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Exploring Patient Satisfaction

Exploring Patient Satisfaction: A Secondary Analysis of a Randomized Clinical Trial of Spinal Manipulation, Home Exercise, and Medication for Acute and Subacute Neck Pain

The Chiro.Org Blog

SOURCE:   J Manipulative Physiol Ther 2014 (Sep 5)

Brent D. Leininger, DC, Roni Evans, DC, PhD,
Gert Bronfort, DC, PhD

Research Fellow, Integrative Health & Wellbeing Research Program,
Center for Spirituality & Healing, University of Minnesota,
Minneapolis, MN.

OBJECTIVE:   The purpose of this study was to assess satisfaction with specific aspects of care for acute neck pain and explore the relationship between satisfaction with care, neck pain, and global satisfaction.

METHODS:   This study was a secondary analysis of patient satisfaction from a randomized trial of spinal manipulation therapy (SMT) delivered by doctors of chiropractic, home exercise and advice (HEA) delivered by exercise therapists, and medication (MED) prescribed by a medical doctors for acute/subacute neck pain. Differences in satisfaction with specific aspects of care were analyzed using a linear mixed model. The relationship between specific aspects of care and (1) change in neck pain (primary outcome of the randomized trial) and (2) global satisfaction were assessed using Pearson’s correlation and multiple linear regression.

RESULTS:   Individuals receiving SMT or HEA were more satisfied with the information and general care received than MED group participants. Spinal manipulation therapy and HEA groups reported similar satisfaction with information provided during treatment; however, the SMT group was more satisfied with general care. Satisfaction with general care (r = -0.75 to -0.77; R2 = 0.55-0.56) had a stronger relationship with global satisfaction compared with satisfaction with information provided (r = -0.65 to 0.67; R2 = 0.39-0.46). The relationship between satisfaction with care and neck pain was weak (r = 0.17-0.38; R2 = 0.08-0.21).

CONCLUSIONS:   Individuals with acute/subacute neck pain were more satisfied with specific aspects of care received during spinal manipulation therapy or home exercise interventions compared to receiving medication. The relationship between neck pain and satisfaction with care was weak.

Key Indexing Terms:   Neck Pain, Patient Satisfaction, Musculoskeletal Manipulations, Exercise Therapy, Pharmaceutical Preparations, Clinical Trial, Chiropractic

From the FULL TEXT Article:


Neck pain is one of the most commonly reported health complaints in primary care settings. [1, 2] As concern for costs and side effects related to treating spinal pain conditions continues to grow, the search for effective, patient-centered treatments has become paramount. Patient satisfaction has become a widely advocated means for measuring patients’ preferences and views related to treatment quality in clinical practice. [3] Furthermore, it is recommended as a core outcome domain for chronic pain clinical trials by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials group. [4]

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The Cellular and Molecular Biology of the Intervertebral Disc: A Clinician’s Primer

The Cellular and Molecular Biology of the Intervertebral Disc: A Clinician’s Primer

The Chiro.Org Blog

SOURCE:   J Can Chiropr Assoc. 2014 (Sep);   58 (3):   246–257

W. Mark Erwin, DC, PhD and Katherine E. Hood, DC

Assistant Professor, Divisions of Neurological and Orthopaedic Surgery,
University of Toronto, Toronto Western Hospital;
Scientist, Toronto Western Research Institute;
Associate Professor, Research Canadian Memorial Chiropractic College.

Clinicians routinely encounter patients suffering from both degenerative and acute spinal pain, often as a consequence of pathology affecting the intervertebral disc (IVD). The IVD is a complex structure essential to spinal function and is subject to degenerative disease and injury. However, due to the complexity of spinal pain syndromes it is often difficult to determine the extent of the IVD’s contribution to the genesis of spinal pain. The location of the IVD is within close proximity to vital neural elements and may in the event of pathological change or injury compromise those structures. It is therefore important that clinicians performing manual therapy understand the cellular and molecular biology of the IVD as well as its clinical manifestation of degeneration/injury in order to safely manage and appreciate the role played by the disc in the development of mechanical spinal pain syndromes.

