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Concussion study: UBC’s Thunderbirds use their heads to advance science

Source CBC News

Canadian Chiropractic Research Foundation funds concussion study at the University of British Columbia.

UBC football players are helping advance the science around concussions — using their own heads.

When the Thunderbirds take to the field for the national semi-finals today a number of them will be wearing head sensors that take measurements to help researchers unravel the impact of concussions on athletes.

“What we’re trying to do is get a little more info on what’s occurring in head trauma and football,” said Harrison Brown, a PhD candidate at UBC in Kinesiology.

The study is also uncovering patterns or trends, such as,  “the differences between positions, practices and games, for example,” Brown said.

More than a dozen players, including the starting quarterback and starting running back, volunteered for the study, funded by the Canadian Chiropractic Research Foundation.

Brown said sensors called “xPatches” — an impact sensing patch — are put behind the players’ ears and worn during practices and games.

Researchers study the number, and the intensity, of hits players take, as well as the effects.

So, while the UBC Thunderbirds take on St. Francis Xavier’s X-men in the hopes of advancing to the Vanier Cup, they will advance science no matter what the final score of the game.

The results of the 2-year study are expected next spring.

Sympathetic and Parasympathetic Responses to Specific Diversified Adjustments to Chiropractic Vertebral Subluxations of the Cervical and Thoracic Spine

Sympathetic and Parasympathetic Responses to Specific Diversified Adjustments to Chiropractic Vertebral Subluxations of the Cervical and Thoracic Spine

The Chiro.Org Blog

SOURCE:   J Chiropractic Medicine 2008 (Sep);   7 (3):   86–93

Arlene Welch, DC, Ralph Boone, PhD, DC

Instructor of Clinical Sciences and Health Center Faculty Doctor,
Sherman College of Straight Chiropractic,
Spartanburg, SC 29304

OBJECTIVE:   The aims of this study were to investigate the response of the autonomic nervous system based upon the area of the spine adjusted and to determine if a cervical adjustment elicits a parasympathetic response and if a thoracic adjustment elicits a sympathetic response.

METHODS:   Forty patients (25-55 years old) met inclusion criteria that consisted of normal blood pressure, no history of heart disease, and being asymptomatic. Patients were evaluated pre- and post-chiropractic adjustment for the following autonomic responses: blood pressure and pulse rate. Seven patients were measured for heart rate variability. The subjects received either a diversified cervical segment adjustment or a diversified thoracic segment adjustment.

RESULTS:   Diastolic pressure (indicating a sympathetic response) dropped significantly postadjustment among those receiving cervical adjustments, accompanied by a moderate clinical effect (0.50). Pulse pressure increased significantly among those receiving cervical adjustments, accompanied by a large effect size (0.82). Although the decrease in pulse pressure for those receiving thoracic adjustments was not statistically significant, the decrease was accompanied by a moderate effect size (0.66).

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Chiropractic Scoliosis Rehabilitation Treatment

Results of Chiropractic Scoliosis Rehabilitation Treatment at Two Years Post-skeletal Maturity in Identical Female Twins

The Chiro.Org Blog

SOURCE:   J Bodyw Mov Ther. 2015 (Oct);   19 (4):   592–596

Brian Dovorany, Mark W. Morningstar, Clayton Stitzel, Aatif Siddiqui

Private Practice of Chiropractic Medicine,
2031 S Webster Avenue,
Green Bay, WI 54301, USA

BACKGROUND:   Scoliosis treatment guidelines for non-operative management suggest that patients should be followed for two years beyond skeletal maturity to appropriately evaluate treatment effect. This report outlines the results of identical twin girls’ treatment with chiropractic rehabilitation treatment at two years post skeletal maturity.

FINDINGS:   The twins participated in a treatment lasting two weeks, followed by home care maintenance and periodic follow-ups for they reached skeletal maturity. Two year follow up showed reduced Cobb angles of 19° and 15°, respectively.

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Happy ThanksGiving! (2015)

Happy ThanksGiving! (2015)

The Chiro.Org Blog

To All Our Friends!

