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Monthly Archives: September 2014

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Exploring Patient Satisfaction

By |September 24, 2014|Chiropractic Care, Patient Satisfaction|

Exploring Patient Satisfaction: A Secondary Analysis of a Randomized Clinical Trial of Spinal Manipulation, Home Exercise, and Medication for Acute and Subacute Neck Pain

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther 2014 (Sep 5)


Brent D. Leininger, DC, Roni Evans, DC, PhD,
Gert Bronfort, DC, PhD

Research Fellow, Integrative Health & Wellbeing Research Program,
Center for Spirituality & Healing, University of Minnesota,
Minneapolis, MN.
lein0122@umn.edu


OBJECTIVE:   The purpose of this study was to assess satisfaction with specific aspects of care for acute neck pain and explore the relationship between satisfaction with care, neck pain, and global satisfaction.

METHODS:   This study was a secondary analysis of patient satisfaction from a randomized trial of spinal manipulation therapy (SMT) delivered by doctors of chiropractic, home exercise and advice (HEA) delivered by exercise therapists, and medication (MED) prescribed by a medical doctors for acute/subacute neck pain. Differences in satisfaction with specific aspects of care were analyzed using a linear mixed model. The relationship between specific aspects of care and (1) change in neck pain (primary outcome of the randomized trial) and (2) global satisfaction were assessed using Pearson’s correlation and multiple linear regression.

RESULTS:   Individuals receiving SMT or HEA were more satisfied with the information and general care received than MED group participants. Spinal manipulation therapy and HEA groups reported similar satisfaction with information provided during treatment; however, the SMT group was more satisfied with general care. Satisfaction with general care (r = -0.75 to -0.77; R2 = 0.55-0.56) had a stronger relationship with global satisfaction compared with satisfaction with information provided (r = -0.65 to 0.67; R2 = 0.39-0.46). The relationship between satisfaction with care and neck pain was weak (r = 0.17-0.38; R2 = 0.08-0.21).

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Patient Satisfaction With Chiropractic Page

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The Cellular and Molecular Biology of the Intervertebral Disc:A Clinician’s Primer

By |September 21, 2014|Continuing Education, Disc Injury|

The Cellular and Molecular Biology
of the Intervertebral Disc: A Clinician’s Primer

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc. 2014 (Sep);   58 (3):   246–257

W. Mark Erwin, DC, PhD and Katherine E. Hood, DC

Assistant Professor, Divisions of Neurological and Orthopaedic Surgery,
University of Toronto, Toronto Western Hospital;
Scientist, Toronto Western Research Institute;
Associate Professor, Research Canadian Memorial Chiropractic College.


Clinicians routinely encounter patients suffering from both degenerative and acute spinal pain, often as a consequence of pathology affecting the intervertebral disc (IVD). The IVD is a complex structure essential to spinal function and is subject to degenerative disease and injury. However, due to the complexity of spinal pain syndromes it is often difficult to determine the extent of the IVD’s contribution to the genesis of spinal pain. The location of the IVD is within close proximity to vital neural elements and may in the event of pathological change or injury compromise those structures. It is therefore important that clinicians performing manual therapy understand the cellular and molecular biology of the IVD as well as its clinical manifestation of degeneration/injury in order to safely manage and appreciate the role played by the disc in the development of mechanical spinal pain syndromes.

Keywords:   spine, degenerative, pain, disc, intervertebral


The Full-Text Article:

Introduction:

The intervertebral disc (IVD) is a complex structure positioned between two adjacent vertebrae where in addition to protecting the spinal cord and segmental spinal nerves it confers flexibility, multi-axial spinal motion and load transmission to the spine. The IVD is vulnerable to injury and degeneration often leading to pain syndromes however much remains to be discovered concerning the development of axial and radicular pain syndromes, the biology of the disc and the capacity of the IVD to repair itself after injury. [1] From the clinician’s perspective, familiarity with the biology of the IVD is vital in order to understand the natural history of disc-related injury/illness and to develop appropriate therapeutic strategies. The purpose of this review is to provide an overview of the salient characteristics of IVD pathology with a particular emphasis upon degenerative disease and its role in the generation of clinical spinal pain syndromes.

