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Monthly Archives: September 2017

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Looking Ahead: Chronic Spinal Pain Management

By |September 13, 2017|Low Back Pain|

Looking Ahead: Chronic Spinal Pain Management

The Chiro.Org Blog


SOURCE:   Journal of Pain Research 2017 (Aug 30); 10: 2089–2095

Gregory F Parkin-Smith, Stephanie J Davies,
Lyndon G Amorin-Woods

School of Health Professions,
Murdoch University,
Perth, WA, Australia


The other day, we oversaw a seminar on pain management for a local consumer pain group, where all consumers (patients) in attendance were experiencing chronic, persistent spinal pain. Each person had a unique story, and their experience and perceived cause of their pain differed. The quality of life in all these consumers was markedly reduced, which was the only clear similarity, confirming that there may be some similarities in the pain experience, but the pain experience was more often unique and individual. These consumers’ criticisms of care services were consistent, however, with dissatisfaction with their access to care and overall management of their pain. They described variable and often difficult access, limited continuity of care, they were often not taken seriously by health care providers, they received scant information about chronic pain and its prognosis and there were often noteworthy variations in the treatment they received. We agree that these criticisms are commonplace and a frequent gripe directed at health care practitioners about the “system.” [1] Moreover, the problems associated with care delivery are confounded by a number of patient/consumer factors, such as lifestyle habits, nutrition, body weight, depression, health literacy, geographical isolation and poor socioeconomic conditions, making the management of persistent pain even more complicated. [2] There is no doubt that, in the future, matching the care service and treatment with the individual patient will become an essential component of care services, as has been implied in published research. [3-6]

Health care practitioners involved in the triage and management of patients with persistent spinal pain will need to become more vigilant about individualizing and coordinating care for each patient, to achieve the best possible outcomes. For example, Cecchi et al concluded that patients with chronic (persistent) lower baseline pain (LBP)-related disability predicted “nonresponse” to standard physiotherapy, but not to spinal manipulation (an intervention commonly employed by chiropractors [7-9]), implying that spinal manipulation should be considered as a first-line conservative treatment. [9] We note that spinal manipulation is now suggested as the first-line intervention by Deyo, [10] since not a single study examined in a recent systematic review found that spinal manipulation was less effective than conventional care. [11]

Garcia et al, [12] conversely, showed that high pain intensity may be an important treatment effect modifier for patients with chronic low back pain receiving Mckenzie therapy (a treatment frequently used by physiotherapists). These examples demonstrate the importance of matching treatments with the characteristics of the patient.

There are more articles like this @ our:

Low Back Pain and Chiropractic Page

and the:

Chiropractic and Spinal Pain Management

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Chronic Neck Pain Patients With Traumatic or Non-traumatic Onset: Differences in Characteristics

By |September 8, 2017|Chronic Neck Pain|

Chronic Neck Pain Patients With Traumatic or Non-traumatic Onset: Differences in Characteristics.
A Cross-sectional Study

The Chiro.Org Blog


SOURCE:   Scand J Pain. 2017 (Jan); 14: 1-8

Inge Ris, Birgit Juul-Kristensen, Eleanor Boyle,
Alice Kongsted, Claus Manniche, Karen Søgaard

Research Unit for Musculoskeletal Function and Physiotherapy,
Department of Sports Science and Clinical Biomechanics,
University of Southern Denmark,
Campusvej 55, 5230 Odense M, Denmark;


BACKGROUND AND AIMS:   Patients with chronic neck pain can present with disability, low quality of life, psychological factors and clinical symptoms. It is unclear whether patients with a traumatic onset differ from those with a non-traumatic onset, by having more complex and severe symptoms. The purpose of this study was to investigate the clinical presentation of chronic neck pain patients with and without traumatic onset by examining cervical mobility, sensorimotor function, cervical muscle performance and pressure pain threshold in addition to the following self-reported characteristics: quality of life, neck pain and function, kinesiophobia, depression, and pain bothersomeness.

METHODS:   This cross-sectional study included 200 participants with chronic neck pain: 120 with traumatic onset and 80 with non-traumatic onset. Participants were recruited from physiotherapy clinics in primary and secondary health care. For participants to be included, they were required to be at least 18 years of age, have had neck pain for at least 6 months, and experienced neck-related activity limitation as determined by a score of at least 10 on the Neck Disability Index. We conducted the following clinical tests of cervical range of motion, gaze stability, eye movement, cranio-cervical flexion, cervical extensors, and pressure pain threshold. The participants completed the following questionnaires: physical and mental component summary of the Short Form Health Survey, EuroQol-5D, Neck Disability Index, Patient-Specific Functional Scale, Pain Bothersomeness, Beck Depression Inventory-II, and TAMPA scale of kinesiophobia. The level of significance for all analyses was defined as p<0.01. Differences between groups for the continuous data were determined using either a Student’s t-test or Mann Whitney U test.

RESULTS:   In both groups, the majority of the participants were female (approximately 75%). Age, educational level, working situation and sleeping patterns were similar in both groups. The traumatic group had symptoms for a shorter duration (88 vs. 138 months p=0.001). Participants in the traumatic group showed worse results on all measures compared with those in the non-traumatic group, significantly on neck muscle function (cervical extension mobility p=0.005, cranio-cervical flexion test p=0.007, cervical extensor test p=0.006) and cervical pressure pain threshold bilateral (p=0.002/0.004), as well on self-reported function (Neck Disability Index p=0.001 and Patient-Specific Functional Scale p=0.007), mental quality of life (mental component summary of the Short Form Health Survey p=0.004 and EuroQol-5D p=0.001) and depression (Beck Depression Inventory-II p=0.001).

