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Whiplash & Chiropractic

Chiro.Org Blog: Whiplash is an enigmatic injury. We spend billions of dollars each year to treat it. Yet many lawyers, legislators, and medical doctors deny its existence. It affects millions of people around the world, yet research is severely under-funded. It is a largely preventable injury, yet we do little to prevent it. Fortunately, times are changing as whiplash enters a new phase of research and understanding. […]

Spinal Manipulation Compared with Back School and with Individually Delivered Physiotherapy

Chiro.Org Blog: Spinal manipulation was associated with higher functional improvement and long-term pain relief than back school or individual physiotherapy, but received more further treatment at follow-ups; pain recurrences and drug intake were also reduced compared to back school or individual physiotherapy. […]

Why You Might Want To Switch Browsers

Chiro.Org Blog: Compare the 3 leading web browsers, and see how poorly 2 of them render tables. The choice is clear, it’s time to step up to Chrome. […]

Behavioral and Physical Treatments for Tension-type and Cervicogenic Headache

Chiro.Org Blog: Manipulation appeared to result in immediate improvement in headache severity when used to treat episodes of cervicogenic headache when compared with an attention-placebo control. Furthermore, when compared to soft-tissue therapies (massage), a course of manipulation treatments resulted in sustained improvement in headache frequency and severity. […]

Changes in Vertebral Artery Blood Flow Following Various Head Positions and Cervical Spine Manipulation

This pilot study was conducted as a blinded examiner cohort with 4 randomized clinical tasks. Ten healthy male participants aged 24 to 30 years (mean, 26.8 years) volunteered to participate in the study. None of the participants had a history of disabling neck, arm, or headache pain within the last 6 months. They did not have any current or history of neurologic symptoms. In a neutral head position, physiologic measures of VA blood flow and velocity at the C1-2 spinal level were obtained using phase-contrast magnetic resonance imaging after 3 different head positions and a chiropractic upper cervical spinal manipulation. A total of 30 flow-encoded phase-contrast images were collected over the cardiac cycle, in each of the 4 conditions, and were used to provide a blood flow profile for one complete cardiac cycle. Differences between flow (in milliliters per second) and velocity (in centimeters per second) variables were evaluated using repeated-measures analysis of variance. […]

Medical Management of Pediatric and Non-Musculoskeletal Conditions by Spinal Manipulation

Chiro.Org Blog: There is a well established precedent by medical doctors, particularly in Europe, of managing infant, paediatric and other patients for so-called organic conditions by spinal manipulation. There are also claims that chiropractic should not be involved with this form of management for so-called visceral disorders because it does not quite meet the current orthodox theories. This seems contradictory if not hypocritical when there is noted evidence in the medical literature itself of not only the rationale supporting these concepts, but evidence of medical doctors carrying out the same procedures for the same purpose on the same conditions. Considering the unpleasant fallout from the Simon Singh Case, this article sheds a unique, new perspective on manipulative care for non-musculoskeletal conditions. […]

The Efficacy of Spinal Manipulation, Amitriptyline and the Combination of Both Therapies for the Prophylaxis of Migraine Headache

Chiro.Org Blog: Spinal manipulation seemed to be as effective as a well-established and efficacious treatment (amitriptyline), and on the basis of a benign side effects profile, it should be considered a treatment option for patients with frequent migraine headaches […]

Spinal Manipulation vs. Amitriptyline for the Treatment of Chronic Tension-type Headaches: A Randomized Clinical Trial

Chiro.Org Blog: This study compared the effects of spinal manipulation and pharmaceutical treatments for chronic tension headaches. Four weeks following the cessation of treatment, the pharmaceutical group demonstrated no improvement from the baseline. In the spinal manipulation group, headache intensity dropped 32 percent; frequency dropped 42 percent; and there was an overall improvement of 16 percent in functional health status. […]

Brief Screening Questions For Depression in Chiropractic Patients With Low Back Pain: Identification of Potentially Useful Questions and Test of Their Predictive Capacity

Chiro.Org Blog: Pain and depression often co-exist [1-3] , and although the causal relation between the two is not clear [4, 5] , evidence suggests that pain negatively affects outcome in depression as well as vice versa [6] . Low back pain (LBP) is a highly frequent pain condition with a substantial impact on global health [7] for which the risk of a poor prognosis is increased in the presence of depression [8, 9] . It is a condition for which there is no generally effective treatment, but non-pharmacological treatment addressing psychological symptoms in addition to the physical symptoms has been demonstrated to improve outcome in LBP patients with high scores on psychological questions [10]. […]

Our No. 1 Medicare Documentation Error

Chiro.Org Blog: We have all heard that chiropractic documentation is being reviewed by multiple Medicare contractors and that we are failing these reviews miserably. So, where are we going wrong? In this and subsequent articles, let’s address the top reasons we are failing review, starting with the No. 1 reason – our treatment plan documentation. […]

Recent Considerations in Nonsteroidal Anti-inflammatory Drug Gastropathy

Chiro.Org Blog: Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures for all NSAID users would be overwhelming, yet the scope of this problem is generally under-appreciated. […]

FDA Asks Docs to Limit Acetaminophen in Prescription Meds

Chiro.Org Blog: The US Food and Drug Administration (FDA) is asking healthcare professionals to stop prescribing combination prescription pain relievers that contain more than 325 mg of acetaminophen per tablet, capsule, or other dosage unit, citing the risk for liver damage. […]

Musculoskeletal Abnormalities in Chronic Headache: A Controlled Comparison of Headache Diagnostic Groups

Chiro.Org Blog: There was a significant difference in the presence of postural abnormalities between the controls and the patients, with posture abnormalities more likely to be present in those with headache. The patients were also significantly more likely to have active trigger points and trigger points in the neck than were the control subjects. […]

The Accuracy of Manual Diagnosis for Cervical Zygapophysial Joint Pain Syndromes

Chiro.Org Blog: The manipulative therapist identified correctly all 15 patients with proven symptomatic zygapophysial joints, and specified correctly the segmental level of the symptomatic joint. None of the five patients with asymptomatic joints was misdiagnosed as having symptomatic zygapophysial joints. Thus, manual diagnosis by a trained manipulative therapist can be as accurate as can radiologically-controlled diagnostic blocks in the diagnosis of cervical zygapophysial syndromes. […]

A Diagnosis-based Clinical Decision Rule For Spinal Pain Part 2: Review Of The Literature

Chiro.Org Blog: Accurate diagnosis or classification of patients with spinal pain has been identified as a research priority [1]. We presented in Part 1 the theoretical model of an approach to diagnosis in patients with spinal pain [2]. This approach incorporated the various factors that have been found, or in some cases theorized, to be of importance in the generation and perpetuation of neck or back pain into an organized scheme upon which a management strategy can be based. The authors termed this approach a diagnosis-based clinical decision rule (DBCDR). The DBCDR is not a clinical prediction rule. It is an attempt to identify aspects of the clinical picture in each patient that are relevant to the perpetuation of pain and disability so that these factors can be addressed with interventions designed to improve them. The purpose of this paper is to review the literature on the methods involved in the DBCDR regarding reliability and validity and to identify those areas in which the literature is currently lacking. […]