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First-Contact Care With a Medical vs Chiropractic Provider

First-Contact Care With a Medical vs Chiropractic Provider After Consultation With a Swiss Telemedicine Provider: Comparison of Outcomes, Patient Satisfaction, and Health Care Costs in Spinal, Hip, and Shoulder Pain Patients

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2015 (Aug 15)] ~ FULL TEXT

Taco A.W. Houweling, DC, MRes, PhD, Andrea V. Braga, MD, MBA,
Thomas Hausheer, DC, arco Vogelsang, DC,
Cynthia Peterson, RN, DC, MMedEd,
B. Kim Humphreys, DC, PhD

Postdoctoral Research Fellow,
Department of Chiropractic Medicine,
University Hospital Balgrist, Forchstrasse 340, 8008
Zürich, Switzerland.
taco.houweling@balgrist.ch


OBJECTIVE:   The purpose of this study was to identify differences in outcomes, patient satisfaction, and related health care costs in spinal, hip, and shoulder pain patients who initiated care with medical doctors (MDs) vs those who initiated care with doctors of chiropractic (DCs) in Switzerland.

METHODS:   A retrospective double cohort design was used. A self-administered questionnaire was completed by first-contact care spinal, hip, and shoulder pain patients who, 4 months previously, contacted a Swiss telemedicine provider regarding advice about their complaint. Related health care costs were determined in a subsample of patients by reviewing the claims database of a Swiss insurance provider.

RESULTS:   The study sample included 403 patients who had seen MDs and 316 patients who had seen DCs as initial health care providers for their complaint. Differences in patient sociodemographic characteristics were found in terms of age, pain location, and mode of onset. Patients initially consulting MDs had significantly less reduction in their numerical pain rating score (difference of 0.32) and were significantly less likely to be satisfied with the care received (odds ratio = 1.79) and the outcome of care (odds ratio = 1.52). No significant differences were found for Patient’s Global Impression of Change ratings. Mean costs per patient over 4 months were significantly lower in patients initially consulting DCs (difference of CHF 368; US $368).

There are more articles like this @ our:

Low Back Pain and Chiropractic Page

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The Shoulder Girdle & Chiropractic Page

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Chiropractic Physicians Call for Conservative Treatments for Pain Management Amid Prescription Painkiller Epidemic

Source American Chiropractic Association

American Chiropractic Association launches 2015 public awareness campaign aimed at curbing opioid overuse and abuse

During National Chiropractic Health Month (NCHM) in October, the American Chiropractic Association (ACA) will work with thousands of doctors of chiropractic (DCs), chiropractic assistants (CAs) and chiropractic doctoral students nationwide to bring attention to the public health crisis caused by pain, and in particular the overuse of prescription painkillers, with this year’s theme #PainFreeNation. The campaign is part of the profession’s ongoing efforts to educate the public about the value of exhaustingconservative forms of care for both acute and chronic pain before resorting to higher risk options, such as opioids.

“Opioid medications involve the risk of overuse and addiction. Beyond the risks of overuse and addiction, prescription drugs that numb pain may convince a patient that a musculoskeletal condition is less severe than it is, or that it has healed. This misunderstanding can lead to overexertion and a delay in the healing process or even to permanent injury,” said ACA President Anthony Hamm, DC.

President Hamm noted that people in pain should be informed of all management strategies, including non-drug approaches such as chiropractic, to reduce their risk of overuse and addiction.

Each patient is unique, and care plans should be tailored to focus on what is the safest, most effective treatment for the individual. Chiropractic physicians stand ready to work together with medical physicians to help address this epidemic that has caused unnecessary suffering, enormous loss of human potential and massive financial and personal costs,” he added.

Fortunately, health care quality organizations have begun to recognize the value of this conservative, multidisciplinary approach. Earlier this year, the Joint Commission, which certifies more than 20,000 health care organizations and programs in the United States, including every major hospital, revised its pain management standard to include chiropractic services and acupuncture. Clinical experts in pain management who provide input to the commission’s standards affirmed that treatment strategies may consider both pharmacologic and nonpharmacologic approaches.   

 

During NCHM this fall, ACA will offer chiropractic physicians resources to help them share information about their conservative approach and why it is especially significant to today’s health care consumers amidst the opioid epidemic.

