April 2017
« Mar   May »


Please support our Sponsors

Areas of Capsaicin-Induced Secondary Hyperalgesia and Allodynia Are Reduced by a Single Chiropractic Adjustment

Chiro.Org Blog: The results confirmed that topical capsaicin induced inflammatory reactions based on occurrence of hyperalgesia and allodynia, augmented pain perception, and increased blood flow following capsaicin application compared with the control session. When compared with N-SMT, spontaneous pain was rated significantly lower post-SMT (P <.014). In addition, areas of both secondary hyperalgesia and allodynia decreased after SMT (hyperalgesia: P <.007; allodynia: P <.003). However, there was no significant treatment effect for local blood flow. […]

The Influence of Expectation on Spinal Manipulation Induced Hypoalgesia: An Experimental Study in Normal Subjects

Chiro.Org Blog: The current study replicates prior findings of c- fiber mediated hypoalgesia in the lower extremity following SMT and this occurred regardless of expectation. A significant increase in pain perception occurred following SMT in the low back of participants receiving negative expectation suggesting a potential influence of expectation on SMT induced hypoalgesia in the body area to which the expectation is directed. […]

Individual Expectation: An Overlooked, But Pertinent, Factor in the Treatment of Individuals Experiencing Musculoskeletal Pain

Chiro.Org Blog: Physical therapists consider many factors in the treatment of patients with musculoskeletal pain. The current literature suggests expectation is an influential component of clinical outcomes related to musculoskeletal pain for which physical therapists frequently do not account. The purpose of this clinical perspective is to highlight the potential role of expectation in the clinical outcomes associated with the rehabilitation of individuals experiencing musculoskeletal pain. The discussion focuses on the definition and measurement of expectation, the relationship between expectation and outcomes related to musculoskeletal pain conditions, the mechanisms through which expectation may alter musculoskeletal pain conditions, and suggested ways in which clinicians may integrate the current literature regarding expectation into clinical practice. […]

A Regional Interdependence Model of Musculoskeletal Dysfunction

Chiro.Org Blog: The revised definition of RI refers to the concept and clinical model that a patient’s primary musculoskeletal symptom(s) may be directly or indirectly related to or influenced by impairments from various body systems regardless of proximity to the primary symptom(s). Although initial local treatment of a patient’s primary complaint is typically a first step in clinical management, RI is a model that may be helpful in identifying treatment strategies for recalcitrant and persistent symptoms that may be due to associated functional limitations and impairments in more distant body regions as well as other body systems. The model of RI is in its infancy and will no doubt change and evolve as our understanding is informed from the results of future, formal investigations. The model presented in this paper is meant to serve as a framework for clinicians and researchers alike as they seek to identify the factors that may contribute to a patient’s impairments as well as for stimulating future research. […]

Prevalence of Low Back Pain in Adolescents
with Idiopathic Scoliosis

Chiro.Org Blog: The results of this systematic review indicate that adolescents with idiopathic scoliosis frequently experience low back pain. However, there was insufficient evidence to confidently estimate low back pain prevalence in adolescents with idiopathic scoliosis and further studies are needed in this area. […]

Elevated Production of Inflammatory Mediators Including Nociceptive Chemokines in Patients With Neck Pain: A Cross-Sectional Evaluation

Chiro.Org Blog: The role of inflammatory mediators in the genesis of persistent pain and hyperalgesia has been recently explored in different clinical and experimental models. [1, 2] In certain clinical conditions associated with chronic pain, proinflammatory cytokine levels appear to correlate with pain intensity. [3] However, the involvement of chemical mediators of inflammation in the pathology of chronic and/or acute spinal pain remains unclear despite localization of inflammatory cytokines such as tumor necrosis factor α (TNF-α), interleukin (IL)- 1β, and IL-6 both in intervertebral disc specimens [4-6] and in facet joint tissues of degenerating lumbar spine. [7, 8] […]

Elevated Production of Nociceptive CC-chemokines and sE-selectin in Patients with Low Back Pain and the Effects of Spinal Manipulation: A Non-randomized Clinical Trial

Chiro.Org Blog: The production of chemotactic cytokines is significantly and protractedly elevated in LBP patients. Changes in chemokine production levels, which might be related to SMT, differ in the acute and chronic LBP patient cohorts. […]

