary component to this, and really where we bring it up to speed right now is that Medscape put out an article literally just this past week, on May 8, Medscape put out an article that said statin use increases the odds of back disorders. And it was a cohort study. So I'm gonna read a little bit from it and give a little bit of take on this as well. So basically, Medscape put out an article saying, hey, there was a large observational study and it was mostly military and family members. And what they found was that these individuals taking statins had an increased risk of having a back disorder. So specifically, for every 17 people that were prescribed a statin, one person had a diagnosed back disorder. And this was going to come out in JAMA in internal medicine. So I want to read a quote that the researchers found here that I think is really important. The researchers found, quote, some of these adverse event effects from statins can greatly impact day to day quality of life for our patients, especially in those who are physically active. Lead author Dr. Una Mattress says so. And they also said, we, quote, we hope that musculoskeletal Adverse events will be part of the patient provider discussion on the risk benefit ratio of these drugs. And they also found, quote, our results provide additional motivation to further investigate the overall influence of statin therapy on musculoskeletal help, specifically if prescribed for primary prevention in physically active individuals. So really what it came down to is the Medscape article just talks a little bit about back pain and musculoskeletal care. Severe back pain could rank $100 billion industry. It's just ridiculous how much money. Now consequently, the statin industry also is a multi, multi billion dollar industry. But really what they found was, you know, people that were taking the statins, they just had a very, very high rate of musculoskeletal disorders. So we've seen, and I posted this immediately online and what I found was some comments of people saying, hey, you know, my uncle had als, what they thought was ALS symptoms that were actually caused from statin use. And hey, you know, my, I know somebody that had, you know, advanced spine issues post statin use. Now those are individual cases. It's difficult to separate out. We don't have the research, those antidotes. But the bottom line is there's a lot to be said for how much statins are being prescribed in our society currently. Consequently, the confusion about cholesterol, I mean, we talk about LDLS and HDLS and the balance of those and just, you know, even different diets, I mean, you look at an Atkins diet versus a ketogenic diet versus a typical American diet and there's play with what's considered safe and functional, LDL and HDL levels and there's a gamut there, there's a span. And what's troubling to me is when we see that cholesterol number oversimplified and we see that the lower and lower numbers of cholesterol, which is an essential part of human function, lower and lower numbers of cholesterol are qualifying people for statin drugs. Long term statin medication, that's a difficult pill to swallow, no pun intended. But the secondary component of that is the new research. Again, side effects. The events following statin use are well documented, but certainly with new research that's showing, hey, statin use increases the odds of a back disorder, including spondylosis, including intervertebral disc disorders, including herniated discs, including spinal stenosis. Those were just a couple of the items that they picked out. So obviously there is significant musculoskeletal effects with long term statin use. And to me that's something that certainly we need to be aware of with the patients are coming into our practice. Let's take, I'm gonna take a little different spin on this. You know, as chiropractors, again, it's outside of our scope to recommend statins or certainly outside of our scope to influence somebody to stop taking their statin medications. That stays all on the MD and do territory. But in my opinion, this is even more important for our patients that are coming in. Let's say we have a patient coming in that's been on statins long term. When's the last time you asked a patient if they're taking statins? If they have advanced spinal challenges in, they might be a, they might be in your office a little longer than the next guy or gal who's not on statins. So it's about setting expectations. It's about patient experience. It's about making sure that your patients know, hey, when we've seen patients with stat that are taking statins, it takes them a bit longer to get well because of the statins effect on their musculoskeletal system. So that gives you a little bit more credence from somebody coming in and dropping out after two visits because they don't have the desired effect. It might take a little bit longer to get that patient back back up that functional scale to get that pain reduced and to get them their lives back. So that's the take home message for this week. Statins come one, come all with statins. Statins for every man in America. Question mark. It's something that's gonna be an uphill battle. It's something with the baby boomer generation, more people getting into that 60 to 75 bracket that it is going to be a very, very big issue in all of our practices. And it is important for us to know the latest research regarding it. So the people that you have coming in on statin medications may be slower to respond because statins have now been proven to increase the risk of back disorders. So take that as you will. I'm going to leave in the show notes, I will leave links to both of these papers and you can certainly check that out. And additionally, before we wrap, what I will say is if you have not had the opportunity. Thank you. Well, let me say one thing first. Thank you. We reached over 3,500 chiropractors last week with the Evidence based Chiropractor podcast. I have said it before and I will say it again. Thank you for taking the time to listen and getting your research and marketing and the time it takes to get to your office every Monday. I greatly appreciate it. 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