Craniocervical Chiropractic Procedures –
A Précis of Upper Cervical Chiropractic

Craniocervical Chiropractic Procedures –
A Précis of Upper Cervical Chiropractic

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc 2015 (Jun);   59 (2):   173–192 ~ FULL TEXT

H. Charles Woodfield, III, BPhm, DC, Craig York, DC.
Roderic P. Rochester, DC, Scott Bales, DC,
Mychal Beebe, DC, Bryan Salminen, DC,
Jeffrey N. Scholten, DC .

Director of Research –
Upper Cervical Research Foundation,
Minneapolis, MN


Presented here is a narrative review of upper cervical procedures intended to facilitate understanding and to increase knowledge of upper cervical chiropractic care. Safety, efficacy, common misconceptions, and research are discussed, allowing practitioners, chiropractic students, and the general public to make informed decisions regarding utilization and referrals for this distinctive type of chiropractic care. Upper cervical techniques share the same theoretical paradigm in that the primary subluxation exists in the upper cervical spine. These procedures use similar assessments to determine if spinal intervention is necessary and successful once delivered. The major difference involves their use of either an articular or orthogonal radiograph analysis model when determining the presence of a misalignment. Adverse events following an upper cervical adjustment consist of mild symptomatic reactions of short-duration (< 24-hours). Due to a lack of quality and indexed references, information contained herein is limited by the significance of literature cited, which included non-indexed and/or non-peer reviewed sources.

KEYWORDS:   adverse events; atlas; cervical; chiropractic; chiropractic adjustment; craniocervical


From the Full-Text Article:

Introduction:

The indexed literature reports the existence of many upper cervical (UC) procedures. [1, 2] Presented here is a brief narrative review or narrative description of upper cervical techniques (UCT) with the intention of increasing knowledge and understanding regarding their effectiveness and utilization. Procedural similarities and differences between UCT are examined. As chiropractic goes the way of other healing professions through stratification into specialties, this characterization of upper cervical procedures can create appreciation and clarity both inside and outside the profession.

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A Précis of Upper Cervical Chiropractic

What Effect Does Chiropractic Treatment Have on Gastrointestinal (GI) Disorder

What Effect Does Chiropractic Treatment Have on Gastrointestinal (GI) Disorders: A Narrative Review of the Literature

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc 2015 (Jun);   59 (2):   122–133 ~ FULL TEXT

Katherine Angus, BSc(Kin), DC, Sepideh Asgharifar, BSc(Hons), DC,
Brian Gleberzon, DC, MHSc

Chiropractic and Health Associates Clinic,
1 St. Clair Ave West, Suite 404,
Toronto, Ontario.


The purpose of this study was to provide a narrative review of the literature of studies describing the management of disorders of the gastro-intestinal (GI) tract using ‘chiropractic therapy’ broadly defined here as spinal manipulation therapy, mobilizations, soft tissue therapy, modalities and stretches. Search limiters include access to full text studies published between 1980 and November 2012 in peer-reviewed journals, English language only involving human subjects. Twenty-one articles were found that met our inclusion criteria. Retrievable articles varied from case reports to clinical trials to review articles of management options. The majority of articles chronicling patient experiences under chiropractic care reported they demonstrated mild to moderate improvements in presenting symptoms. No adverse side effects were reported. This suggests chiropractic care can be considered as an adjunctive therapy for patients with various GI conditions providing there are no co-morbidities.

KEYWORDS:  chiropractic; gastro-intestinal; manipulation; therapy


From the FULL TEXT Article

Introduction

The purpose of this paper was to conduct a narrative review of the literature that investigated the effectiveness of chiropractic treatment for gastrointestinal (GI) disorders. A previous review by Gleberzon et al [1] reviewed the literature from 2007 to 2011 that investigated the use of one type of chiropractic treatment (spinal manipulative therapy) for pediatric health conditions one of which was colic, often considered a type of GI condition effecting infants [Authors’ note: there is considerable debate whether or not ‘infantile colic’ is a GI condition, or simply ‘baby back pain’ and there is debate if the method used to monitor its existence (crying time) is a subjective or objective outcome measure. [1] That debate notwithstanding, for the purposes of this report, we have included colic as a GI condition].