Keywords:   spine, degenerative, pain, disc, intervertebral

The Full-Text Article:


The intervertebral disc (IVD) is a complex structure positioned between two adjacent vertebrae where in addition to protecting the spinal cord and segmental spinal nerves it confers flexibility, multi-axial spinal motion and load transmission to the spine. The IVD is vulnerable to injury and degeneration often leading to pain syndromes however much remains to be discovered concerning the development of axial and radicular pain syndromes, the biology of the disc and the capacity of the IVD to repair itself after injury. [1] From the clinician’s perspective, familiarity with the biology of the IVD is vital in order to understand the natural history of disc-related injury/illness and to develop appropriate therapeutic strategies. The purpose of this review is to provide an overview of the salient characteristics of IVD pathology with a particular emphasis upon degenerative disease and its role in the generation of clinical spinal pain syndromes.

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September 18, 2014 – Happy 119th Anniversary!

September 18, 2014 – Happy 119th Anniversary!

The Chiro.Org Blog

SOURCE:   Palmer Website Archives

Chiropractic turns 119 today. At Palmer, it’s also referred to as Founder’s Day. Wish DD and all of us success for the next 119 years. We are on a roll!

Chiropractic Treatment Helps Back-Related Leg Pain

Chiropractic Treatment Helps Back-Related Leg Pain

The Chiro.Org Blog

Spinal Manipulation and Home Exercise With Advice for Subacute and Chronic Back-Related Leg Pain: A Trial With Adaptive Allocation

SOURCE:   Annals of Internal Medicine 2014 (Sep 16); 161 (6): 381-391

Gert Bronfort, DC, PhD; Maria A. Hondras, DC, MPH;
Craig A. Schulz, DC, MS; Roni L. Evans, DC, PhD;
Cynthia R. Long, PhD; and Richard Grimm, MD, PhD

University of Minnesota, Northwestern Health Sciences University, and
Berman Center for Outcomes and Clinical Research at the Minneapolis
Medical Research Foundation, Minneapolis, Minnesota, and
Palmer Center for Chiropractic Research, Davenport, Iowa

Chiropractic Treatment Helps Back-Related Leg Pain

FROM:   MedPage Today ~ September 16, 2014

By Shara Yurkiewicz , Staff Writer, MedPage Today

Patients with back-related leg pain who received spinal manipulative therapy (SMT) plus home exercise and advice (HEA) had less leg pain, lower back pain, and disability after 12 weeks than patients who received home exercise and advice alone, researchers reported.

At 1 year, those differences were no longer significant, wrote Gert Bronfort, DC, PhD, at Northwestern Health Sciences University in Bloomington, Minn., and colleagues in a study appearing in Annals of Internal Medicine. But patients experienced more global improvement, higher satisfaction, and lower medication use, the researchers reported.

The findings suggest that SMT in addition to HEA could be a safe and effective conservative, short-term treatment approach for back-related leg pain, the authors said.

“Prior to this study, SMT was considered a viable treatment option of what is known as ‘uncomplicated low back pain,’ which is low back pain without radiating pain to the leg,” authors Bronfort and Roni Evans, DC, PhD, at the University of Minnesota in Minneapolis, wrote in an email to MedPage Today.

“This study shows that for patients without progressive neurological deficits and serious identifiable causes (e.g., spinal fracture, etc.) SMT, coupled with home exercise and advice, may be helpful, and should be considered,” they added.

Review the Abstract:

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Study offers suggestions on what to do when sex is a pain in the back

Source Canada.com


Professor Stuart McGill demonstrates the motion of the spine during sex in a handout photo. Contrary to popular belief, spooning is not always the best sex position for those with a bad back, according to new research from the University of Waterloo. THE CANADIAN PRESS/HO-University of Waterloo

For many people, intimacy in the bedroom often takes a back seat to low back pain, say researchers, who have scientifically determined the best sexual positions to prevent spinal muscles from seizing up at an inopportune moment.

In what they believe is the first biomechanical study of its kind, researchers at the University of Waterloo have found that certain positions are better than others for keeping different kinds of back pain at bay.

And they’ve thrown out the long-held belief that spooning — where partners lie sideways curled back to front — is the only pose for back-saving sex.

“Before now, spooning was often recommended by physicians as the one position that fit all. But as we’ve discovered, that is not the case,” said Natalie Sidorkewicz, a PhD candidate and lead author of the paper published Thursday in the journal Spine.