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Disc Herniation and Chiropractic Page

The disc as an organ:

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Chiropractic Treatment Helps Back-Related Leg Pain

By |September 16, 2014|Chiropractic Care, Low Back Pain|

Chiropractic Treatment Helps
Back-Related Leg Pain

The Chiro.Org Blog


Spinal Manipulation and Home Exercise With Advice for Subacute and Chronic Back-Related Leg Pain: A Trial With Adaptive Allocation

SOURCE:   Annals of Internal Medicine 2014 (Sep 16)

Gert Bronfort, DC, PhD; Maria A. Hondras, DC, MPH;
Craig A. Schulz, DC, MS; Roni L. Evans, DC, PhD;
Cynthia R. Long, PhD; and Richard Grimm, MD, PhD

University of Minnesota,
Northwestern Health Sciences University,
and Berman Center for Outcomes and Clinical Research
at the Minneapolis Medical Research Foundation,
Minneapolis, Minnesota, and
Palmer Center for Chiropractic Research,
Davenport, Iowa


Chiropractic Treatment Helps Back-Related Leg Pain

FROM:   MedPage Today ~ September 16, 2014

By Shara Yurkiewicz , Staff Writer, MedPage Today

Patients with back-related leg pain who received spinal manipulative therapy (SMT) plus home exercise and advice (HEA) had less leg pain, lower back pain, and disability after 12 weeks than patients who received home exercise and advice alone, researchers reported.

At 1 year, those differences were no longer significant, wrote Gert Bronfort, DC, PhD, at Northwestern Health Sciences University in Bloomington, Minn., and colleagues in a study appearing in Annals of Internal Medicine. But patients experienced more global improvement, higher satisfaction, and lower medication use, the researchers reported.

The findings suggest that SMT in addition to HEA could be a safe and effective conservative, short-term treatment approach for back-related leg pain, the authors said.

“Prior to this study, SMT was considered a viable treatment option of what is known as ‘uncomplicated low back pain,’ which is low back pain without radiating pain to the leg,” authors Bronfort and Roni Evans, DC, PhD, at the University of Minnesota in Minneapolis, wrote in an email to MedPage Today.

“This study shows that for patients without progressive neurological deficits and serious identifiable causes (e.g., spinal fracture, etc.) SMT, coupled with home exercise and advice, may be helpful, and should be considered,” they added.

Review the Abstract:

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Low Back Pain and Chiropractic Page

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Study offers suggestions on what to do when sex is a pain in the back

By |September 12, 2014|Biomechanics|

Source Canada.com
SHERYL UBELACKER, THE CANADIAN PRESS

10188848

Professor Stuart McGill demonstrates the motion of the spine during sex in a handout photo. Contrary to popular belief, spooning is not always the best sex position for those with a bad back, according to new research from the University of Waterloo. THE CANADIAN PRESS/HO-University of Waterloo

For many people, intimacy in the bedroom often takes a back seat to low back pain, say researchers, who have scientifically determined the best sexual positions to prevent spinal muscles from seizing up at an inopportune moment.

In what they believe is the first biomechanical study of its kind, researchers at the University of Waterloo have found that certain positions are better than others for keeping different kinds of back pain at bay.

And they’ve thrown out the long-held belief that spooning — where partners lie sideways curled back to front — is the only pose for back-saving sex.

“Before now, spooning was often recommended by physicians as the one position that fit all. But as we’ve discovered, that is not the case,” said Natalie Sidorkewicz, a PhD candidate and lead author of the paper published Thursday in the journal Spine.

“What that failed to do was recognize that there are all sorts of triggers for back pain,” she said from Waterloo, Ont. “So someone may find relief in one position that may cause pain for someone else.”

To conduct the study, the researchers recruited 10 heterosexual couples, with an average age of about 30, to have sexual intercourse in a controlled laboratory setting.

Each participant was fitted with remote sensors, which tracked how their spines moved when they engaged in five common sex positions. Infrared and electromagnetic motion capture systems — such as those used to animate figures in video games and films — showed how the men’s and women’s spines flexed when they assumed each position.

“So we were able to actually determine what angle the spine is at, at each moment in time that they’re having sex,” said Sidorkewicz, adding that electrodes on participants’ skin also captured activity in their core and hip muscles.

The findings were used to create an atlas, or set of guidelines, that recommends different sex positions and thrusting techniques based on what movements trigger a patient’s pain.
(more…)

Miss Correct Posture

By |September 12, 2014|Posture|

Source Neatorama and Google Life Archives

 

miss-perfect-posture

In the 50s and 60s, American chiropractors held a series of rather unusual beauty pageants where contestants were judged and winners picked not only by their apparent beauty and poise, but also their standing posture (backed with X-rays of their spines, of course).

The contests were a publicity stunt, Reginal Hug, past president of the Association for the History of Chiropractic, told Scott Hensley of NPR, and was meant to burnish the reputation of the profession. The message, he said, was that good posture led to good health and that chiropractors could help with that. “In those days, nobody was concerned about radiation,” Hug added, noting the use of X-rays to check for spinal structures.miss-correct-posture-3

Why not contests for men? Actually, there were some but they weren’t as popular and didn’t last very long. “The guys always slouched,” Hug added.

Like many things that were hot back in the early 20th century (like flagpole sitting, goldfish swallowing and phone booth stuffing), the popularity of the chiropractic beauty pageant waned. The last big contest was held in Chattanooga, Tennessee, in 1969.

 

miss-correct-posture-5