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Is EBM Damaging the Social Conscience of Chiropractic?

Chiro.Org Blog: OBJECTIVE: To explore whether an observed schism occurring within chiropractic education, where a minority of institutions are minimising the major premise of the discipline and replacing it with an emphasis on only the science or literature component of the evidence-based triad, has any potential impact on the quality of care provided particularly within the charitable context. […]

Overtreating Chronic Back Pain: Time to Back Off?

Chiro.Org Blog: Chronic back pain is among the most common patient complaints. Its prevalence and impact have spawned a rapidly expanding range of tests and treatments. Some of these have become widely used for indications that are not well validated, leading to uncertainty about efficacy and safety, increasing complication rates, and marketing abuses. […]

The Chiropractic Hospital-Based Interventions Research Outcomes Study

Chiro.Org Blog: The findings of this study show that regardless of the treating DC, most patients with acute LBP without radiculopathy appear to experience consistent levels of improvement in terms of back pain and general physical functioning (PF) after receiving guidelines-based treatment that includes a component of standardized HVLA SMT. […]

Adherence to Clinical Practice Guidelines Among Three Primary Contact Professions

Chiro.Org Blog: 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. Of the three professions examined, 73% of chiropractors adhered to current clinical practice guidelines, followed by physiotherapists (62%) and then medical practitioners (52%). […]

The Evidence House: How to Build an Inclusive Base for Complementary Medicine

Chiro.Org Blog: We all want good evidence available when making medical decisions. Evidence, however, comes in a variety of forms and purposes, and what may be good for one purpose may not be good for another. The term “evidence-based medicine” (EBM) has become almost a cliché in recent years, being used as a synonym for “good” or “scientific,” both to support and refute the value of complementary medicine practices. [1] But EBM takes a narrow view of what constitutes “good” evidence, and it excludes important qualitative and observational information about the use and benefits of complementary medicine. […]

The Comparative Effect of Episodes of Chiropractic and Medical Treatment on the Health of Older Adults

Chiro.Org Blog: This study provides evidence of the comparative effectiveness of chiropractic care relative to medical-only services on the functional health of older adults during acute episodes of back care. Our results are the first to show the importance of examining chiropractic use within an episode of care in traditional practice settings, rather than focusing on visit frequency alone. Moreover, we evaluated the effects of the treatments received during the episodes on ADLs, IADLs, and LBFs, which are critically important measures that inform patients, clinicians, and payers about the benefits and harms of certain treatments relative to others. Given the literature supporting a minimally effective chiropractic treatment level for back problems, this research provides additional support that such therapeutic levels are indeed beneficial in terms of protecting older persons from functional declines and self-rated health over as much as 2 years. […]

The Collateral Benefits Of Having Chiropractic Available In A Public Central Hospital

Chiro.Org Blog: The objective of this paper is to show that improved management of muscular and skeletal problems within a hospital setting depends on the availability of chiropractic health care as a treatment option. A majority of pain patients, after being subjected to traditional conservative treatment, usually over a period of several years, fail to return to work despite younger than average age. The only effective procedures seem to be those of chiropractors. In order to benefit from their particular knowledge, public hospitals need to open their doors to chiropractors. […]

Spinal Manipulation Compared with Back School and with Individually Delivered Physiotherapy

Chiro.Org Blog: Spinal manipulation was associated with higher functional improvement and long-term pain relief than back school or individual physiotherapy, but received more further treatment at follow-ups; pain recurrences and drug intake were also reduced compared to back school or individual physiotherapy. […]

Behavioral and Physical Treatments for Tension-type and Cervicogenic Headache

Chiro.Org Blog: Manipulation appeared to result in immediate improvement in headache severity when used to treat episodes of cervicogenic headache when compared with an attention-placebo control. Furthermore, when compared to soft-tissue therapies (massage), a course of manipulation treatments resulted in sustained improvement in headache frequency and severity. […]

The Efficacy of Spinal Manipulation, Amitriptyline and the Combination of Both Therapies for the Prophylaxis of Migraine Headache

Chiro.Org Blog: Spinal manipulation seemed to be as effective as a well-established and efficacious treatment (amitriptyline), and on the basis of a benign side effects profile, it should be considered a treatment option for patients with frequent migraine headaches […]

Spinal Manipulation vs. Amitriptyline for the Treatment of Chronic Tension-type Headaches: A Randomized Clinical Trial

Chiro.Org Blog: This study compared the effects of spinal manipulation and pharmaceutical treatments for chronic tension headaches. Four weeks following the cessation of treatment, the pharmaceutical group demonstrated no improvement from the baseline. In the spinal manipulation group, headache intensity dropped 32 percent; frequency dropped 42 percent; and there was an overall improvement of 16 percent in functional health status. […]

A Theoretical Model For The Development Of A Diagnosis-based Clinical Decision Rule For The Management Of Patients With Spinal Pain

Chiro.Org Blog: Chronic spinal pain is an increasingly common problem in Western Society [1]. Spinal disorders exact great costs, in terms of both direct medical costs and indirect costs related to disability and lost productivity [1-3]. A number of researchers have attempted to improve our ability to identify the causes of spinal pain as well as to diagnose and treat patients with this problem. In spite of this, accurate diagnosis, leading to specific, targeted treatments, of patients with spinal pain has been elusive. […]

A Randomised Controlled Trial of Preventive Spinal Manipulation With and Without a Home Exercise Program For Patients With Chronic Neck Pain

Chiro.Org Blog: This study hypothesised that participants in the combined intervention group would have less pain and disability and better function than participants from the 2 other groups during the preventive phase of the trial. This hypothesis was not supported by the study results. Lack of a treatment specific effect is discussed in relation to the placebo and patient provider interactions in manual therapies. Further research is needed to delineate the specific and non-specific effects of treatment modalities to prevent unnecessary disability and to minimise morbidity related to NCNP. Additional investigation is also required to identify the best strategies for secondary and tertiary prevention of NCNP. […]

Evidence-Based Guidelines for the Chiropractic Treatment of Adults With Neck Pain

Chiro.Org Blog: The annual prevalence of nonspecific neck pain is estimated to range between 30% and 50%. [1] Persistent or recurrent neck pain continues to be reported by 50% to 85% of patients 1 to 5 years after initial onset. [2] Its course is usually episodic, and complete recovery is uncommon for most patients. [3] Twenty-seven percent of patients seeking chiropractic treatment report neck or cervical problems. [4] Thus, treatment of neck pain is an integral part of chiropractic practice. […]

A Clinical Model for the Diagnosis and Management of Patients with Cervical Spine Syndromes

Chiro.Org Blog: Neck pain and related disorders are a group of conditions that are common and often disabling. It can be argued that the importance of these disorders is under-appreciated. Because of the prevalence of low back pain and its great cost to society, much clinical attention and research dollars are focused on the low back. But epidemiological research suggests that cervical related disorders are as common and may be more costly to society than low back disorders. [1-4] […]