“What that failed to do was recognize that there are all sorts of triggers for back pain,” she said from Waterloo, Ont. “So someone may find relief in one position that may cause pain for someone else.”

To conduct the study, the researchers recruited 10 heterosexual couples, with an average age of about 30, to have sexual intercourse in a controlled laboratory setting.

Each participant was fitted with remote sensors, which tracked how their spines moved when they engaged in five common sex positions. Infrared and electromagnetic motion capture systems — such as those used to animate figures in video games and films — showed how the men’s and women’s spines flexed when they assumed each position.

“So we were able to actually determine what angle the spine is at, at each moment in time that they’re having sex,” said Sidorkewicz, adding that electrodes on participants’ skin also captured activity in their core and hip muscles.

The findings were used to create an atlas, or set of guidelines, that recommends different sex positions and thrusting techniques based on what movements trigger a patient’s pain.
Continue reading Study offers suggestions on what to do when sex is a pain in the back

Miss Correct Posture

Source Neatorama and Google Life Archives



In the 50s and 60s, American chiropractors held a series of rather unusual beauty pageants where contestants were judged and winners picked not only by their apparent beauty and poise, but also their standing posture (backed with X-rays of their spines, of course).

The contests were a publicity stunt, Reginal Hug, past president of the Association for the History of Chiropractic, told Scott Hensley of NPR, and was meant to burnish the reputation of the profession. The message, he said, was that good posture led to good health and that chiropractors could help with that. “In those days, nobody was concerned about radiation,” Hug added, noting the use of X-rays to check for spinal structures.miss-correct-posture-3

Why not contests for men? Actually, there were some but they weren’t as popular and didn’t last very long. “The guys always slouched,” Hug added.

Like many things that were hot back in the early 20th century (like flagpole sitting, goldfish swallowing and phone booth stuffing), the popularity of the chiropractic beauty pageant waned. The last big contest was held in Chattanooga, Tennessee, in 1969.



Adherence to Clinical Practice Guidelines Among Three Primary Contact Professions

Adherence to Clinical Practice Guidelines Among Three Primary Contact Professions: A Best Evidence Synthesis of the Literature for the Management of Acute and Subacute Low Back Pain

The Chiro.Org Blog

SOURCE:   J Can Chiropr Assoc 2014 (Sept);   58(3):   220–237

Lyndon G. Amorin-Woods, B.App.Sci (Chiropractic)
Randy W. Beck, BSc (Hons), DC, PhD, DACNB, FAAFN, FACFN
Gregory F. Parkin-Smith, MTech(Chiro), MBBS, MSc, DrHC
James Lougheed, BA (Hons)
Alexandra P. Bremner, BSc (Hons), DipEd, GradDipAppStats, PhD

Senior Clinical Supervisor, School of Health Professions [Discipline of Chiropractic]
Murdoch University
Enrolled student, Master of Public Health
School of Population Health Faculty of Medicine, Dentistry and Health Sciences
The University of Western Australia
Email: L.Woods@murdoch.edu.au
Postal Address: Murdoch University, South Street Campus
90 South Street, MURDOCH Western Australia 6150
Telephone: +61 8-93601202

Aim:   To determine adherence to clinical practice guidelines in the medical, physiotherapy and chiropractic professions for acute and subacute mechanical low back pain through best-evidence synthesis of the healthcare literature.

Methods:   A structured best-evidence synthesis of the relevant literature through a literature search of relevant databases for peer-reviewed papers on adherence to clinical practice guidelines from 1995 to 2013. Inclusion of papers was based on selection criteria and appraisal by two reviewers who independently applied a modified Downs & Black appraisal tool. The appraised papers were summarized in tabular form and analysed by the authors.

Results:   The literature search retrieved 23 potentially relevant papers that were evaluated for methodological quality, of which 11 studies met the inclusion criteria. The main finding was that no profession in the study consistently attained an overall high concordance rating. Of the three professions examined, 73% of chiropractors adhered to current clinical practice guidelines, followed by physiotherapists (62%) and then medical practitioners (52%).