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Conditions That Respond Well to Chiropractic Page

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Validity of Palpation of the C1 Transverse Process

Validity of Palpation of the C1 Transverse Process: Comparison with a Radiographic Reference Standard

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc 2015 (Jun);   59 (2):   91–100 ~ FULL TEXT

Robert Cooperstein,MA, DC, Morgan Young,DC, Makani Lew,DC

Palmer West College of Chiropractic
Palmer Center for Chiropractic Research


Primary goal:   to determine the validity of C1 transverse process (TVP) palpation compared to an imaging reference standard.

METHODS:   Radiopaque markers were affixed to the skin at the putative location of the C1 TVPs in 21 participants receiving APOM radiographs. The radiographic vertical distances from the marker to the C1 TVP, mastoid process, and C2 TVP were evaluated to determine palpatory accuracy.

RESULTS:   Interexaminer agreement for radiometric analysis was “excellent.” Stringent accuracy (marker placed ±4mm from the most lateral projection of the C1 TVP) = 57.1%; expansive accuracy (marker placed closer to contiguous structures) = 90.5%. Mean Absolute Deviation (MAD) = 4.34 (3.65, 5.03) mm; root-mean-squared error = 5.40mm.

Continue reading Validity of Palpation of the C1 Transverse Process

Brain Atrophy in Cognitively Impaired Elderly

Brain Atrophy in Cognitively Impaired Elderly:
The Importance of Long-chain ω-3 Fatty Acids
and B Vitamin Status in a Randomized Controlled Trial

The Chiro.Org Blog


SOURCE:   Am J Clin Nutr. 2015 (Jul);   102 (1):   215–221

Fredrik Jernerén, Amany K Elshorbagy, Abderrahim Oulhaj,
Stephen M Smith, Helga Refsum, and A David Smith

From the Oxford Project to Investigate Memory and Ageing (OPTIMA),
Department of Pharmacology,
University of Oxford, Oxford, United Kingdom;
fredrik.jerneren@pharm.ox.ac.uk



This study provides clarity to earlier studies that found that B vitamins and/or Omega-3 fatty acids were found to slow brain loss in areas of the brain associated with Alzheimer’s disease.


In a 2010 study, Smith et al. [1] (in the Oxford Project to Investigate Memory and Ageing study) gave 271 individuals with mild cognitive impairment high-dose B vitamins for 2 years.   Pre- and post-MRI studies were done, and they demonstrated that the B vitamin group experienced 30-percent slower rates of brain atrophy, on average, and in some cases patients experienced reductions as high as 53 percent.


In a 2012 study, Bowman et al. [2] (in the Oregon Brain Aging Study) reviewed blood nutrient levels in 104 dementia-free elders.   They found two nutrient biomarker patterns (NBPs) that were associated with more favorable cognitive and MRI measures: one was high plasma levels of the vitamins B, C, D, and E, and the second NBP was high plasma marine omega-3 fatty acids.   They also demonstrated that high trans fat blood levels were associated with less favorable cognitive function and less total cerebral brain volumes.

When this article was pre-released, the New York Times ran a banner headline titled:
4 Vitamins That Strengthen Older Brains. [3]


In a 2013 study, Douaud et al. [4] provided high-dose B-vitamin treatment to elderly subjects with increased dementia risk for 2 years.   They found that B vitamins reduced brain shrinkage and reduced levels of plasma total homocysteine (tHcy).   This is important because many cross-sectional and prospective studies have shown that high tHcy levels are associated with cognitive impairment, Alzheimer’s disease (AD), and vascular dementia.


The current study also helps explain why some trials that focused solely on the B vitamins or Omega-3s had mixed results. Apparently having high blood levels of BOTH the B vitamins AND Omega-3 fatty acids provides better results in preventing the deterioration of brain tissue in Alzheimer’s patients.


REFERENCES:

  1. Homocysteine-lowering by B Vitamins Slows the Rate of Accelerated Brain Atrophy in Mild Cognitive Impairment: A Randomized Controlled Trial
    PLoS One. 2010 (Sep 8); 5 (9): e12244

  2. Nutrient Biomarker Patterns, Cognitive Function, and MRI Measures of Brain Aging
    Neurology. 2012 (Jan 24); 78 (4): 241–249

  3. 4 Vitamins That Strengthen Older Brains
    The New York Times ~ January 2, 2012

  4. Preventing Alzheimer’s Disease-related Gray Matter Atrophy by B-vitamin Treatment
    Proc Natl Acad Sci U S A. 2013 (Jun 4); 110 (23): 9523–9528

