Chiro.org - Chiropractic Resource Organization.     Support Chiropractic Research!

Monthly Archives: November 2013

Home/2013/November

Elimination of Intermittent Chronic Low Back Pain in a Recreational Golfer Following Improvement of Hip Range of Motion Impairments

By |November 30, 2013|Low Back Pain|

Elimination of Intermittent Chronic Low Back Pain in a Recreational Golfer Following Improvement of Hip Range of Motion Impairments

The Chiro.Org Blog


SOURCE:   J Bodywork and Movement Ther 2013; 17 (4): 448-52

Peter M. Lejkowski, Erik Poulsen

Faculty of Undergraduate Education,
Canadian Memorial Chiropractic College,
Toronto, ON, Canada


BACKGROUND:   The biomechanical relationship between the hip and low back is well described and impairment of hip range of motion is thought to affect lumbar spine function, possibly leading to increased loading and subsequent symptoms. However therapy for low back pain (LBP) patients is commonly directed solely to the low back area overlooking possible hip impairment.

CASE DESCRIPTION:   A 56-year-old male recreational golfer presented with a chronic golf-related low back complaint. Previous conservative therapy targeting the spine did not result in complete symptom relief. A working diagnosis of L4-S1 facet joint irritation and lower lumbar segmental instability secondary to bilateral hip ROM impairment was established. A trial of therapy strictly addressing the hip ROM impairments was initiated and following 2 treatment sessions, a complete resolution of symptoms was achieved and maintained at a 2-month follow-up.

(more…)

Evidence-Based Guidelines for the Chiropractic Treatment of Adults With Neck Pain

By |November 28, 2013|Chiropractic Care, Chiropractic Research, Evidence-based Medicine, Neck Pain|

Evidence-Based Guidelines for the Chiropractic Treatment of Adults With Neck Pain

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther 2014 (Jan);   37 (1):   42–63

Roland Bryans, DC, Philip Decina, DC, Martin Descarreaux, DC, PhD, Mireille Duranleau, DC, Henri Marcoux, DC, Brock Potter, BSc, DC, Richard P. Ruegg, PhD, DCs, Lynn Shaw, PhD, OT, Robert Watkin, BA, LLB, Eleanor White, MSc, DC

Guidelines Development Committee (GDC) Chairman; Chiropractor, Clarenville, Newfoundland, Canada.


OBJECTIVE:   The purpose of this study was to develop evidence-based treatment recommendations for the treatment of nonspecific (mechanical) neck pain in adults.

METHODS:   Systematic literature searches of controlled clinical trials published through December 2011 relevant to chiropractic practice were conducted using the databases MEDLINE, EMBASE, EMCARE, Index to Chiropractic Literature, and the Cochrane Library. The number, quality, and consistency of findings were considered to assign an overall strength of evidence (strong, moderate, weak, or conflicting) and to formulate treatment recommendations.

RESULTS:   Forty-one randomized controlled trials meeting the inclusion criteria and scoring a low risk of bias were used to develop 11 treatment recommendations. Strong recommendations were made for the treatment of chronic neck pain with manipulation, manual therapy, and exercise in combination with other modalities. Strong recommendations were also made for the treatment of chronic neck pain with stretching, strengthening, and endurance exercises alone. Moderate recommendations were made for the treatment of acute neck pain with manipulation and mobilization in combination with other modalities. Moderate recommendations were made for the treatment of chronic neck pain with mobilization as well as massage in combination with other therapies. A weak recommendation was made for the treatment of acute neck pain with exercise alone and the treatment of chronic neck pain with manipulation alone. Thoracic manipulation and trigger point therapy could not be recommended for the treatment of acute neck pain. Transcutaneous nerve stimulation, thoracic manipulation, laser, and traction could not be recommended for the treatment of chronic neck pain.

CONCLUSIONS:   Interventions commonly used in chiropractic care improve outcomes for the treatment of acute and chronic neck pain. Increased benefit has been shown in several instances where a multimodal approach to neck pain has been used.


Thanks to Dynamic Chiropractic for these comments from their article:
The Science of Treating Neck Pain

Following a literature search of controlled clinical trials through December 2011, 560 studies were narrowed to 41 that met the authors’ inclusion criteria and served as the basis for their treatment recommendations, graded as strong, moderate or weak based on the number, quality and consistency of research results.

Treatment strategies given strong recommendations for chronic neck pain included manipulation, manual therapy and exercise in combination with other modalities; as well as stretching, strengthening and endurance exercises alone.

Mobilization, as well as massage in combination with other therapies, received moderate recommendations for chronic neck pain.

