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Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain

Chiro.Org Blog: Given that most patients with acute or subacute low back pain improve over time regardless of treatment, clinicians and patients should select nonpharmacologic treatment with superficial heat (moderate-quality evidence), massage, acupuncture, or spinal manipulation (low-quality evidence). […]

GRADE: An Emerging Consensus on Rating Quality of Evidence and Strength of Recommendations

Chiro.Org Blog: Guidelines are inconsistent in how they rate the quality of evidence and the strength of recommendations. This article explores the advantages of the GRADE system, which is increasingly being adopted by organisations worldwide. […]

Clinical Practice Guidelines for the Noninvasive Management
of Low Back Pain

Chiro.Org Blog: Most high-quality guidelines recommend education, staying active/exercise, manual therapy and paracetamol/NSAIDs as first-line treatments for LBP. Recommendation of paracetamol for acute LBP is challenged by recent evidence and needs updating. […]

Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society

Chiro.Org Blog: Many options are available for evaluation and management of low back pain. However, there has been little consensus, either within or between specialties, on appropriate clinical evaluation [9] and management [10] of low back pain. Numerous studies show unexplained, large variations in use of diagnostic tests and treatments. [11, 12] Despite wide variations in practice, patients seem to experience broadly similar outcomes, although costs of care can differ substantially among and within specialties. [13, 14] […]

An Updated Overview of Clinical Guidelines for the Management of Non-specific Low Back Pain in Primary Care

Chiro.Org Blog: This updated review includes national clinical guidelines from 13 countries and 2 international clinical guidelines from Europe published from 2000 until 2008. The content of the guidelines appeared to be quite similar regarding the diagnostic classification (diagnostic triage) and the use of diagnostic and therapeutic interventions. Consistent features for acute low back pain were the early and gradual activation of patients, the discouragement of prescribed bed rest and the recognition of psychosocial factors as risk factors for chronicity. […]

Management of Neck Pain and Associated Disorders

Chiro.Org Blog: This guideline is based on recent systematic reviews of high-quality studies. A multidisciplinary expert panel considered the evidence of effectiveness, safety, cost-effectiveness, societal and ethical values, and patient experiences (obtained from qualitative research) when formulating recommendations. Target audience includes clinicians; target population is adults with grades I-III NAD <6 months duration. […]

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 Nordic Maintenance Care Program: The Clinical Use of Identified Indications for Preventive Care

Chiro.Org Blog: The study largely confirms the clinical use of the previously identified indications for recommending Maintenance Care for recurrent and persistent LBP. Previous episodes of LBP was the strongest indicator. […]

New Oregon LBP Guidelines: Try Chiropractic First

Chiro.Org Blog: The new State of Oregon Evidence-Based Clinical Guidelines for the Evaluation and Management of Low Back Pain recommend spinal manipulation as the only nonpharmacological treatment for acute lower back pain. […]

When Research Challenges Our Assumptions

Chiro.Org Blog: When new research, research reviews or practice guidelines support our current beliefs and practices, enthusiasm comes easily. When the 2007 medical practice guidelines on low back pain (LBP) jointly prepared by the American Pain Society and the American College of Physicians recognized spinal manipulation as the only non-pharmacologic method providing “proven benefits” for acute LBP and as one of several methods (including exercise, rehabilitation, acupuncture and yoga) proven effective for chronic LBP, the American Chiropractic Association and doctors of chiropractic (DCs) everywhere welcomed this as a long-overdue recognition of the value of our primary treatment methods. […]

The First Domino: Chiropractic Before Spinal Surgery for Chronic Low Back Pain

Chiro.Org Blog: As of Jan. 1, 2012, candidates for spine surgery must receive “prior authorization to determine medical necessity,” which includes verification that the patient has “tried and failed a 3-month course of conservative management that included physical therapy, chiropractic therapy, and medication.” […]

ACOEM Recognizes the Value of Chiropractic for Chronic Spinal Pain

Chiro.Org Blog: The American College of Occupational and Environmental Medicine recommends spinal manipulation for Chronic Spinal Pain […]

The CCE and Section 602.13

As has been (not so) widely reported, the National Advisory Committee on Institutional Quality and Integrity (NACIQI) of the US Department of Education met on December 14, 2011 to consider the Council on Chiropractic Education’s petition for renewal of recognition. The process of continuing the recognition of an existing agency is generally […]

A Systematic Review of Chiropractic Management of Adults with Whiplash Associated Disorders: Recommendations for Advancing Evidence-based Practice and Research

Chiro.Org Blog: There is a baseline of evidence that suggests chiropractic care improves the cervical range of motion (cROM) and pain in the management of WAD. However, the level of this evidence relevant to clinical practice remains low or draws on clinical consensus at this time. The WAD-Plus Model has implications for use by chiropractors and interdisciplinary professionals in the assessment and management of acute, sub-acute and chronic pain due to WAD. Furthermore, the WAD-Plus Model can be used in the future study of interventions and outcomes to advanced evidenced-based care in the management of WAD. […]

How To Use the Evaluation & Management (E&M) Codes Properly: Part III

Chiro.Org Blog: In the last installment, the elements of your patient’s examination were reviewed and you learned how it is the second of the three key elements of the patient’s E/M service. Now, the third part of this E/M documentation series will unravel the final component of the E/M code: medical decision making (MDM). For chiropractors, this is usually the diagnosis and treatment plan. […]