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Link between vitamin D and dementia risk confirmed

Source University of Exeter

Vitamin D deficiency is associated with a substantially increased risk of dementia and Alzheimer’s disease in older people, according to the most robust study of its kind ever conducted.

An international team, led by Dr David Llewellyn at the University of Exeter Medical School, found that study participants who were severely Vitamin D deficient were more than twice as likely to develop dementia and Alzheimer’s disease.

The team studied elderly Americans who took part in the Cardiovascular Health Study. They discovered that adults in the study who were moderately deficient in vitamin D had a 53 per cent increased risk of developing dementia of any kind, and the risk increased to 125 per cent in those who were severely deficient.

Similar results were recorded for Alzheimer’s disease, with the moderately deficient group 69 per cent more likely to develop this type of dementia, jumping to a 122 per cent increased risk for those severely deficient.

The study was part-funded by the Alzheimer’s Association, and is published in August 6 2014 online issue of Neurology, the medical journal of the American Academy of Neurology. It looked at 1,658 adults aged 65 and over, who were able to walk unaided and were free from dementia, cardiovascular disease and stroke at the start of the study. The participants were then followed for six years to investigate who went on to develop Alzheimer’s disease and other forms of dementia.

Dr Llewellyn said: “We expected to find an association between low Vitamin D levels and the risk of dementia and Alzheimer’s disease, but the results were surprising – we actually found that the association was twice as strong as we anticipated.

Continue reading…


Nutritional Factors Affecting Postpartum Depression

Nutritional Factors Affecting Postpartum Depression

The Chiro.Org Blog

SOURCE:   Journal of Clinical Chiropractic Pediatrics 2011 (Jun);   12 (1):   849–860

Lia M. Nightingale, PhD

Assistant Professor, Division of Life Sciences,
Palmer College of Chiropractic,
1000 Brady Street, Davenport, IA 52803, USA.
Email: lia.nightingale@palmer.edu

Pregnancy and lactation represent a period of substantial physiological changes for the mother and increased nutritional requirements to meet these adjustments. A number of nutritional depletions occur during pregnancy. Serum concentrations of iron and folate take months before they normalize to pre-pregnancy levels. Additionally, many micronutrients required during pregnancy interfere with each other, making absorption difficult. Postpartum depression is the primary complication of childbirth, possibly caused by several nutritional and non-nutritional factors. The current review highlights the impact nutrition may have on the etiology of this debilitating disorder, most notably on prevention of inflammation and maintenance of a healthy central nervous system. The most notable nutritional deficiencies associated with postpartum depression include omega-3 fatty acids, folate, iron, and zinc; however, supplementation trials for prevention of postpartum depression are severely lacking. Practical recommendations are given to minimize micronutrient interference and reduce the risk of postpartum depression.

Key Words:   postpartum depression, nutrition, diet, folate, essential fatty acids, iron, zinc

If there are terms in these articles you don’t understand, you can get a definition from the Merriam Webster Medical Dictionary. If you want information about a specific disease, you can access the Merck Manual. You can also search Pub Med for more abstracts on this, or any other health topic.

From the Full-Text Article:


Depression is the second leading cause of disability for those of reproductive age. [1] Although all forms of depression are devastating, postpartum depression (PPD) has long-lasting consequences for all family members involved. Postpartum depression is the most common complication of childbirth, defined as having major or minor depressive episodes that occur within 12 months after delivery. [2, 3] Postpartum depression has been associated with impaired mother-child interactions, poorer child development, and more violent behavior in children with mothers displaying PPD. [4-6]

Pregnancy is a time of increased nutritional requirements to support fetal growth and development. There are several lines of thought concerning the cause of PPD, including the link between nutritional intake and risk of depression. Therefore, the goal of this review is to examine maternal depletion of nutrients, assess whether these nutritional factors may play a role in PPD, and summarize simple recommendations to implement in practice.