Manipulation and mobilization in combination with other modalities received moderate recommendations for treating acute neck pain.

Here are the recommendations:


Acute Neck Pain


  • Manipulation / Multimodal:   “Spinal manipulative therapy is recommended for the treatment of acute neck pain for both short- and long-term benefit (pain and the number of days to recover) when used in combination with other treatment modalities (advice, exercise, and mobilization;
    (grade of recommendation – moderate).”

  • Mobilization/ Multimodal:   “Mobilization is recommended for the treatment of acute neck pain for short-term (up to 12 weeks) and long-term benefit (days to recovery, pain) in combination with advice and exercise
    (grade of recommendation – moderate).”

  • Exercise:   “Home exercise with advice or training is recommended in the treatment of acute neck pain for both long- and short-term benefits
    (neck pain; grade of recommendation – weak).”


Chronic Neck Pain

  • Manipulation / Multimodal:   “Spinal manipulative therapy is recommended in the treatment of chronic neck pain as part of a multimodal approach (including advice, upper thoracic high-velocity low-amplitude thrust, low-level laser therapy, soft-tissue therapy, mobilizations, pulsed short-wave diathermy, exercise, massage, and stretching) for both short- and long-term benefit
    (pain, disability, cROMs; grade of recommendation – strong).”

  • Manual Therapy / Multimodal:   “Manual therapy is recommended in the treatment of chronic neck pain for the short- and long-term benefit (pain, disability, cROM, strength) in combination with advice, stretching, and exercise
    (grade of recommendation – strong).”

  • Exercise:   “Regular home stretching (3-5 times per week) with advice / training is recommended in the treatment of chronic neck pain for long- and short-term benefits in reducing pain and analgesic intake
    (grade of recommendation – strong).”

  • Exercise / Multimodal:   “Exercise (including stretching, isometric, stabilization, and strengthening) is recommended for short- and long-term benefits (pain, disability, muscle strength, QoL, cROM) as part of a multimodal approach to the treatment of chronic neck pain when combined with infrared radiation, massage, or other physical therapies
    (grade of recommendation – strong).”

  • Mobilization:   “Mobilization is recommended for the treatment of chronic neck pain for short-term (immediate) benefit
    (pain, cROM; grade of recommendation – moderate)”

  • Massage / Multimodal:   “Massage is recommended for the treatment of chronic neck pain for short-term (up to 1 month) benefit (pain, disability, and cROM) when provided in combination with self-care, stretching, and/or exercise (grade of recommendation – moderate).”

  • Manipulation:   “Spinal manipulative therapy is recommended in the treatment of chronic neck pain for short- and long-term benefit
    (pain, disability; grade of recommendation – weak).”


In their conclusion, the authors note that their findings suggest “interventions commonly used in chiropractic care improve outcomes for the treatment of acute and chronic neck pain” and that “increased benefit has been shown in several instances where a multimodal approach to neck pain has been used.”


There are more articles like this @ our:

Clinical Model for the Diagnosis and Management Page and the:

Chronic Neck Pain and Chiropractic Page

Food to Fight Cancer ~ A 2-Part Series

By |November 23, 2013|Cancer, Nutrition|

Food to Fight Cancer
A 2-Part Series

The Chiro.Org Blog


SOURCE:   Medscape Oncology ~ 11-20-2013
NOTE: Registration is free @ Medscape

By Laura A. Stokowski, RN, MS


Editor’s Note: In this 2-part series, Medscape looks at diet as an essential therapeutic strategy for cancer patients. Part 1 focuses on the nutritional assessment of cancer patients, foods that help patients cope with side effects, and ways to make fortifying foods more appealing to the cancer-dulled appetite. Part 2 looks at extreme nutrition and the growing interest in fighting cancer with food.

Speaking to Medscape on these topics are 2 high-profile cancer nutrition and food experts. Suzanne Dixon, MPH, MS, RD, is a dietician, author, speaker, and internationally recognized expert in chronic disease prevention health, and cancer nutrition. Rebecca Katz, MS, is a chef; nutritionist; national speaker; and award-winning author whose books include One Bite at a Time, The Cancer-Fighting Kitchen, and The Longevity Kitchen.


Nutrition Affects Cancer Outcomes

After receiving a diagnosis of cancer, a patient’s thoughts often turn to treatment options and prognosis. Many patients face surgery, radiation therapy, chemotherapy, or a combination of those strategies. Most of their questions and concerns are about how they will get through it all.

Nutrition is not likely to be on their list of immediate concerns, but it should be. Not only will patients reap the benefits of being healthier and better able to withstand treatments and side effects, but mental outlook and quality of life can be improved by taking control of one’s nutritional health. Patients might have little control over their disease, but what they eat remains under their own purview, and deciding to eat well and taking the steps to do so is empowering.