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Chronic Neck Pain and Chiropractic Page

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An Observational Study on Recurrences of Low Back Pain During the First 12 Months After Chiropractic Treatment

By |September 7, 2017|Recurrent Low Back Pain|

An Observational Study on Recurrences of Low Back Pain During the First 12 Months After Chiropractic Treatment

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2017 (Jul); 40 (6): 427–433

Christina Knecht, BMed,
Barry Kim Humphreys, DC, PhD,
Brigitte Wirth, PT, MSc, PhD

Chiropractic Medicine Department,
Faculty of Medicine,
University of Zürich and University Hospital Balgrist,
Zürich, Switzerland.


OBJECTIVES:   The purpose of this study was to investigate recurrence rate and prognostic factors in a large population of patients with low back pain (LBP) up to 1 year after chiropractic care using standardized definitions.

METHODS:   In Switzerland, 722 patients with LBP (375 male; mean age = 44.5 ± 13.8 years) completed the Numeric Rating Scale for pain (NRS) and the Oswestry Disability Index (ODI) before treatment and 1, 3, 6, and 12 months later (ODI up to 3 months). Based on NRS values, patients were categorized as “fast recovery,” “slow recovery,” “recurrent,” “chronic,” and “others.” In multivariable logistic regression models, age, sex, work status, duration of complaint (subacute: ≥14 days to <3 months; chronic: ≥3 months), previous episodes, baseline NRS, and baseline ODI were investigated as predictors.

RESULTS:   Based on NRS values, 13.4% of the patients were categorized as recurrent. The recurrent pattern significantly differed from fast recovery in duration of complaint (subacute: odds ratio [OR] = 3.3; chronic: OR = 10.1). The recurrent and chronic pattern significantly differed in duration of complaint (chronic: OR = 0.14) and baseline NRS (OR = 0.75).

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Low Back Pain and Chiropractic Page

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Can Neurotransmitter Status Affect the Results of Exercise-Based Scoliosis Treatment?

By |September 6, 2017|Scoliosis|

Can Neurotransmitter Status Affect the Results of Exercise-Based Scoliosis Treatment? Results of a Controlled Comparative Chart Review

The Chiro.Org Blog


SOURCE:   Alternative & Integrative Medicine 2014 (Nov 20); 3: 177

Mark W Morningstar, Aatif Siddiqui,
Brian Dovorany and Clayton J Stitzel

Natural Wellness & Pain Relief Center
8293 Office Park Dr.,
Grand Blanc, MI 48439, USA


Idiopathic scoliosis has long been held as a purely orthopedic spinal deformity without a known origin. Hence all treatment of scoliosis has involved physical methods exclusively to treat the condition, whether by bracing, surgery, or exercise-based methods. Over the last several years many authors have introduced etiological concepts of scoliosis involving multiple biochemical central nervous system pathways, such as neurotransmitter imbalances. The purpose of this study is to evaluate how these neurotransmitter imbalances affect patients’ ability to participate in a scoliosis therapy program and the ability of the resultant radiographic changes to be maintained. Two groups of patients performed baseline neurotransmitter testing, and completed a short-term chiropractic rehabilitation program for scoliosis. One group additionally participated in a nutrient program designed to rebalance their neurotransmitter levels, while the second group declined. Both groups were evaluated 6 months after the completion of their rehabilitation program to evaluate Cobb angle changes

Keywords   Chiropractic; Nutrition; Scoliosis; Spine; Rehabilitation


From the Full-Text Article:

Introduction:

Scoliosis is historically thought of as a purely biomechanical or orthopedic disorder of the spine wherein the spine curves greater than 10 degrees on radiographic assessment. [1] Conventional treatments of scoliosis have been entirely based upon this model of scoliosis, whether it be bracing or surgery. Both of these treatments entirely focus upon the spine curvature, and attempt to straighten or stabilize the spine throughout the human growing years.

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Chiropractic Treatments for Idiopathic Scoliosis: A Narrative Review Based on SOSORT Outcome Criteria

By |September 5, 2017|Scoliosis|

Chiropractic Treatments for Idiopathic Scoliosis: A Narrative Review Based on SOSORT Outcome Criteria

The Chiro.Org Blog


SOURCE:   J Chiropractic Medicine 2017 (Mar); 16 (1): 64–71

Mark W. Morningstar, DC, PhD, Clayton J. Stitzel, DC,
Aatif Siddiqui, DC, Brian Dovorany, DC

Natural Wellness & Pain Relief Center,
Grand Blanc, MI.


OBJECTIVE:   The purpose of this review was to evaluate the current body of literature on chiropractic treatment of idiopathic scoliosis against the 2014 consensus paper of the Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) and the Scoliosis Research Society (SRS) Non-Operative Management Committee for outcome reporting in nonoperative treatments.

METHODS:   A search of the PubMed and Index to Chiropractic Literature databases for studies published from January 2000 through February 2016 detailing specific treatments and outcomes for idiopathic scoliosis was conducted.

RESULTS:   A total of 27 studies that discussed chiropractic scoliosis treatments were identified. Of these, there were 15 case reports, 10 case series, 1 prospective cohort, and 1 randomized clinical trial. Of the 27 studies, only 2 described their outcomes as recommended in the 2014 SOSORT and SRS Non-Operative Management Committee consensus paper.

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Scoliosis and Chiropractic Page

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