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Deconstructing Chronic Low Back Pain in the Older Adult –
Part IV: Depression

Chiro.Org Blog: To present the fourth in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. The series presents CLBP as a syndrome, a final common pathway for the expression of multiple contributors rather than a disease localized exclusively to the lumbosacral spine. Each article addresses one of twelve important contributors to pain and disability in older adults with CLBP. This article focuses on depression. […]

Deconstructing Chronic Low Back Pain in the Older Adult –
Part III: Fibromyalgia Syndrome

Chiro.Org Blog: Recognition of FMS as a common contributor to CLBP in older adults and initiating treatment targeting both fibromyalgia syndrome (FMS) and chronic low back pain (CLBP) may lead to improved outcomes in pain and disability. […]

Deconstructing Chronic Low Back Pain in the Older Adult –
Part II: Myofascial

Chiro.Org Blog: We present an algorithm and supportive materials to help guide the care of older adults with MP, an important contributor to chronic low back pain (CLBP). Addressing any perpetuating factors should be the first step of managing myofascial pain (MP). Patients should be educated on self-care approaches, home exercise, and the use of safe analgesics when indicated. Trigger point deactivation can be accomplished by manual therapy, injection therapy, dry needling, and/or acupuncture. […]

Deconstructing Chronic Low Back Pain in the Older Adult –
Part I: Hip Osteoarthritis

Chiro.Org Blog: Hip OA is common and should be evaluated routinely in the older adult with chronic low back pain (CLBP) so that appropriately targeted treatment can be designed. […]

Deconstructing Chronic Low Back Pain in the Older Adult –
Introduction

Chiro.Org Blog: Over the past decade, the estimated prevalence of low back pain (LBP) among older adults (typically defined as those ≥age 65) has more than doubled [1], and the utilization of advanced spinal imaging (e.g., computerized tomography (CT), magnetic resonance imaging [MRI]) and procedures guided by this imaging (e.g., epidural corticosteroids, spinal surgery) have continued to skyrocket. [1-3] Treatment outcomes, however, have not improved apace. Why? Part of the answer lies in the fact that treatment may in part be misdirected. […]

BJ Palmer Adjusting in 1924

Chiro.Org Blog: Film of BJ Palmer Adjusting in 1924 […]

Back and Pelvic Pain in an Underserved United States
Pregnant Population

Chiro.Org Blog: Multi-focal musculoskeletal pain in pregnancy was prevalent in this underserved patient population. The pain in this population negatively affected sleep and treatment appeared inadequate. […]

A Non-surgical Approach to the Management of Lumbar Spinal Stenosis

Chiro.Org Blog: This is a prospective consecutive case series with long term follow up (FU) of fifty-seven consecutive patients who were diagnosed with lumbar spinal stenosis (LSS). Disability was measured using the Roland Morris Disability Questionnaire (RM) and pain intensity was measured using the Three Level Numerical Rating Scale (NRS). Patients were also asked to rate their perceived percentage improvement. […]

Overtreating Chronic Back Pain: Time to Back Off?

Chiro.Org Blog: Chronic back pain is among the most common patient complaints. Its prevalence and impact have spawned a rapidly expanding range of tests and treatments. Some of these have become widely used for indications that are not well validated, leading to uncertainty about efficacy and safety, increasing complication rates, and marketing abuses. […]

Effects of Upper and Lower Cervical Spinal Manipulative Therapy on Blood Pressure

Chiro.Org Blog: The results of this study demonstrate that parasympathetic response was predominant after SMT applied to an upper cervical segment with a significant decrease in systolic BP. As well, a sympathetic response was predominant after SMT of a lower cervical segment in the healthy volunteer group. However, there was decreased sympathetic action with parasympathetic predominance, which was associated with decreased systolic BP and NPS, following both upper and lower cervical SMT in the patient’s group. […]

Morbidity and Mortality of Major Adult Spinal Surgery

Chiro.Org Blog: Major spinal surgery in the adult is associated with a high incidence of intra- and postoperative complications. We identified a very high rate of previously unrecognized postoperative complications, which adversely affect hospital length of stay. […]

Interview With Michael Schneider, DC, PhD,
On A Non-surgical Approach to Spinal Stenosis

Chiro.Org Blog: Michael Schneider, DC, PhD, is an Associate Professor at the School of Health and Rehabilitation Sciences at the University of Pittsburgh.   Schneider was the only chiropractor to receive a grant as part of the Patient Centered Outcomes Research Institute’s (PCORI) first wave of 25 grants, in late 2012.   PCORI was created as an independent entity by the Patient Protection and Affordable Care Act, with a mission to fund high-quality comparative effectiveness research.   The topic of Dr. Schneider’s research is A Comparison of Nonsurgical Treatment Methods for Patients with Lumbar Spinal Stenosis. […]

Chiropractic Spinal Manipulative Therapy for
Cervicogenic Headache

Chiro.Org Blog: Cervicogenic headache (CEH) is a secondary headache which affects 1.0-4.6% of the population. Although the costs are unknown, the health consequences are substantial for the individual; especially considering that they often suffers chronicity. Pharmacological management has no or only minor effect on CEH. Thus, we aim to assess the efficacy of chiropractic spinal manipulative therapy (CSMT) for CEH in a single-blinded placebo-controlled randomized clinical trial (RCT). […]

Life-Threatening Lower Back Pain

Chiro.Org Blog: This article will help clinicians identify life-threatening conditions that present with lower back pain. Intra-abdominal bleed (e.g. aortic aneurysm), infection and tumor are the most dangerous causes of lower back pain and carry the potential for devastating consequences. Table 1 identifies red flags that should raise suspicion of a serious disorder. [1] […]

Vitamins and Nutrients as Primary Treatments
in Experimental Brain Injury

Chiro.Org Blog: With the numerous failures of pharmaceuticals to treat traumatic brain injury in humans, more researchers have become interested in combination therapies. This is largely due to the multimodal nature of damage from injury, which causes excitotoxicity, oxidative stress, edema, neuroinflammation and cell death. Polydrug treatments have the potential to target multiple aspects of the secondary injury cascade, while many previous therapies focused on one particular aspect. Of specific note are vitamins, minerals and nutrients that can be utilized to supplement other therapies. Many of these have low toxicity, are already FDA approved and have minimal interactions with other drugs, making them attractive targets for therapeutics. […]