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Monthly Archives: May 2017

Elon Musk’s chiropractic connection

By |May 16, 2017|History, Uncategorized|

Source Regina Leader-Post

Dr. Scott Haldeman is a board certified Neurologist in active clinical practice in Santa Ana, California. He currently is a distinguished Professor at the University of California, the Chairman of the Research Council for the World Federation of Chiropractic and the Founder/President of World Spine Care.


Accomplished in his own right, he also happens to be the uncle of one of the worlds great innovators, Elon Musk. Read how the young Musk spent time on the Haldeman family farm in Saskatchewan. Both Scott’s father and his grandmother (Musk’s great-grandmother) were chiropractors. In fact, Almeda Haldeman became Canada’s first known chiropractor in the early 1900’s.

You can read the rest of the story here.

Information on the Haldeman’s and other chiropractic pioneers can be found in Dr J.C. Keating’s notes in our Chiropractic History section.

Take the Guideline Challenge

By |May 16, 2017|Clinical Guidelines, Low Back Pain|

Take the Guideline Challenge

The Chiro.Org Blog

SOURCE:   ACA News ~ May 15, 2017

By Christine Goertz, DC, PhD

Dr. Goertz is senior scientific advisor for the ACA. She also serves as vice chancellor for research and health policy at Palmer College of Chiropractic and is the CEO of the Spine Institute for Quality (Spine IQ)

In my last blog post, I talked about the unprecedented opportunity the chiropractic profession has to make a critical difference in areas of great public health impact, such as low back pain. I strongly believe that if we do the right thing right now, the chiropractic profession is uniquely positioned to significantly impact the quality of spine care delivery, increasing access to chiropractic care for millions of patients who desperately need conservative treatment for spine-related conditions. The flipside is that if we don’t take right action now, chiropractic risks becoming a marginalized profession that’s on the outside looking in as other health care providers take ownership of musculoskeletal conditions and spinal manipulation.

So what is right action? Recently, I asked this question of several of my colleagues who influence policy at the highest levels of research and/or health care delivery in the United States. One of those people was Francis Collins, MD, PhD, director of the National Institutes of Health. [1] Dr. Collins responded by saying:

Chiropractic’s commitment to evidence-based practice and to addressing gaps in the scientific basis of chiropractic care is vital for the progress of the field. Robust research on the safety and effectiveness of chiropractic therapies in the management of common musculoskeletal complaints must continue to be a high priority for the profession. Advancing evidence-based chiropractic care will further the integration of chiropractic into medical systems at a time when the need for effective approaches to improve outcomes for patients with chronic pain could not be more pressing.

There are more articles like this @ our:

Low Back Pain Guidelines Page and the:

Best Practices in Chiropractic Page


Clinical Classification in Low Back Pain: Best-evidence Diagnostic Rules Based on Systematic Reviews

By |May 15, 2017|Clinical Decision Rule, Clinical Decision-making|

Clinical Classification in Low Back Pain: Best-evidence Diagnostic Rules Based on Systematic Reviews

The Chiro.Org Blog

SOURCE:   BMC Musculoskelet Disord. 2017 (May 12); 18 (1): 188

Tom Petersen, Mark Laslett and
Carsten Juhl

Back Center Copenhagen,
Mimersgade 41, 2200,
Copenhagen N, Denmark.

A clinical decision rule “is a clinical tool that quantifies the individual contributions that various components of the history, physical examination, and basic laboratory results make toward the diagnosis, prognosis, or likely response to treatment in a patient. Clinical decision rules attempt to formally test, simplify, and increase the accuracy of clinicians’ diagnostic and prognostic assessments”   [23].

This is probably the best and most comprehensive review you will read this year, as it drills down into the findings and treatment of:

  • Intervertebral disc issues
  • Facet joint issues
  • Sacroiliac joint
  • Nerve root involvement
  • Spinal stenosis
  • Spondylolisthesis
  • Fracture
  • Myofascial pain
  • Peripheral nerve issues
  • Central sensitization

Take the time and enjoy this extensive review

BACKGROUND:   Clinical examination findings are used in primary care to give an initial diagnosis to patients with low back pain and related leg symptoms. The purpose of this study was to develop best evidence Clinical Diagnostic Rules (CDR] for the identification of the most common patho-anatomical disorders in the lumbar spine; i.e. intervertebral discs, sacroiliac joints, facet joints, bone, muscles, nerve roots, muscles, peripheral nerve tissue, and central nervous system sensitization.

METHODS:   A sensitive electronic search strategy using MEDLINE, EMBASE and CINAHL databases was combined with hand searching and citation tracking to identify eligible studies. Criteria for inclusion were: persons with low back pain with or without related leg symptoms, history or physical examination findings suitable for use in primary care, comparison with acceptable reference standards, and statistical reporting permitting calculation of diagnostic value. Quality assessments were made independently by two reviewers using the Quality Assessment of Diagnostic Accuracy Studies tool. Clinical examination findings that were investigated by at least two studies were included and results that met our predefined threshold of positive likelihood ratio ≥ 2 or negative likelihood ratio ≤ 0.5 were considered for the CDR.

RESULTS:   Sixty-four studies satisfied our eligible criteria. We were able to construct promising CDRs for symptomatic intervertebral disc, sacroiliac joint, spondylolisthesis, disc herniation with nerve root involvement, and spinal stenosis. Single clinical test appear not to be as useful as clusters of tests that are more closely in line with clinical decision making.