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Pre-Eclampsia and the Impact on Chiropractic Management
of the Pregnant Patient

Pre-Eclampsia and the Impact on Chiropractic Management
of the Pregnant Patient

The Chiro.Org Blog

SOURCE:   Journal of Clinical Chiropractic Pediatrics 2012 (Dec);   14 (1):   1032–1036

Sharon Gordon, BAppSc(Chiro), DICCP and Sherryn Silverthorne, M Clinical Chiro, RN, RM

Sharon Gordon, BAppSc(Chiro), DICCP
Private Practice, Gippsland, Victoria, Australia

Sherryn Silverthorne, M Clinical Chiro, RN, RM
Private Practice, Melbourne, Victoria, Australia
Corresponding author Email: Sharon.gordon@rmit.edu

Up to 10% of women develop pre-eclampsia during pregnancy. It is a significant cause of mortality, responsible for 10-15% of maternal deaths. Its diagnosis is based on the presence of hypertension, with or without proteinuria and edema. As primary contact health care providers, chiropractors must be aware of the risk factors, clinical signs of pre-eclampsia, and the need to modify their management appropriately. An open internet search was conducted for current guidelines in scientific journal databases, in the diagnosis and management of pre-eclampsia. Although there is little literature outlining the role of the chiropractor in patient management, it is clear that specific history and examination procedures must be performed for appropriate co-management and referral.

Key Words:   pre-eclampsia, eclampsia, toxemia, hypertension, pregnancy, chiropractic

From the Full-Text Article:


Pre-eclampsia (also known as toxemia of pregnancy) is one of the major causes of maternal mortality and morbidity. 10%-15% of maternal deaths are directly associated with pre-eclampsia and eclampsia. [1] Up to 10% of pregnant women develop pre-eclampsia. [2] The incidence of pre-eclampsia in the nulliparous woman is cited as being between 3%-7% and for the multiparous woman 1%-3%. [1, 3] This diagnosis is based on the presence of hypertension, proteinuria, with or without edema. As primary contact health care providers, chiropractors must be aware of the risk factors, clinical signs of pre-eclampsia, and the need to modify their management appropriately.


To review the diagnostic criteria, risk factors and complications of pre-eclampsia, and discuss how this may affect chiropractic management of the pregnant patient.


Continue reading Pre-Eclampsia and the Impact on Chiropractic Management
of the Pregnant Patient

Tracking Low Back Problems in a Major Self-Insured Workforce:
Toward Improvement in the Patient’s Journey

Tracking Low Back Problems in a Major Self-Insured Workforce:
Toward Improvement in the Patient’s Journey

The Chiro.Org Blog

SOURCE:   J Occup Environ Med. 2014 (Jun);   56 (6):   604-620

Allen, Harris PhD; Wright, Marcia PharmD; Craig, Terri PharmD; Mardekian, Jack PhD; Cheung, Raymond PhD; Sanchez, Robert PhD; Bunn, William B. III MD, JD, MPH; Rogers, William PhD

From the Harris Allen Group, LLC (Dr Allen), Brookline, Mass; US Medical Affairs (Dr Wright), Pfizer Integrated Health, Overland Park, Kans; Pfizer Primary Care Medical Affairs (Dr Craig), Lincoln, Nebr; Pfizer Inc (Dr Mardekian), New York; Pfizer Integrated Health (Drs Cheung and Sanchez), New York; Health, Safety, Security & Productivity, Navistar, Inc (Dr Bunn)

This comprehensive new study from the Journal of Occupational and Environmental Medicine reveals that chiropractic care costs significantly less than other forms of low back care, and appears to comply with guideline recommendations more closely than than any of the other 4 comparison groups.

The authors came to these conclusions after an exhaustive analysis of an integrated database belonging to a giant, self-insured Fortune 500 manufacturer covering nine years of claims They evaluated the direct and indirect costs of LBP for all employees, looking in-depth at personnel characteristics, and medical, behavioral health, pharmaceutical, Workers Comp costs, disability, absenteeism, and lost productivity during the 2001 to 2009 period.

Thanks to Dynamic Chiropractic for some of the following comments. Make sure to read their full article!

The study had four objectives:

  1. Identify all active employees reporting a back problem diagnosis during the study period.
  2. Define and classify their initial patterns of medical care and use of Rx medication.
  3. Track the effect of these patterns on direct and indirect cost outcomes.
  4. Further stratify these treatment patterns by measures of congruence with the previously described guideline aspects for LBP care and determine the effect on cost outcomes.