Continue reading Brain Atrophy in Cognitively Impaired Elderly

Multiple Venous Thromboses Presenting as Mechanical Low Back Pain in an 18-Year-Old Woman

Multiple Venous Thromboses Presenting as Mechanical Low Back Pain in an 18-Year-Old Woman

The Chiro.Org Blog


SOURCE:   J Chiropr Med. 2015 (Jun);   14 (2):   83–89

Andrée-Anne Marchand, DC, Jean-Alexandre Boucher, DC,
Julie O’Shaughnessy, DC, MSc

Université du Québec à Trois-Rivières,
3351 Boul. Des Forges. C.P 500, Trois-Rivières,
Québec, Canada, G9A 5H7


Objective   The purpose of this case report is to describe a patient who presented with acute musculoskeletal symptoms but was later diagnosed with multiple deep vein thrombosis (DVT).

Clinical Features   An 18-year-old female presented to a chiropractic clinic with left lumbosacral pain with referral into the posterior left thigh. A provisional diagnosis was made of acute myofascial syndrome of the left piriformis and gluteus medius muscles. The patient received 3 chiropractic treatments over 1 week resulting in 80% improvement in pain intensity. Two days later, a sudden onset of severe abdominal pain caused the patient to seek urgent medical attention. A diagnostic ultrasound of the abdomen and pelvis were performed and interpreted as normal. Following this, the patient reported increased pain in her left leg. Evaluation revealed edema of the left calf and decreased left lower limb sensation. A venous Doppler ultrasound was ordered.

Intervention and Outcomes   Doppler ultrasound revealed reduction of the venous flow in the femoral vein area. An additional ultrasonography evaluation revealed an extensive DVTs affecting the left femoral vein and iliac axis extending towards the vena cava. Upon follow-up with a hematologist, the potential diagnosis of May-Thurner syndrome was considered based on the absence of blood dyscrasias and sustained anatomical changes found in the left common iliac vein at its junction with the right common iliac artery. A week following discharge, she presented with chest pain and was diagnosed with venous thromboembolism. The patient was successfully treated with anticoagulation therapy and insertion of a vena cava filter.

Continue reading Multiple Venous Thromboses Presenting as Mechanical Low Back Pain in an 18-Year-Old Woman

High Prevalence of Daily and Multi-site pain — A Cross-sectional Population-based Study Among 3000 Danish Adolescents

High Prevalence of Daily and Multi-site pain — A Cross-sectional Population-based Study Among 3000 Danish Adolescents

The Chiro.Org Blog


SOURCE:   BMC Pediatr. 2013 (Nov 19);   13:   191 ~ FULL TEXT

Michael S Rathleff, Ewa M Roos, Jens L Olesen, and Sten Rasmussen

HEALTH,
Aarhus University,
Vennelyst Boulevard 9,
8000 Aarhus C, Denmark.
misr@rn.dk


BACKGROUND:   Daily pain and multi-site pain are both associated with reduction in work ability and health-related quality of life (HRQoL) among adults. However, no population-based studies have yet investigated the prevalence of daily and multi-site pain among adolescents and how these are associated with respondent characteristics. The purpose of this study was to investigate the prevalence of self-reported daily and multi-site pain among adolescents aged 12-19 years and associations of almost daily pain and multi-site pain with respondent characteristics (sex, age, body mass index, HRQoL and sports participation).

METHODS:   A population-based cross-sectional study was conducted among 4,007 adolescents aged 12-19 years in Denmark. Adolescents answered an online questionnaire during physical education lessons. The questionnaire contained a mannequin divided into 12 regions on which the respondents indicated their current pain sites and pain frequency (rarely, monthly, weekly, more than once per week, almost daily pain), characteristics, sports participation and HRQoL measured by the EuroQoL 5D. Multivariate regression was used to calculate the odds ratio for the association between almost daily pain, multi-site pain and respondent characteristics.

RESULTS:   The response rate was 73.7%. A total of 2,953 adolescents (62% females) answered the questionnaire. 33.3% reported multi-site pain (pain in > 1 region) while 19.8% reported almost daily pain. 61% reported current pain in at least one region with knee and back pain being the most common sites. Female sex (OR: 1.35-1.44) and a high level of sports participation (OR: 1.51-2.09) were associated with increased odds of having almost daily pain and multi-site pain. Better EQ-5D score was associated with decreased odds of having almost daily pain or multi-site pain (OR: 0.92-0.94).