There are more articles like this @ our:

Clinical Prediction Rule Page and the:

Low Back Pain and Chiropractic Page


Joint Manipulation: Toward a General Theory of High-Velocity, Low-Amplitude Thrust Techniques

By |May 14, 2017|Chiropractic Technique|

Joint Manipulation: Toward a General Theory of High-Velocity, Low-Amplitude Thrust Techniques

The Chiro.Org Blog

SOURCE:   J Chiropractic Humanities 2017 (Mar); 20 (1): 1–9

Andrew S. Harwich, D.O.

The Bridge House Practice,
154 Caledonian Road,
Kings Cross, London, UK, N1 9RD

Objective   The objective of this study was to describe the initial stage of a generalized theory of high-velocity, low-amplitude thrust (HVLAT) techniques for joint manipulation.

Methods   This study examined the movements described by authors from the fields of osteopathy, chiropractic, and physical therapy to produce joint cavitation in both the metacarpophalangeal (MCP) joint and the cervical spine apophysial joint. This study qualitatively compared the kinetics, the similarities, and the differences between MCP cavitation and cervical facet joint cavitation. A qualitative vector analysis of forces and movements was undertaken by constructing computer-generated, simplified graphical models of the MCP joint and a typical cervical apophysial joint and imposing the motions dictated by the clinical technique.

Results   Comparing the path to cavitation of 2 modes of HVLAT for the MCP joint, namely, distraction and hyperflexion, it was found that the hyperflexion method requires an axis of rotation, the hinge axis, which is also required for cervical HVLAT. These results show that there is an analogue of cervical HVLAT in one of the MCP joint HVLATs.

There are more articles like this @ our:

Chiropractic Technique Page


AMI Model Working in Florida: Functional Improvements, Reduced Utilization Costs by Medicaid Patients

By |May 12, 2017|Chiropractic Care, Integrative Care|

AMI Model Working in Florida: Functional Improvements, Reduced Utilization Costs
by Medicaid Patients

The Chiro.Org Blog

SOURCE:   Dynamic Chiropractic

Background:   Alternative Medicine Integration (AMI) originally achieved recognition within the chiropractic community for its unique HMO model that utilized doctors of chiropractic as primary-care physicians (PCPs) and the portal of entry into an integrated health care delivery system, inclusive of hospitals, MDs and MD specialists and outpatient facilities. Contracted with Blue Cross Blue Shield’s HMO-Illinois, AMI’s integrated IPA demonstrated excellent clinical and cost outcomes.

These outcomes were published in the June 2007 issue of JMPT and reviewed in the June 4, 2007 issue of DC. [1] In July 2007, AMI received the national endorsement of the Congress of Chiropractic State Associations (COCSA) for its outcomes-based model of chiropractic medical management.

AMI also has been documenting the clinical and cost outcomes of its holistic, patient-centered disease management program for chronic pain patients enrolled in the Florida Medicaid system. While pharmaceutically oriented disease-management programs for diabetes, hypertension, COPD and heart disease have become staples of compliance-driven, cost-containment measures offered by insurance companies and managed-care organizations, largely unnoticed by media and consumers is the growth of costs associated with chronic pain, which has become the number-one cost driver for Medicaid and the commercial populations. Coupled with the national health care trend of increased pharmaceutical usage and its associated issues of prescription drug complications, contraindications, addiction to painkillers and accidental death inherent and measurable within the conventional medical model, treatment costs for chronic pain-related diagnoses continue to escalate.

AMI’s initial three-year findings suggest integrating complementary and alternative medicine with conventional care management approaches in the Florida Medicaid system reduces the cost of care for the payer and improves the quality of life for the patient. All indications point to the conclusion that an integrative approach to treating the “whole” person is effective in this patient population.

To chiropractors and other practitioners of natural medicine, this is not a surprise. Chances are you have anecdotal stories of patient improvement within this vulnerable and challenging population. However, what is noteworthy is that since April 2004, AMI has successfully worked with the state of Florida to provide services to those beneficiaries who have been diagnosed with chronic fatigue syndrome, chronic back pain, chronic neck pain and/or fibromyalgia. AMI’s holistic nurse case managers integrate the conventional medical care these beneficiaries receive with CAM services from providers including chiropractors, acupuncturists, massage therapists, nutritionists, pharmacists and registered nurse care managers.

There are more articles like this @ our:

Integrated Health Care and Chiropractic Page and the:

Chiropractic and Spinal Pain Management Page


An Integrated Approach to Chronic Pain

By |May 11, 2017|Chiropractic Care, Integrative Care|

An Integrated Approach to Chronic Pain

The Chiro.Org Blog

SOURCE:   Dynamic Chiropractic ~ May 2017

By Peter W. Crownfield, Executive Editor

A Rhode Island Medicaid pilot program is yielding
significant benefits and savings.

Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state’s Department of Health, [1] demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.

Since 2012, Rhode Island Medicaid “Community of Care” enrollees suffering from chronic pain have participated in an integrated chronic pain program administered by Advanced Medicine Integration. Longtime readers will recall that for nearly two decades, AMI has been coordinating chiropractic and integrated care services in various states to help address the chronic pain epidemic in a community-based, integrated fashion. [2-3]

AMI’s integrated chronic pain program is designed to “reduce pain levels, improve function and overall health outcomes, reduce emergency room costs, and through a holistic approach and behavioral change models, educate members in self-care and accountability.”

The program features holistic nurse case management with referrals to CAM providers including chiropractors, massage therapists and acupuncturists; and patient education including stress-reduction tips and more.

There are more articles like this @ our:

Chiropractic and Spinal Pain Management