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Chiropractic Spinal Manipulative Therapy for Migraine

Chiropractic Spinal Manipulative Therapy for Migraine: A Study Protocol of a Single-blinded Placebo-controlled Randomised Clinical Trial

The Chiro.Org Blog

SOURCE:   BMJ Open. 2015 (Nov 19);   5 (11):   e008095 ~ FULL TEXT

Aleksander Chaibi, Jurate Šaltyte Benth,
Peter J Tuchin, Michael Bjørn Russell

Head and Neck Research Group,
Research Centre, Akershus University Hospital,
Lørenskog, Norway Institute of Clinical Medicine,
Akershus University Hospital,
University of Oslo,
Nordbyhagen, Norway

INTRODUCTION:   Migraine affects 15% of the population, and has substantial health and socioeconomic costs. Pharmacological management is first-line treatment. However, acute and/or prophylactic medicine might not be tolerated due to side effects or contraindications. Thus, we aim to assess the efficacy of chiropractic spinal manipulative therapy (CSMT) for migraineurs in a single-blinded placebo-controlled randomised clinical trial (RCT).

METHOD AND ANALYSIS:   According to the power calculations, 90 participants are needed in the RCT. Participants will be randomised into one of three groups: CSMT, placebo (sham manipulation) and control (usual non-manual management). The RCT consists of three stages: 1 month run-in, 3 months intervention and follow-up analyses at the end of the intervention and 3, 6 and 12 months. The primary end point is migraine frequency, while migraine duration, migraine intensity, headache index (frequency x duration x intensity) and medicine consumption are secondary end points. Primary analysis will assess a change in migraine frequency from baseline to the end of the intervention and follow-up, where the groups CSMT and placebo and CSMT and control will be compared. Owing to two group comparisons, p values below 0.025 will be considered statistically significant. For all secondary end points and analyses, a p value below 0.05 will be used. The results will be presented with the corresponding p values and 95% CIs.

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Natural anti-inflammatory agents for pain relief

Source US National Library of Medicine


The use of both over-the-counter and prescription nonsteroidal medications is frequently recommended in a typical neurosurgical practice. But persistent long-term use safety concerns must be considered when prescribing these medications for chronic and degenerative pain conditions. This article is a literature review of the biochemical pathways of inflammatory pain, the potentially serious side effects of nonsteroidal drugs and commonly used and clinically studied natural alternative anti-inflammatory supplements. Although nonsteroidal medications can be effective, herbs and dietary supplements may offer a safer, and often an effective, alternative treatment for pain relief, especially for long-term use.

Read the full article…


Prediction of Pain Outcomes in a Randomized Controlled Trial of Dose-response of Spinal Manipulation for the Care of Chronic Low Back Pain

Prediction of Pain Outcomes in a Randomized Controlled Trial of Dose-response of Spinal Manipulation for the Care of Chronic Low Back Pain

The Chiro.Org Blog

SOURCE:   BMC Musculoskelet Disord. 2015 (Aug 19);   16:   205 ~ FULL TEXT

Darcy Vavrek, Mitchell Haas,
Moni Blazej Neradilek, and Nayak Polissar

University of Western States,
2900 NE 132nd Ave,
Portland, OR, 97230, USA

BACKGROUND: &nbsp No previous studies have created and validated prediction models for outcomes in patients receiving spinal manipulation for care of chronic low back pain (cLBP). We therefore conducted a secondary analysis alongside a dose-response, randomized controlled trial of spinal manipulation.

METHODS: &nbsp We investigated dose, pain and disability, sociodemographics, general health, psychosocial measures, and objective exam findings as potential predictors of pain outcomes utilizing 400 participants from a randomized controlled trial. Participants received 18 sessions of treatment over 6-weeks and were followed for a year. Spinal manipulation was performed by a chiropractor at 0, 6, 12, or 18 visits (dose), with a light-massage control at all remaining visits. Pain intensity was evaluated with the modified von Korff pain scale (0-100). Predictor variables evaluated came from several domains: condition-specific pain and disability, sociodemographics, general health status, psychosocial, and objective physical measures. Three-quarters of cases (training-set) were used to develop 4 longitudinal models with forward selection to predict individual “responders” (≥50% improvement from baseline) and future pain intensity using either pretreatment characteristics or post-treatment variables collected shortly after completion of care. The internal validity of the predictor models were then evaluated on the remaining 25% of cases (test-set) using area under the receiver operating curve (AUC), R(2), and root mean squared error (RMSE).