Through their database review, the authors identified five specific care patterns that were typical of employee experiences

  1. Information and Advice (“TalkInfo”):
           information gathering, office visit consults, lab tests, imaging (X-ray, ultrasound, CT, or MRI)
           but no other procedures.
           (59 percent of employees).

  2. Complex Medical Management (Complex MM):
           physician visits for nerve blocks, surgeries, or comparable procedures
           (2 percent of employees).

  3. Chiropractic (Chiro):
           more than one visit to a DC.
           (11 percent of employees)

  4. Physical therapy (PT):
           more than one visit to a PT.
           (11 percent of employees)

  5. “Dabble”:
           episodes with at most one visit for physician, chiropractic, or PT care,
           or at most one visit to two or more of these categories.
           (17 percent of employees)

The average overall costs for care were a real eye opener

Low Back/Neuro (three-year total)

Continue reading Tracking Low Back Problems in a Major Self-Insured Workforce:
Toward Improvement in the Patient’s Journey

Energy Drinks and Adolescents –
What Should Health Practitioners Know?

Energy Drinks and Adolescents –
What Should Health Practitioners Know?

The Chiro.Org Blog

SOURCE:   Journal of Clinical Chiropractic Pediatrics 2012 (Dec);   13 (1): 1042-1044

Sharon Gordon, BAppSc(Chiro), DICCP

Private practice, Gippsland, Victoria, Australia.
Email: Sharon.gordon@rmit.edu.au

Energy Drinks are readily available in supermarkets throughout the world. There are currently no restrictions or guidelines on safe consumption by children. Energy drink consumption by adolescents is on the rise, as companies continue to aggressively market their product to this demographic. It has become socially acceptable for children to consume these drinks, as there is a perception that the products are safe. In addition, they have become a popular accessory in the youth extreme-sport culture. Overall, research on adolescent energy drink consumption is lacking, however side effects similar to that seen in adults, have been reported in the adolescent population. The chiropractor must be aware of these side effects, including how they may relate to presenting symptoms, and educate their patients on the dangers of energy drink consumption.

Key Words:   energy drink, caffeine, adolescent, chiropractic


To review the literature on energy drink consumption amongst adolescents, and discuss the physiological effects that may present to the chiropractic office.


Scientific journal databases were searched, including PubMed, Medline, Proquest, Cochrane, CINAHL, Medscape, and Index to Chiropractic Literature. An open internet search was also performed.


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What Should Health Practitioners Know?

Low Back Pain – part of a whiteboard visual lecture series

Source DocMikeEvans

Costs of Routine Care for Infant Colic in the UK and Costs of Chiropractic Manual Therapy as a Management Strategy Alongside a RCT for this Condition

Costs of Routine Care for Infant Colic in the UK and Costs of Chiropractic Manual Therapy as a Management Strategy Alongside a RCT for this Condition

The Chiro.Org Blog

SOURCE:   Journal of Clinical Chiropractic Pediatrics 2013 (Jun);   14 (1):   1063–1069

Joyce Miller, DC, FAC O, FCC, FEAC (Paeds)

Associate Professor, Anglo-European College of Chiropractic,
Lead Tutor in Advanced Professional Practice (Paediatrics),
Bournemouth University, United Kingdom
Email: jmiller@aecc.ac.uk

Background:   There is a small body of published research (six research studies and a Cochrane review) suggesting that manual therapy is effective in the treatment of infant colic. Research from the UK has shown that the costs of NHS treatment are high (£65million [USD100 million] in 2001) with no alleviation of the condition.

Objectives:   The objectives of this study were to: investigate the cost of the inconsolable nocturnal crying infant syndrome which is popularly known as infant colic in the first 20 weeks of life, estimate the costs of different types of treatment commonly chosen by parents for a colicky infant for a week of care or an episode of care, investigate the cost of chiropractic manual therapy intervention aimed at reducing the hours of infant crying alongside a randomised controlled trial (RCT) showing effectiveness of treatment

Design:   Economic evaluation incorporating a RCT

Methods:   A cost analysis was conducted using data from a RCT conducted in a three-armed single-blinded trial that randomized excessively crying infants into one of three groups: a) routine chiropractic manual therapy (CMT), b) CMT with parent blinded or c) no treatment control group with parent blinded. These costs were compared with costs of caring for infant colic from Unit Costs of Health and Social Care, UK, 2011. It has been widely estimated that 21% of infants in the UK present annually to primary care for excessive crying and this calculated to 167,000 infants (to the nearest 1,000) used in the cost analysis as there were 795,249 infants in the UK in mid-2010 according to the UK Office of National Statistics, 2011.