Workers’ Compensation, Return to Work, and Lumbar Fusion for Spondylolisthesis

Chiro.Org Blog: This is an interesting follow-up to a 2011 study drawn from the Ohio Bureau of Workers’ Compensation database. [Startling New Study Reveals That Back Surgery Fails 74% of the Time] In the 2011 study, two years AFTER surgery, only 26 percent had returned to work. That translates to a resounding 74% failure rate! In this current study, researchers reviewed the files of 686 workers who underwent fusion surgery for spondylolisthesis between 1993 and 2013, revealing that only 29.9% of them ever returned to work (for at least 6 months). The failure rate (meaning return-to-work) was 70.1%. […]

A Qualitative Study of Changes in Expectations Over Time Among Patients with Chronic Low Back Pain Seeking Four CAM Therapies

Chiro.Org Blog: Participants seeking one of four CAM therapies focused most of their expectations and hopes during initial interviews on whether or not the treatment could lessen their pain. In later interviews, where self-care was included in the interview guide, emphasis tended to be broader, shifting from needing to be “fixed” to an emphasis on the body as a work in progress, in need of ongoing attention and care from both the patient and the CAM practitioner. This trend toward attention to management, self-care and wellness, and increased acceptance of pain as chronic, was reported by participants seeking all four therapies. We also noted that this overall shift over time was evaluated in various ways by participants, depending on how they were able to orient their sense of self and understanding of illness toward ongoing management and engagement. […]

Provider and Patient Perspectives on Opioids and Alternative Treatments for Managing Chronic Pain

Chiro.Org Blog: These results suggest that education about realistic expectations for chronic pain management and therapy options, as well as making acupuncture and chiropractic (A/C) care more easily accessible, might lead to more satisfaction for patients and providers, and provide important input to policy makers. […]

Characteristics of Chiropractic Practitioners, Patients, and Encounters in Massachusetts and Arizona

Chiro.Org Blog: Data for 2,550 chiropractic patient visits were recorded. Care for low back, head and neck pain accounted for almost three quarters of visits. Extremity conditions and wellness care accounted for approximately half of the remaining visits. Spinal and soft tissue examinations were the most frequently reported diagnostic procedures (80% and 56% of visits, respectively), and high-velocity spinal manipulation techniques were the most frequently reported therapeutic procedures (almost 85% of visits). Rehabilitation exercises, thermal modalities, electric stimulation, and counseling/education/self-care were each performed during approximately 25% of visits. Approximately 85% of patients seen were self-referred, whereas only approximately 5% came from medical physicians. Approximately 35% of visits had an expected source of payment directly from the patient. Approximately 80% of visits ended with a plan for the patient to return at a specified time. […]

Do Older Adults with Chronic Low Back Pain Differ from Younger Adults in Regards to Baseline Characteristics and Prognosis?

Chiro.Org Blog: A total of 14,479 participants were included in the study. Of these 3,087 (21%) patients were older adults, 6,071 (42%) were middle aged and 5,321 (37%) were young adults. At presentation older adults were statistically different to the middle aged and younger adults for most characteristics measured (e.g. less intense back pain, more leg pain and more depression); however, the differences were small. The change in pain and disability over 12 months did not differ between age groups. […]

Knowledge Transfer within the Canadian Chiropractic Community. Part 2: Narrowing the Evidence-Practice Gap

Chiro.Org Blog: In Part 1 of this series, [3] we presented an overview of the barriers that impede successful knowledge translation (KT) in the chiropractic profession. Now in Part 2, we provide an overview of KT strategies followed by a discussion of relevant KT efforts in the Canadian chiropractic community. This discussion will lead to a long-term vision of KT for Canadian chiropractic with suggestions to where KT can be applied or where current efforts can be augmented. The overall goal of this article is to present potential strategies for successful KT implementation in order to reduce the gap between current best evidence and its application in chiropractic practice. […]

Knowledge Transfer within the Canadian Chiropractic Community. Part 1: Understanding Evidence-Practice Gaps

Chiro.Org Blog: This two-part commentary aims to provide a basic understanding of knowledge translation (KT), how KT is currently integrated in the chiropractic community and our view of how to improve KT in our profession. Part 1 presents an overview of KT and discusses some of the common barriers to successful KT within the chiropractic profession. Part 2 will suggest strategies to mitigate these barriers and reduce the evidence-practice gap for both the profession at large and for practicing clinicians. […]

Spinal Pain in Danish School Children –
How Often and How Long?

Chiro.Org Blog: Although rates of spinal pain report were high, for most children the pain was short-lived and did not recur frequently. Of concern though, was the rather substantial number of children who reported either persistent or recurrent pain. In at least a quarter of those with spinal pain, the episodes lasted for more than 4 weeks and/or occurred three times or more during a study year. It is towards this group that a concerted research effort is needed to inform evidence-based prevention and management. […]