RESULTS: &nbsp The pretreatment responder model performed no better than chance in identifying participants who became responders (AUC = 0.479). Similarly, the pretreatment pain intensity model predicted future pain intensity poorly with low proportion of variance explained (R(2) = .065). The post-treatment predictor models performed better with AUC = 0.665 for the responder model and R(2) = 0.261 for the future pain model. Post-treatment pain alone actually predicted future pain better than the full post-treatment predictor model (R(2) = 0.350). The prediction errors (RMSE) were large (19.4 and 17.5 for the pre- and post-treatment predictor models, respectively).

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Chronicles of Health Creation: RAND Report Begs New Look at Integrative Medicine and Health Professionals in the Triple Aim Era

Excerpted from Huffington Post
John Weeks

A recent report from the RAND Corporation describes how regular medicine reduced complementary and alternative medicine professionals to “thing” status — as “modalities” — in the first years of the integrative medicine era.

The title of the report is “Complementary and Alternative Medicine: Professions or Modalities?” The discussions among policy makers, practitioners and delivery system leaders synthesized in the 75-page document beg a more significant question: Does the emergence of values-based medicine urge a major re-think regarding the potential contributions of these professionals?

The case statement by RAND’s Patricia Herman, ND, PhD and Ian Coulter, PhD begins with a blunt irony. “One of the hallmarks of complementary and alternative medicine (CAM) is treatment of the whole person.” Yet in the fee-for-service procedure and production orientation of the medical industry, licensed practitioners of chiropractic, acupuncture and Oriental medicine, and naturopathic medicine were typically stripped of this core value — treating the whole person — before being put to any use.

Regular medicine’s dominant influence when “CAM” integration by medical delivery organizations began in the mid-1990s was the industrial value of service production. Mayo Clinic’s director of innovation captures this concisely when he recently spoke of medicine’s historic focus on “producing” services rather than on “creating health.”

In such an industrial setting, a chiropractor became a thing to be use sparingly. Chiropractor = spinal manipulation for low back pain.

A precedent for this boiling down of a chiropractor’s potential value in human health to thing status was set for chiropractors decades earlier in Medicare. In that even more intransigent fee-for-service era, only adjustment of the spine for low back pain made the grade. Unremunerated was the time that a chiropractor spends in evaluation and management. Most of the chiropractic professional’s education and practice rights were dumped overboard. No value was placed on a chiropractor’s counseling of patients on diet, lifestyle, dietary supplements, or ergonomics, for instance.

Getting into Medicare at all back then was a victory for the field. But a consequence of this limited economic relationship was the rack ’em and crack ’em – as fast as possible method of treatment. Produce!


Breast Cancer and Chiropractic

Breast Cancer and Chiropractic

The Chiro.Org Blog

SOURCE:   ACANews ~ October 2015

By Jeffrey Sklar, DC

Regional Director of Chiropractic for the
Cancer Treatment Centers of America

Well known celebrities discussing their personal challenges with breast cancer has led to frequent media coverage. Primarily, the focus is on the oncological decisions regarding treatment: whether to have radical surgery along with chemo and radiation, just radiation or take a holistic approach. However, there isn’t much attention drawn to Quality of Life (QoL) factors that parallel the breast cancer patient experience.

In other words, treatment decisions and outcomes often seem to shadow the collateral damage experienced by patients who undergo conventional breast cancer treatment. Many premenopausal women face the inevitable decision to take the drug tamoxifen to help prevent recurrence of the disease at the risk of having menopausal-like symptoms. Also, reconstructive post-mastectomies can lead to complications during the healing process and beyond. These complications may include poor wound healing at the site of reconstruction, as well as the tissue donor site. Frozen shoulder is a common occurrence for post-mastectomy, breast reconstruction patients. Many breast cancer patients are forced to look outside their core oncology team to find services that will help with QoL.