CONCLUSION:   In this population-based cohort of school-attending Danish adolescents, nearly two out of three reported current pain and, on average, one out of three reported pain in more than one body region. Female sex, and high level of sports participation were associated with increased odds of having almost daily pain and multi-site pain. The study highlights an important health issue that calls for investigations to improve our understanding of adolescent pain and our capacity to prevent and treat this condition.


From the Full-Text Article:

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Chiropractic Pediatrics Page

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Is Back Pain During Childhood or Adolescence Associated with Muscle Strength, Muscle Endurance or Aerobic Capacity?

Is Back Pain During Childhood or Adolescence Associated with Muscle Strength, Muscle Endurance or Aerobic Capacity: Three Systematic Literature Reviews with one Meta-analysis

The Chiro.Org Blog


SOURCE:   Chiropractic & Manual Therapies 2015 (Jul 16);   23:   21 ~ FULL TEXT

Arnaud Lardon 1, 2, Charlotte Leboeuf-Yde 1, 2, 3, and
Christine Le Scanff 1

1   EA 4532 CIAMS,
Université Paris-Sud, UFR STAPS,
Orsay, 91405, France
alardon@ifec.net

2  
Institut Franco-Européen de Chiropraxie,
24 Bld Paul Vaillant Couturier,
Ivry sur Seine, 94200, France

3   Research Department Spine centre of Southern Denmark Hospital,
Hospital Lillebælt Middelfart,
Institute of Regional Health Research,
University of Southern Denmark,
Odense, Denmark


Background   Back pain is a common condition during childhood and adolescence. The causes of back pain are largely unknown but it seems plausible that some physical factors such as back muscle strength, back muscle endurance and aerobic capacity may play a role in its development, in particular in the early years.

Objectives   The objectives of this review were to investigate in childhood and adolescence 1) if muscular strength in trunk extension is associated with back pain, 2) if muscular endurance in trunk extension is associated with back pain and 3) if aerobic capacity is associated with back pain.

Design   Three systematic critical literature reviews with one meta-analysis.

Methods   Systematic searches were made in June 2014 in PubMed, Embase and SportDiscus including longitudinal, retrospective or cross-sectional studies on back pain for subjects <20 years. Articles were accepted if they were written in French or English. The review process followed the AMSTAR recommendations. The possibility of conducting a meta-analysis was assessed for each research question.

Results   Four articles were included for the first objective, four for the second and three for the last. None of the included articles found an association between back muscle strength in extension and back pain. For the second objective, a protective association between back muscle endurance in extension and back pain was found, later confirmed in a meta-analysis (OR = 0.75, 95 % CI 0.58-0.98). The association between aerobic capacity and back pain is not clear.

Conclusions   High back muscle endurance in extension appears protective of back pain in youngsters, but the roles of high back muscle strength in extension and aerobic capacity are less clear.

Keywords:   Back pain; Adolescent; Children; Back muscle endurance; Back muscle strength; Aerobic capacity; Meta-analysis; Systematic review


From the Full-Text Article:

Background

Pain is relatively common in childhood and adolescence [1]. For example, in a population of circa 3000 adolescents, 61 % reported musculoskeletal pain at least in one area [2]. Back pain (BP) was noted to be the second most common type with 25 % reporting daily complaints [2]. BP is common during childhood and has been shown to be a predictor of low back pain (LBP) in adulthood [3]. Therefore, more knowledge is needed about BP in the early years, as attention needs to be focused on this period of life.

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The Chiropractic Hospital-Based Interventions Research Outcomes Study

The Chiropractic Hospital-Based Interventions Research Outcomes Study: Consistency of Outcomes Between Doctors of Chiropractic Treating Patients With Acute Lower Back Pain

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2015 (Jun 24) ~ FULL TEXT

Jeffrey A. Quon, DC, MHSc, PhD, FCCS(C), Paul B. Bishop, DC, MD, PhD,
Brian Arthur, DC, MSc

Clinical Associate Professor,
Faculty of Medicine,
School of Population and Public Health,
University of British Columbia


Introduction

Within mainstream health care, the customary management of low back pain (LBP) by primary care medical physicians is often not evidence based. Interestingly, clinical practice guidelines (CPG) for the treatment of acute mechanical LBP, for example, have been developed independently by multidisciplinary expert panels in 12 countries. [1-12]

The recommendations from those guidelines have been further accompanied by rigorous systematic reviews of the evidence [13-15] rather than expert consensus alone, [1] and, to date, they have generally endorsed the use of the following conservative modalities:

(1) reassurance about the favorable natural history of acute LBP,

(2) early activation,

(3) time-limited nonsteroidal anti-inflammatory medication
(barring contraindications
), and

(4) spinal manipulative therapy (SMT).

