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Complementary and Integrative Medicine
in the Management of Headache

Chiro.Org Blog: Headaches, including primary headaches such as migraine and tension-type headache, are a common clinical problem. Complementary and integrative medicine (CIM), formerly known as complementary and alternative medicine (CAM), uses evidence informed modalities to assist in the health and healing of patients. CIM commonly includes the use of nutrition, movement practices, manual therapy, traditional Chinese medicine, and mind-body strategies. This review summarizes the literature on the use of CIM for primary headache and is based on five meta-analyses, seven systematic reviews, and 34 randomized controlled trials (RCTs). […]

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

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

An Integrated Approach to Chronic Pain

Chiro.Org Blog: Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state’s Department of Health, [1] demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.   Since 2012, Rhode Island Medicaid “Community of Care” enrollees suffering from chronic pain have participated in an integrated chronic pain program administered by Advanced Medicine Integration. Longtime readers will recall that for nearly two decades, AMI has been coordinating chiropractic and integrated care services in various states to help address the chronic pain epidemic in a community-based, integrated fashion. [2-3] […]

New Canadian Opioid Guidelines Recommends Chiropractic As Care Option

Chiro.Org Blog: A new Canadian guideline published today (May 8, 2017) in the Canadian Medical Association Journal (CMAJ) strongly recommends doctors to consider non-pharmacologic therapy, including chiropractic, in preference to opioid therapy for chronic non-cancer pain. […]

For Bad Backs, It May Be Time to Rethink Biases About Chiropractors

For Bad Backs, It May Be Time to Rethink Biases About Chiropractors

The Chiro.Org Blog

SOURCE:   The New York Times ~ 5-01-2017 Aaron E. Carroll, MD, MS

Indiana University School of Medicine

About two of every three people will probably experience significant low back pain at some point. A physician […]

Areas of Capsaicin-Induced Secondary Hyperalgesia and Allodynia Are Reduced by a Single Chiropractic Adjustment

Chiro.Org Blog: The results confirmed that topical capsaicin induced inflammatory reactions based on occurrence of hyperalgesia and allodynia, augmented pain perception, and increased blood flow following capsaicin application compared with the control session. When compared with N-SMT, spontaneous pain was rated significantly lower post-SMT (P <.014). In addition, areas of both secondary hyperalgesia and allodynia decreased after SMT (hyperalgesia: P <.007; allodynia: P <.003). However, there was no significant treatment effect for local blood flow. […]

A Qualitative Study of Changes in Expectations Over Time Among Patients with Chronic Low Back Pain Seeking Four CAM Therapies

Chiro.Org Blog: Participants seeking one of four CAM therapies focused most of their expectations and hopes during initial interviews on whether or not the treatment could lessen their pain. In later interviews, where self-care was included in the interview guide, emphasis tended to be broader, shifting from needing to be “fixed” to an emphasis on the body as a work in progress, in need of ongoing attention and care from both the patient and the CAM practitioner. This trend toward attention to management, self-care and wellness, and increased acceptance of pain as chronic, was reported by participants seeking all four therapies. We also noted that this overall shift over time was evaluated in various ways by participants, depending on how they were able to orient their sense of self and understanding of illness toward ongoing management and engagement. […]

Characteristics of Chiropractic Practitioners, Patients, and Encounters in Massachusetts and Arizona

Chiro.Org Blog: Data for 2,550 chiropractic patient visits were recorded. Care for low back, head and neck pain accounted for almost three quarters of visits. Extremity conditions and wellness care accounted for approximately half of the remaining visits. Spinal and soft tissue examinations were the most frequently reported diagnostic procedures (80% and 56% of visits, respectively), and high-velocity spinal manipulation techniques were the most frequently reported therapeutic procedures (almost 85% of visits). Rehabilitation exercises, thermal modalities, electric stimulation, and counseling/education/self-care were each performed during approximately 25% of visits. Approximately 85% of patients seen were self-referred, whereas only approximately 5% came from medical physicians. Approximately 35% of visits had an expected source of payment directly from the patient. Approximately 80% of visits ended with a plan for the patient to return at a specified time. […]

Do Older Adults with Chronic Low Back Pain Differ from Younger Adults in Regards to Baseline Characteristics and Prognosis?