It was reported in the Journal of Clinical Oncology that among 453 cancer patients surveyed, 83.3 percent had used at least one complementary alternative medicine (CAM) therapy concurrent with conventional treatment. Another discovery was that 24.7 percent of participants used seven or more CAM therapies. [1]

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Resolution of Recurrent Acute Otitis Media in a Child

Resolution of Recurrent Acute Otitis Media in a Child Undergoing Chiropractic Care: A Case Report

The Chiro.Org Blog

SOURCE:   Journal of Clinical Chiropractic Pediatrics 2015;   15 (1) ~ FULL TEXT

Karine Dunn-Sigouin, DC

Private practice,
Saint-Zotique, Quebec, Canada

Objective:   Discuss the chiropractic management of a pediatric patient suffering from recurrent acute otitis media.

Clinical features:   23-month-old female presenting with 6 acute otitis media episodes since the age of 6 months. Parents are alerted to otitis media symptoms when the child pulls on the ear and cries. Current allopathic treatment consists of antibiotic therapy but episodes of otitis media are still recurrent.

Intervention and outcomes:   The patient received 6 full spine diversified chiropractic adjustments with myofascial release of cervical muscles and effleurage of the frontal and maxillary sinuses over the course of one month. Treatment protocol was then changed to 1 visit per 2 weeks, 1 visit per month and lastly, prevention visits at 1 visit per 2 months or whenever the patient presented with cold symptoms. During the year following the first chiropractic treatment, the patient continued chiropractic care every two months and has had no reoccurrence of AOM.

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Developmental Advancements Following Chiropractic Care
in a Four-year-old Child

Developmental Advancements Following Chiropractic Care in a Four-year-old Child With Dyspraxia and Associated Developmental Delays: A Case Report

The Chiro.Org Blog

SOURCE:   Journal of Clinical Chiropractic Pediatrics 2015; 15 (1) ~ FULL TEXT

Jordenne Troy 1, Tara Dennis 1 and Alice Cade 2 BSc, B Chiro, DICCP

1.   Senior Intern,
New Zealand College of Chiropractic,
Auckland, New Zealand

2.   Lecturer and Intern Mentor,
New Zealand College of Chiropractic,
Auckland, New Zealand

Objective:   To present the chiropractic management of a 4-year-old child diagnosed with dyspraxia and concomitant vertebral subluxations.

Clinical Features:   A four-year-old boy with a history of developmental motor delays was presented by his mother for chiropractic evaluation. The child was previously diagnosed with dyspraxia at one year of age, based on a delay in developmental milestones being met; specifically of speech and fine motor control. The patient was 1.25-years-old before starting to walk and 3-years-old before being able to produce any basic sounds such as “Ma” or “Da”.

At the commencement of chiropractic care the child was undergoing concomitant speech therapy; six weeks of intensive repetitive therapy was the average amount of time required for the patient to learn and retain one new sound or word.

Intervention:   Modified Diversifed (Touch-and-hold) and Sacro-Occipital Techniques were utilized to reduce subluxation indicators through the cranium, upper cervical and lumbopelvic spine. Fifteen adjustments were administered over a 4-month period.

Outcome:   The child experienced a number of developmental advancements over the duration of chiropractic care, specifically in speech, fine motor control and coordination. After 8 visits the patient learned 20 new words in one week, after 12 visits all primitive reflexes were tested to be within normal limits and after 15 visits their vocabulary consisted of hundreds of words and continued to expand.

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Immediate Effects on Pressure Pain Threshold Following a Single Cervical Spine Manipulation in Healthy Subjects

Immediate Effects on Pressure Pain Threshold Following a Single Cervical Spine Manipulation in Healthy Subjects

The Chiro.Org Blog

SOURCE:   J Orthop Sports Phys Ther. 2007 (Jun);   37 (6):   325–329

CéSar Fernández-De-Las-Peñas, PT, PhD, Marta Pérez-De-Heredia, OT,
Miguel Brea-Rivero, OT, Juan C. Miangolarra-Page, MD, PhD

Department of Physical Therapy,
Occupational Therapy,
Physical Medicine and Rehabilitation,
Universidad Rey Juan Carlos,
Alcorcön, Spain

DESIGN:   A placebo, control, repeated-measures, single-blinded randomized study.