Despite widespread dissemination of CPG for LBP, compliance with this knowledge in general and with the SMT component in particular has been limited among mainstream health care providers. This is particularly true among family medical physicians, [16-18] whose personal beliefs about effective LBP care are often discordant with what is known from external research evidence. [19, 20] Yet, ironically, family medical physicians account for most office visits for LBP in many North American jurisdictions. [21]

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Inter-examiner Reliability of the Interpretation of Paraspinal Thermographic Pattern Analysis

Inter-examiner Reliability of the Interpretation of Paraspinal Thermographic Pattern Analysis

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc 2015 (Jun);   59 (2):   157-164 ~ FULL TEXT

Barbara A. Mansholt, DC, MS, Robert D. Vining, DC,
Cynthia R. Long, PhD, Christine M. Goertz, DC, PhD

Associate Professor, Clinic,
Palmer College of Chiropractic
barbara.mansholt@palmer.edu


INTRODUCTION:   A few spinal manipulation techniques use paraspinal surface thermography as an examination tool that informs clinical-decision making; however, inter-examiner reliability of this interpretation has not been reported. The purpose of this study was to report inter-examiner reliability for classifying cervical paraspinal thermographic findings.

METHODS:   Seventeen doctors of chiropractic self-reporting a minimum of 2 years of experience using thermography classified thermographic scans into categories (full pattern, partial +, partial, partial -, and adaptation). Kappa statistics (k) were calculated to determine inter-examiner reliability.

RESULTS:   Overall inter-examiner reliability was fair (k=0.43). There was good agreement for identifying full pattern (k=0.73) and fair agreement for adaptation (k=0.55). Poor agreement was noted in partial categories (k=0.05-0.22).

CONCLUSION:   Inter-examiner reliability demonstrated fair to good agreement for identifying comparable (full pattern) and disparate (adaptation) thermographic findings; agreement was poor for those with moderate similarity (partial). Further research is needed to determine whether thermographic findings should be used in clinical decision-making for spinal manipulation.


From the FULL TEXT Article:

Introduction

Doctors of chiropractic (DCs) use complex clinical decision-making when determining where, when, and when not to perform spinal manipulation. [1] Factors considered may include the diagnosis, symptom severity, presence of co-morbid conditions, patient preferences, and other examination findings [2, 3] such as static or segmental motion palpation, [4, 5] posture analysis, leg length analysis, [6] biomechanical interpretation of spinal radiographs, the presence of spinal/paraspinal tenderness, and abnormal muscle tone. [7] Some chiropractic spinal manipulation techniques, particularly those focusing on upper cervical manipulation, use thermographic and other diagnostic instruments to provide primary information to determine whether treatment should or should not occur. [8] The use of unique diagnostic instrumentation is not new to the chiropractic profession. B.J. Palmer, considered the “developer” of chiropractic, used an instrument called the electroencephaloneuromentimpograph and later, the neurocalometer. [9] The neurocalometer was the predecessor of the current nervo-scope, which is still used by some practitioners using the Gonstead technique system. [10, 11]

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Today’s the Day

Happy 4th of July (2015)

Happy Independence Day!

Enjoy the Fireworks Over the Lady of Liberty in NYC


IN CONGRESS, July 4, 1776

The unanimous Declaration of the thirteen united States of America

When in the Course of human events, it becomes necessary for one people to dissolve the political bands which have connected them with another, and to assume among the powers of the earth, the separate and equal station to which the Laws of Nature and of Nature’s God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation.