Chiro.Org Blog: A total of 14,479 participants were included in the study. Of these 3,087 (21%) patients were older adults, 6,071 (42%) were middle aged and 5,321 (37%) were young adults. At presentation older adults were statistically different to the middle aged and younger adults for most characteristics measured (e.g. less intense back pain, more leg pain and more depression); however, the differences were small. The change in pain and disability over 12 months did not differ between age groups. […]

Knowledge Transfer within the Canadian Chiropractic Community. Part 2: Narrowing the Evidence-Practice Gap

Chiro.Org Blog: In Part 1 of this series, [3] we presented an overview of the barriers that impede successful knowledge translation (KT) in the chiropractic profession. Now in Part 2, we provide an overview of KT strategies followed by a discussion of relevant KT efforts in the Canadian chiropractic community. This discussion will lead to a long-term vision of KT for Canadian chiropractic with suggestions to where KT can be applied or where current efforts can be augmented. The overall goal of this article is to present potential strategies for successful KT implementation in order to reduce the gap between current best evidence and its application in chiropractic practice. […]

Attitudes and Opinions of Doctors of Chiropractic Specializing in Pediatric Care Toward Patient Safety

Chiro.Org Blog: Compared with 2014 Agency for Healthcare Research and Quality physician referent data from medical offices, pediatric DCs appear to have more positive patient safety attitudes and opinions. Future patient safety studies need to prospectively evaluate safety performance with direct feedback from patients and compare results with these self-assessed safety attitudes, as well as make further use of this survey to develop a comparable database for spinal manipulation providers. […]

Subclinical Neck Pain and the Effects of Cervical Manipulation on Elbow Joint Position Sense

Chiro.Org Blog: These results suggest that asymptomatic people with a history of subclinical neck pain (SCNP) have reduced elbow JPS accuracy compared to those with no history of any neck complaints. Furthermore, the results suggest that adjusting dysfunctional cervical segments in people with SCNP can improve their upper limb JPS accuracy. […]

Association Between the Type of First Healthcare Provider and the Duration of Financial Compensation for Occupational Back Pain

Chiro.Org Blog: The type of healthcare provider first visited for back pain is a determinant of the duration of financial compensation during the first 5 months. Chiropractic patients experience the shortest duration of compensation, and physiotherapy patients experience the longest. These differences raise concerns regarding the use of physiotherapists as gatekeepers for the worker’s compensation system. […]

Early Predictors of Lumbar Spine Surgery After Occupational Back Injury

Chiro.Org Blog: In the D-RISC sample of 1885 workers, 174 (9.2%) had a lumbar spine surgery within 3 years. Baseline variables associated with surgery (P < 0.05) in the multivariate model included higher Roland-Morris Disability Questionnaire scores, greater injury severity, and surgeon as first provider seen for the injury. Reduced odds of surgery were observed for those younger than 35 years, females, Hispanics, and those whose first provider was a chiropractor. Approximately 42.7% of workers who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor. […]

The Association of Complementary and Alternative Medicine Use and Health Care Expenditures for Back and Neck Problems

Chiro.Org Blog: A total of 12,036 respondents with spine problems were included, including 4306 (35.8%) CAM users (40.8% in weighted sample). CAM users had significantly better self-reported health, education, and comorbidity compared with non-CAM users. Adjusted annual medical costs among CAM users was $424 lower (95% confidence interval: $240, $609; P<0.001) for spine-related costs, and $796 lower (95% confidence interval: $121, $1470; P = 0.021) for total health care cost than among non-CAM users. Average expenditure for CAM users, based on propensity matching, was $526 lower for spine-specific costs (P<0.001) and $298 lower for total health costs (P = 0.403). Expenditure differences were primarily due to lower inpatient expenditures among CAM users. […]