“The days when healthcare professionals could just tell cancer patients to eat whatever they want, and not to worry about what they eat, are over,” says Rebecca Katz, author of The Cancer-Fighting Kitchen. [1] “Patients are starting to rebel against that. They are realizing that what you eat can make a difference in how you feel, your outcomes, the side effects you experience, and how well you will get through treatment. We need to acknowledge that food is important.”


No “One Size Fits All” Strategy

(more…)

Chiropractic Summit Promotes Drug-Free Approach to Health Care

By |November 18, 2013|News|

Source The Chiropractic Summit

Arlington, Va.—The Chiropractic Summit, an umbrella leadership group of prominent chiropractic organizations, met on Nov. 7 in Seattle, Wash. and approved, by unanimous motion, the following historic statements of agreement:

Summit Promotes Drug-Free Approach:
The drug issue is a non-issue because no chiropractic organization in the Summit promotes the inclusion of prescription drug rights and all chiropractic organizations in the Summit support the drug-free approach to health care.

Summit Supports the Council on Chiropractic Education (CCE):
The Summit fully supports the continued recognition of CCE. Even though there are some issues of concern remaining, such as CCE’s governance model, many good things have occurred the last couple of years. In addition, CCE has agreed to carefully review governance models for possible improvements beginning in 2014 in connection with the Summit Roundtable.

In addition, the Summit voted unanimously to reaffirm its support of CCE before the Department of Education’s (DOE) National Advisory Committee on Institutional Quality and Integrity (NACIQI) this December.

Marketing Language:
After multiple focus groups, the following marketing language was passed: The Summit acknowledges the concepts of spinal health and well-being as credible marketing messages and we encourage further efforts to refine and test such efforts.

“I am proud to say today that after much time, effort and energy, the Summit partner organizations— representing the leadership of our profession—have come to an agreement on the long divisive issue on drugs,“ said Summit chair Lewis J. Bazakos, MS, DC. “This truly was an historic meeting.”

First convened in September 2007, the Chiropractic Summit represents leadership from some 40 organizations within the profession. The Summit meets regularly to collaborate, seek solutions and support collective action to address challenges with the common goal of advancing chiropractic. For more information about the Summit and its leadership, visit www.chirosummit.org.

A Clinical Model for the Diagnosis and Management of Patients with Cervical Spine Syndromes

By |November 13, 2013|Chiropractic Care, Diagnosis, Evidence-based Medicine|

A Clinical Model for the Diagnosis and Management of Patients with Cervical Spine Syndromes

The Chiro.Org Blog


SOURCE:   Australasian Chiropractic & Osteopathy 2004 (Nov); 12 (2): 57–71

Donald R. Murphy DC, DACAN

Clinical Director, Rhode Island Spine Center
Clinical Teaching Associate
Department of Community Health
Brown University School of Medicine


Background:   Disorders of the cervical spine are common and often disabling. The etiology of these disorders is often multifactorial and a comprehensive approach to both diagnosis and management is essential to successful resolution.

Objective:   This article provides an overview of a clinical model of the diagnosis and management of patients with disorders related to the cervical spine. This model is based in part on the scientific literature, clinical experience, and communication with other practitioners over the course of the past 20 years.

Discussion:   The clinical model presented here involves taking a systematic approach to diagnosis, and management. The diagnostic process is one that asks three essential questions. The answers to these questions then guides the management process, allowing the physician to apply specific methods that address the many factors that can be involved in each individual patient. This clinical model allows the physician to individualize the management strategy while utilizing principles that can be applied to all patients. At times, the management strategy must be multidisciplinary, and cooperation with other physicians and therapists is often necessary for effective patient care. This model is currently being used by the author in practice, as well as forming the basis upon which further research can be conducted to refine or, if necessary, abandon any of its aspects, as the evidence dictates. It is the purpose of this paper to present this clinical model and the clinical and scientific evidence, or lack thereof, of its components.

Key Words   Cervical spine, chiropractic, conservative management, neck pain, headache, rehabilitation.


Introduction

Neck pain and related disorders are a group of conditions that are common and often disabling. It can be argued that the importance of these disorders is under-appreciated. Because of the prevalence of low back pain and its great cost to society, much clinical attention and research dollars are focused on the low back. But epidemiological research suggests that cervical related disorders are as common and may be more costly to society than low back disorders. [1-4]

There are more articles like this @ our:

Chronic Neck Pain and Chiropractic Page and the:

Clinical Model for the Diagnosis and Management Page

(more…)