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Daily Archives: July 15, 2014

What Happened To The ‘Bio’ In The Bio-psycho-social Model of Low Back Pain?

By |July 15, 2014|Chiropractic Research, Low Back Pain|

What Happened To The ‘Bio’ In The Bio-psycho-social Model of Low Back Pain?

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SOURCE:   Eur Spine J. 2011 (Dec); 20 (12): 2105-2110

Mark J. Hancock, Chris G. Maher, Mark Laslett,
Elaine Hay, and Bart Koes

Faculty of Health Sciences,
University of Sydney,
PO Box 170,
Lidcombe 1825, NSW, Australia.
mark.hancock@sydney.edu.au


Purpose   Over 20 years ago the term non-specific low back pain became popular to convey the limitations of our knowledge of the pathological source of most people’s low back pain. Knowledge of underlying pathology has advanced little since then, despite limited improvements in outcomes for patients with low back pain.

Methods   This paper discusses potential misunderstandings related to diagnostic studies in the field of low back pain and argues that future diagnostic studies should include and investigate pathological sources of low back pain.

Results   Six potential misunderstandings are discussed.

  1. Until diagnosis is shown to improve outcomes it is not worth investigating;
  2. without a gold standard it is not possible to investigate diagnosis of low back pain;
  3. the presence of pathology in some people without low back pain means it is not important;
  4. dismissal of the ability to diagnose low back pain in clinical guidelines is supported by the same level of evidence as recommendations for therapy;
  5. suggesting use of a diagnostic test in research is misinterpreted as endorsing its use in current clinical practice;
  6. we seem to have forgotten the ‘bio’ in biopsychosocial low back pain.

Conclusions   We believe the misunderstandings presented in this paper partly explain the lack of investigation into pathology as an important component of the low back pain experience. A better understanding of the biological component of low back pain in relation, and in addition, to psychosocial factors is important for a more rational approach to management of low back pain.

Keywords:   Low back pain, Diagnosis, Back pain

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Biopsychosocial Model Page


From the FULL TEXT Article

Introduction

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Joint Assessment – P.A.R.T.S.

By |July 15, 2014|Diagnosis, Medical Necessity, Medicare|

Joint Assessment – P.A.R.T.S.

The Chiro.Org Blog


SOURCE:   Topics in Clinical Chiropractic 2000; 7 (3): 1–10

Thomas F. Bergmann, DC,
Bradley A. Finer, DC, DACAN

Clinical Science Division
Northwestern Health Sciences University
College of Chiropractic
Bloomington, Minnesota


Purpose:   An approach to systematically perform clinical work-up for chiropractic subluxation is proposed. Literature on assessment approaches is reviewed and a discussion is presented.

Method:   A qualitative review of clinical and scientific literature related to assessment methodologies for subluxation was performed.

Summary:   Variation in assessment techniques exists for identification of spinal and other articular joint dysfunction. Useful scientific data also are limited to only a few approaches. and there is a need for a more systematic assessment approach profession wide.

Key words:   articular range oj motion, chiropractic, Medicare, palpation, physical examination, subluxation

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What is The Chiropractic Subluxation? Page


From the FULL TEXT Article

Background

Doctors of chiropractic are portals of entry to the health care system for many patients seeking health care services. As such, they must maintain broad and thorough assessment/diagnostic skills. Before employing any therapy, a clinician must first determine if there is a need for treatment. Therefore, the clinical information that any primary contact provider would want, including a case history, physical examination, clinical laboratory findings, radiographic findings, and any other tests necessary to check for suspected health problems, is needed. Having gathered and interpreted this information, it must be processed in order to arrive at a sound clinical conclusion. The role of this assessment process in the chiropractic office is to determine whether the patient should receive chiropractic care only, chiropractic care in concert with other forms of health care, or a referral to another health care professional for some other form of stand-alone management such as acute, crisis care. This article suggests the need for, and possible form of, a standardized assessment procedure for use by chiropractic clinicians.


INTRODUCTION

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