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Back Pain in Adolescents With Idiopathic Scoliosis

Back Pain in Adolescents With Idiopathic Scoliosis: Epidemiological Study for 43,630 Pupils in Niigata City, Japan

The Chiro.Org Blog


SOURCE:   Eur Spine J. 2011 (Feb);   20 (2):   274–279 ~ FULL TEXT

Tsuyoshi Sato, Toru Hirano, Takui Ito, Osamu Morita, Ren Kikuchi,
Naoto Endo, and Naohito Tanabe

Department of Orthopedic Surgery,
Niigata Prefectural Shibata Hospital,
Shibata, Japan.
tsuyoshis1@mac.com


There have been a few studies regarding detail of back pain in adolescents with idiopathic scoliosis (IS) as prevalence, location, and severity. The condition of back pain in adolescents with IS was clarified based on a cross-sectional study using a questionnaire survey, targeting a total of 43,630 pupils, including all elementary school pupils from the fourth to sixth grade (21,893 pupils) and all junior high pupils from the first to third year (21,737 pupils) in Niigata City (population of 785,067), Japan.

32,134 pupils were determined to have valid responses (valid response rate: 73.7%). In Niigata City, pupils from the fourth grade of elementary school to the third year of junior high school are screened for scoliosis every year. This screening system involves a three-step survey, and the third step of the survey is an imaging and medical examination at the Niigata University Hospital.

In this study, the pupils who answered in the questionnaire that they had been advised to visit Niigata University Hospital after the school screening were defined as Scoliosis group (51 pupils; 0.159%) and the others were defined as No scoliosis group (32,083 pupils). The point and lifetime prevalence of back pain, the duration, the recurrence, the severity and the location of back pain were compared between these groups.

The severity of back pain was divided into three levels (level 1 no limitation in any activity; level 2 necessary to refrain from participating in sports and physical activities, and level 3 necessary to be absent from school). The point prevalence was 11.4% in No scoliosis group, and 27.5% in Scoliosis group. The lifetime prevalence was 32.9% in No scoliosis group, and 58.8% in Scoliosis group. According to the gender- and school-grade-adjusted odds ratios (OR), Scoliosis group showed a more than twofold elevated odds of back pain compared to No scoliosis group irrespective of the point or lifetime prevalence of back pain (OR, 2.29; P = 0.009 and OR, 2.10; P = 0.012, respectively).

Scoliosis group experienced significantly more severe pain, and of a significantly longer duration with more frequent recurrences in comparison to No scoliosis group. Scoliosis group showed significantly more back pain in the upper and middle right back in comparison to No scoliosis group. These findings suggest that there is a relationship between pain around the right scapula in Scoliosis group and the right rib hump that is common in IS.


From the Full-Text Article:

Introduction:

Most patients with adolescent idiopathic scoliosis (AIS) visit the hospital when a trunk deformity, such as rib or lumbar hump and waist asymmetry, is pointed out either after the school screening or by family members, and it is rare for these patients to visit the hospital due to back pain. However, some adolescent patients with idiopathic scoliosis (IS) do complaint of back pain in outpatient clinics. Previously, it had been accepted that special attention should be paid to patients with scoliosis who experienced back pain, because it was thought that might be additional pathologies such as an occult syrinx, spinal cord tumors, or neuromuscular disorders [4, 6, 20].

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Q&A With the First VA Chiropractic Residents

Q&A With the First VA Chiropractic Residents

The Chiro.Org Blog


SOURCE:   Dynamic Chiropractic ~ July 1, 2015 ~ FULL TEXT

By Clinton Daniels, DC, MS, Amanda Dluzneiwski, DC, Derek Golley, DC,
Benjamin Liang, DC and Rachel Perrucci, DC


The Inaugural class of 2015 shares their residency experiences.


As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.1-2 This program is the result of years of dedication and strategic planning by the VA chiropractic leadership, and is congruent with the VA’s mission to train providers to serve the VA and the nation at large.

As the inaugural class, we are honored to have participated in the first phase of the three-year pilot program.

In March 2015, we had the opportunity to gather for a VA meeting held in advance of the Association of Chiropractic Colleges /Research Agenda Conference in Las Vegas. At this meeting, we worked with representatives from VA Central Office, the five residency program directors, and representatives from each program’s academic affiliates: Logan University, New York Chiropractic College, Southern California University of Health Sciences and the University of Bridgeport.

After this, many of us attended the ACC/RAC conference itself, where we participated in workshops and observed several cutting-edge research presentations. In our interaction with many of the ACC/RAC attendees, we noted a tremendous amount of interest in the VA Chiropractic Residency Program. We received questions ranging from inquiries about our future career plans to how perspective residents may apply. The following are some of the most frequent questions we fielded, as well as personal residency experiences.


How long is the residency program and is it a paid position?

Continue reading Q&A With the First VA Chiropractic Residents