Results:   100 infants completed the RCT and this resulted in treatment costs of £58/child ($93). An additional cost of GP care of £27.50 was added for initial evaluation of the general health of the child and suitability for chiropractic management, totaling £85.50 per child in the RCT. Clinical outcomes are published elsewhere, but care showed both statistically and clinically significant efficacy in reduced crying time by an average of 2.6 hours resulting in a crying time of less than two hours a day (reaching “normal” levels which could be classified as non-colic behavior). Cost per child’s care was £85.50 extrapolated to £14,278,500 for the full cohort of 167,000. If chiropractic care had been given privately, costs were calculated as £164/child per episode of care and this equalled £27,388,000 for the entire cohort. Medical costs through a normal stream of care amounted to £1089.91 per child or £182,014,970 for the cohort (including all costs of care, not just NHS). No benefits of effectiveness were accrued from any of those types of treatment. If the Morris NHS data were extrapolated to 2010, applying wage inflation, the cost would be £118 million (USD180 million) yearly. An episode of an average of four treatments of chiropractic manual therapy with documented efficacy of CMT cost from 8% to 24% of NHS care or routine care.

Conclusion:   chiropractic manual therapy was a cost-effective option in this study. A much larger randomized study of routine medical care versus routine chiropractic care is recommended to determine whether there is confirmation of these findings.

From the Full-Text Article:


As effective treatment for children with infant colic remains elusive, the costs of managing the condition is gaining increasing attention. Although it is uncommon for clinicians to be quizzed about the cost-effectiveness of their treatments, [1] particularly where the clinicians’ services are covered by a national health plan, it is increasingly appropriate to ask this question, when prudence in health care expenditure is required.

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Chiropractic and Breastfeeding Dysfunction:
A Literature Review

Chiropractic and Breastfeeding Dysfunction:
A Literature Review

The Chiro.Org Blog

SOURCE:   Journal of Clinical Chiropractic Pediatrics 2014 (Mar);   14 (2)

Lauren M. Fry, BAppSc (CompMed-Chiro), MClinChiro

Lauren M. Fry, BAppSc(CompMed-Chiro), MClinChiro, private practice, Elwood, Victoria, Australia
Contact: laurenfry85@gmail.com

Objective:   Breastfeeding an infant has many long and short-term health benefits. Chiropractic care, as part of a multidisciplinary team, has the potential to assist with biomechanical causes of breastfeeding dysfunction. The purpose of this study was to review the literature and explore what evidence there is to support this theory.

Methods:   Database searches were performed (PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health and Index to Chiropractic Literature) and hand searches to identify relevant studies. Inclusion criteria were: written in the English language in a peer-reviewed journal, involving infant human participants and a focus on chiropractic treatment for breastfeeding (dysfunction).

Results:   Ten articles were reviewed; 5 case studies, 3 case series, 1 clinical trial and 1 narrative.

Conclusions:   Limited evidence exists to support chiropractic treatment for infants with breastfeeding dysfunction. Of the 6 case studies, 3 case series and 1 clinical trial found in this report there was a trend towards resolution of breastfeeding issues with chiropractic treatment of biomechanical imbalances. More meticulous, higher evidence studies are needed to provide further evidence of this.

Key Words:   breastfeeding, chiropractic, infant, spinal manipulation.

From the Full-Text Article:


Breastfeeding, particularly exclusively for the first 6 months, has been associated with numerous beneficial short and long term health outcomes for an infant. [1, 2] Breast milk has been shown to contain secretory IgA antibodies, lactoferrin, oligosaccharides, numerous cytokines and growth factors which all aid in an infant’s immune response. [3, 4] Purported short term benefits to the infant are a decreased risk of many childhood illnesses. [5] Incidence of gastro-intestinal infections, otitis media, other respiratory tract infections and asthma, even in those with a strong family history, may be decreased in infants who are breastfed. [6, 7]

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A Literature Review