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Cost Effectiveness of Spinal Manipulation

Chiro.Org Blog: This systematic review found SMT to be a cost-effective treatment to manage spinal pain when used alone or in combination with GP care or advice and exercise compared to GP care alone, exercise or any combination of these. The findings were primarily based on single studies conducted in the UK and the Netherlands. […]

Changes in Vertebral Artery Blood Flow Following Various Head Positions and Cervical Spine Manipulation

This pilot study was conducted as a blinded examiner cohort with 4 randomized clinical tasks. Ten healthy male participants aged 24 to 30 years (mean, 26.8 years) volunteered to participate in the study. None of the participants had a history of disabling neck, arm, or headache pain within the last 6 months. They did not have any current or history of neurologic symptoms. In a neutral head position, physiologic measures of VA blood flow and velocity at the C1-2 spinal level were obtained using phase-contrast magnetic resonance imaging after 3 different head positions and a chiropractic upper cervical spinal manipulation. A total of 30 flow-encoded phase-contrast images were collected over the cardiac cycle, in each of the 4 conditions, and were used to provide a blood flow profile for one complete cardiac cycle. Differences between flow (in milliliters per second) and velocity (in centimeters per second) variables were evaluated using repeated-measures analysis of variance. […]

A Diagnosis-based Clinical Decision Rule For Spinal Pain Part 2: Review Of The Literature

Chiro.Org Blog: Accurate diagnosis or classification of patients with spinal pain has been identified as a research priority [1]. We presented in Part 1 the theoretical model of an approach to diagnosis in patients with spinal pain [2]. This approach incorporated the various factors that have been found, or in some cases theorized, to be of importance in the generation and perpetuation of neck or back pain into an organized scheme upon which a management strategy can be based. The authors termed this approach a diagnosis-based clinical decision rule (DBCDR). The DBCDR is not a clinical prediction rule. It is an attempt to identify aspects of the clinical picture in each patient that are relevant to the perpetuation of pain and disability so that these factors can be addressed with interventions designed to improve them. The purpose of this paper is to review the literature on the methods involved in the DBCDR regarding reliability and validity and to identify those areas in which the literature is currently lacking. […]

The Effect of Application Site of Spinal Manipulative Therapy (SMT) on Spinal Stiffness

Chiro.Org Blog: Decreases in terminal spinal stiffness were observed after SMT delivered at some application sites but not the others. The results suggest that SMT contact site modulates SMT’s effect on spinal stiffness in a feline model. Changes in spinal terminal instantaneous spinal stiffness were similar in magnitude and direction to those observed in symptomatic human subjects who report benefits after SMT. […]

A Comprehensive Review of Chiropractic Research

Chiro.Org Blog: You will love this comprehensive review of Chiropractic Research, by Anthony L. Rosner, Ph.D., Former Director of Research and Education for the Foundation for Chiropractic Education and Research (FCER) until its demise (1992-2007), and is now the current Director of Research at International College of Applied Kinesiology (USA). […]

Spinal Manipulation: The Right Choice For Relieving Low Back Pain

Chiro.Org Blog: In a subgroup of patients with acute nonspecific LBP, spinal manipulation was significantly better than nonsteroidal anti-inflammatory drug diclofenac and clinically superior to placebo. […]

More on Chiropractic Cost Effectiveness

Chiro.Org Blog: This 2012 systemic review found spinal manipulation therapy to be more cost-effective for neck and low back pain when compared with general practitioner care, physiotherapy or exercise. […]

Clinical Disorders and the Sensory System

Chiro.Org Blog: This chapter describes those sensory mechanisms, joint signals, and abnormal sensations (eg, pain, thermal abnormalities) that have particular significance within clinical diagnosis. The basis and differentiation of pain are described, as are the related subjects of trigger points and paresthesia. The chapter concludes with a description of the neurologic basis for the evaluation of the sensory system and the sensory fibers of the cranial nerves. […]

The Quality of Reports on Cervical Arterial Dissection Following Cervical Spinal Manipulation

Chiro.Org Blog: This paper examined the quality of literature describing an association between cSMT and CAD. Case reports represented the majority of this literature. Since these reports may contribute to further understanding CADs as they relate to manual therapy, it is important that they are of the highest quality. This study has demonstrated that the literature infrequently reports useful data toward understanding the association between cSMT, CADs and stroke. As a result, the value of these reports toward informing our understanding of the relation between cSMT and CAD is minimal. We suggest that through the systematic collection of data features presented in this paper, a clearer clinical picture of the association between cSMT and CAD would be possible. This study lays the groundwork for developing a universal reporting tool for adverse events related to cSMT. […]

Algorithms for the Chiropractic Management of Acute and Chronic Spine-Related Pain

Chiro.Org Blog: The complexity of clinical documentation and case management for health care providers has increased along with the rise of managed care. Keeping up with the policies of different insurers and third party administrators can be a daunting task. To address these issues for doctors of chiropractic (DCs) and policymakers, the Council for Chiropractic Guidelines and Practice Parameters (CCGPP) developed three consensus documents. Each of these documents was the outcome of a formal consensus process in which a multidisciplinary Delphi panel consisting of experts in chiropractic and low back pain treatment came to agreement on terminology and treatment parameters for the chiropractic management of spine-related musculoskeletal pain. [1-3] […]

Combination of Acupuncture and Spinal Manipulative Therapy: Management of a 32-year-old Patient With Chronic Tension-type Headache and Migraine

Chiro.Org Blog: The combination of acupuncture with chiropractic spinal manipulative therapy was a reasonable alternative in treating this patient’s chronic tension-type headaches superimposed with migraine. […]

There Will Never Be Enough Research To Satisfy Our Critics

Chiro.Org Blog: For some, there will never be enough research to support the use of chiropractic. These people mask themselves behind a claim that they wish to protect patients from quackish practices. For those who may have forgotten, or for those who never knew, organized medicine spent decades and tens of millions of dollars trying to discredit and destroy chiropractic. Today the vestiges of this suppression are still found on fringe web sites that ignore the body of peer-reviewed research supporting chiropractic care. […]

Comparison of Outcomes in Neck Pain Patients With and Without Dizziness

Chiro.Org Blog: Neck pain patients with dizziness reported significantly higher pain and disability scores at baseline compared to patients without dizziness. A high proportion of patients in both groups reported clinically relevant improvement on the PGIC scale. At 6 months after start of chiropractic treatment there were no differences in any outcome measures between the two groups. […]

Clinical Biomechanics: Mechanical Concepts and Terms

Chiro.Org Blog: All motor activities such as walking, running, jumping, squatting, pushing, pulling, lifting, and throwing are examples of dynamic musculoskeletal mechanics. To better appreciate the sometimes simple and often complex factors involved, this chapter reviews the basic concepts and terms involved in maintaining static equilibrium. Static equilibrium is the starting point for all dynamic activities. […]

Choice: It Really Does Matter!

Chiro.Org Blog: This review, by scientists at the Department of Orthopaedics at the Geisel School of Medicine, clearly suggests that the first doctor you choose to see will have a dramatic effect on whether you end up having spinal surgery. […]