OBJECTIVES:   To compare the immediate effects on pressure pain threshold (PPT) tested over the lateral elbow region following a single cervical high-velocity low-amplitude (HVLA) thrust manipulation, a sham-manual application (placebo), or a control condition; and to analyze if a different effect was evident on the side ipsilateral to, compared to the side contralateral to, the intervention.

BACKGROUND:   Previous studies investigating the effects of spinal manual therapy used passive mobilization procedures. There is a lack of studies exploring the effect of cervical manipulative interventions.

METHODS:   Fifteen asymptomatic volunteers (7 male, 8 female; aged 19-25 years) participated in this study. Each subject attended 3 experimental sessions on 3 separate days, at least 48 hours apart. At each session, subjects received either the manipulation, placebo, or control intervention provided by an experienced therapist. The manipulative intervention was directed at the posterior joint of the C5-6 vertebral level. PPT over the lateral epicondyle of both elbows was assessed preintervention and 5 minutes postintervention by an examiner blinded to the treatment allocation of the subject. A 3-way analysis of covariance (ANCOVA) with intervention, side, and time as factors, and gender as covariate, was used to evaluate changes in PPT.

RESULTS:   The analysis of variance detected a significant effect for intervention (F = 31.46, P < .001) and for time (F = 33.81, P < .001), but not for side (F = 0.303, P > .5). A significant interaction between intervention and time (F = 15.74, P < .001) was also found. Gender did not influence the comparative analysis (F = 0.252, P > .6). Post hoc analysis revealed that the application of a HVLA thrust manipulation produced a greater increase of PPT in both elbows, as compared to placebo or control interventions (P < .001). No significant changes in PPT levels were found after the placebo and control interventions (P > .6). Within-group effect sizes were large for PPT levels in both elbows after the manipulative procedure (d > 1.0), but small after placebo or control intervention (d < 0.1).

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Wellness-related Use of Common Complementary Health Approaches Among Adults

Wellness-related Use of Common Complementary Health Approaches Among Adults: United States, 2012

The Chiro.Org Blog

SOURCE:   Natl Health Stat Report. 2015 (Nov 4);   (85):   1–12 ~ FULL TEXT

Barbara J. Stussman, B.A., Lindsey I. Black, M.P.H.,
Patricia M. Barnes, M.A., and Tainya C. Clarke, Ph.D., M.P.H.,
and Richard L. Nahin, Ph.D., M.P.H.

National Institutes of Health
National Center for Health Statistics

Objective   This 12 page National Institutes of Health report presents national estimates of selected wellness-related reasons for the use of natural product supplements, yoga, and spinal manipulation among U.S. adults in 2012. Self-reported perceived health outcomes were also examined.

Methods   Data from 34,525 adults aged 18 and over collected as part of the 2012 National Health Interview Survey were analyzed for this report. In particular, whether adults who used selected complementary health approaches did so to treat a specific health condition or for any of five wellness-related reasons was examined, as well as whether these adults perceived that this use led to any of nine health-related outcomes. Sampling weights were used to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population.

Results   Users of natural product supplements and yoga were more likely to have reported using the approach for a wellness reason than for treatment of a specific health condition, whereas more spinal manipulation users reported using it for treatment rather than for wellness. The most common wellness-related reason reported by users of each of the three approaches was for ‘‘general wellness or disease prevention.’’ The majority of users of all three health approaches reported that they perceived this use improved their overall health and made them feel better. Yoga users perceived higher rates of all of the self-reported wellness-related health outcomes than users of natural product supplements or spinal manipulation.

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Immediate Effects of Spinal Manipulative Therapy on
Myofascial Trigger Points

Immediate Effects of Spinal Manipulative Therapy on Regional Antinociceptive Effects in Myofascial Tissues in Healthy Young Adults

The Chiro.Org Blog

SOURCE:   J Manipulative Physiol Ther. 2013 (Jul);   36 (6):   333–341 ~ FULL TEXT

John Z. Srbely, DC PhD, Howard Vernon, DC, PhD,
David Lee, DC, Miranda Polgar, BSc

Department of Human Health and Nutritional Science,
University of Guelph, Guelph,
Ontario, Canada

OBJECTIVE:   The purpose of this study was to investigate if spinal manipulative therapy (SMT) can evoke immediate regional antinociceptive effects in myofascial tissues by increasing pressure pain thresholds (PPTs) over myofascial trigger points in healthy young adults.

METHODS:   A total of 36 participants (19 men, 17 women; age, 28.0 [5.3] years; body mass index, 26.5 [5.7] kg/m(2)) with clinically identifiable myofascial trigger points in the infraspinatus and gluteus medius muscles were recruited from the University of Guelph, Ontario, Canada. Participants were randomly allocated to 2 groups. Participants in the test group received chiropractic SMT targeted to the C5-C6 spinal segment. Participants in the control group received sham SMT. The PPT was recorded from the right infraspinatus and gluteus medius muscles at baseline (preintervention) and 1, 5, 10, and 15 minutes postintervention.

RESULTS:   Three participants were disqualified, resulting in a total of 33 participants analyzed. Significant increases in the pressure pain thresholds (PPT) [decreased pain sensitivity] were observed in the test infraspinatus group when compared with test gluteus medius, control infraspinatus, and control gluteus medius groups (P < .05). No significant differences in PPT were observed at any time point when comparing test gluteus medius, control infraspinatus, and control gluteus medius groups (P > .05).

CONCLUSIONS:   This study showed that SMT evokes short-term regional increases in PPT within myofascial tissues in healthy young adults.

Key Indexing Terms:   Manipulation, Myofascial Pain Syndrome, Myofascial Trigger Point, Pain Threshold, Chiropractic

From the Full-Text Article:


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Acupuncture and Chiropractic Care Utilization

Acupuncture and Chiropractic Care: Utilization and Electronic Medical Record Capture

The Chiro.Org Blog

SOURCE:   Am J Manag Care. 2015 (Jul 1); 21 (7): e414-21 ~ FULL TEXT

Charles Elder, MD, MPH; Lynn DeBar, PhD, MPH;
Cheryl Ritenbaugh, PhD, MPH; et. al

Kaiser Permanente Northwest,
Center for Health Research,
3800 N Interstate Ave,
Portland, OR 97227

This recent study, published in the American Journal of Managed Care, underscores why so many chiropractic patients have to go “out of network” in order to get the care they need: Managed care appears to be be effectively locking them out. This study reviews chiropractic and acupuncture utilization by adults with chronic musculoskeletal pain at Kaiser Permanente Northwest, an HMO.

Evidently, physician referral for acupuncture is strictly limited to chronic pain complaints, while referral for chiropractic benefits is limited to acute pain. This is why 43-54% of those individuals who sought chiropractic care had to seek “out-of-plan” (aka out-of-pocket) care.

Physician referrals within this Kaiser program was tipped in favor of acupuncture, with 55% of them being referred for care, versus only 9% of the chiropractic patients.

Thanks to Dynamic Chiropractic for their brief review of this study!

OBJECTIVES:   To describe acupuncture and chiropractic use among patients with chronic musculoskeletal pain (CMP) at a health maintenance organization, and explore issues of benefit design and electronic medical record (EMR) capture.

STUDY DESIGN:   Cross-sectional survey.

METHODS:   Kaiser Permanente members meeting EMR diagnostic criteria for CMP were invited to participate. The survey included questions about self-identified presence of chronic musculoskeletal pain, use of acupuncture and chiropractic care, use of ancillary self-care modalities, and communication with conventional medicine practitioners. Analysis of survey data was supplemented with a retrospective review of EMR utilization data.

RESULTS:   Of 6068 survey respondents, 32% reported acupuncture use, 47% reported chiropractic use, 21% used both, and 42% used neither. For 25% of patients using acupuncture and 43% of those using chiropractic care, utilization was undetected by the EMR. Thirty-five percent of acupuncture users and 42% of chiropractic users did not discuss this care with their health maintenance organization (HMO) clinicians. Among chiropractic users, those accessing care out of plan were older (P < .01), were more likely to use long-term opioids (P = .03), and had more pain diagnoses (P = .01) than those accessing care via clinician referral or self-referral. For acupuncture, those using the clinician referral mechanism exhibited these same characteristics.

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