April 2017
M T W T F S S
« Mar    
 12
3456789
10111213141516
17181920212223
24252627282930

Archives

Please support our Sponsors

Leg Pain Location and Neurological Signs Relate to Outcomes in Primary Care Patients with Low Back Pain

Leg Pain Location and Neurological Signs Relate to Outcomes in Primary Care Patients with Low Back Pain

The Chiro.Org Blog


SOURCE:   BMC Musculoskelet Disord. 2017 (Mar 31); 18 (1): 133

Lisbeth Hartvigsen, Lise Hestbaek, Charlotte Lebouef-Yde,
Werner Vach and Alice Kongsted

Department of Sports Science and Clinical Biomechanics,
University of Southern Denmark


BACKGROUND:   Low back pain (LBP) patients with related leg pain and signs of nerve root involvement are considered to have a worse prognosis than patients with LBP alone. However, it is unclear whether leg pain location above or below the knee and the presence of neurological signs are important in primary care patients. The objectives of this study were to explore whether the four Quebec Task Force categories (QTFC) based on the location of pain and on neurological signs have different characteristics at the time of care seeking, whether these QTFC are associated with outcome, and if so whether there is an obvious ranking of the four QTFC on the severity of outcomes.

METHOD:   Adult patients seeking care for LBP in chiropractic or general practice were classified into the four QTFC based on self-reported information and clinical findings. Analyses were performed to test the associations between the QTFC and baseline characteristics as well as the outcomes global perceived effect and activity limitation after 2 weeks, 3 months, and 1 year and also 1-year trajectories of LBP intensity.

RESULTS:   The study comprised 1,271 patients; 947 from chiropractic practice and 324 from general practice. The QTFC at presentation were statistically significantly associated with most of the baseline characteristics, with activity limitation at all follow-up time points, with global perceived effect at 2 weeks but not 3 months and 1 year, and with trajectories of LBP. Severity of outcomes in the QTFC increased from LBP alone, across LBP with leg pain above the knee and below the knee to LBP with nerve root involvement. However, the variation within the categories was considerable.

There are more articles like this @ our:

Clinical Prediction Rule Page and the:

Low Back Pain and Chiropractic Page

Continue reading Leg Pain Location and Neurological Signs Relate to Outcomes in Primary Care Patients with Low Back Pain

Pain Location Matters: The Impact of Leg Pain on Health Care Use, Work Disability and Quality of Life in Patients with Low Back Pain

Pain Location Matters: The Impact of Leg Pain on Health Care Use, Work Disability and Quality of Life in Patients with Low Back Pain

The Chiro.Org Blog


SOURCE:   Eur Spine J. 2015 (Mar); 24 (3): 444–451

Samantha L. Hider, David G. T. Whitehurst,
Elaine Thomas, Nadine E. Foster

Arthritis Research UK Primary Care Centre,
Keele University, Keele,
Staffordshire, ST5 5BG, UK.


PURPOSE:   In low back pain (LBP) patients, those with radiating leg pain or sciatica have poorer pain and disability outcomes. Few studies have assessed the effect of leg pain on health care use and quality of life.

METHODS:   Prospective cohort study of 1,581 UK LBP primary care consulters. Back pain, employment, health care utilisation, and quality of life (EQ-5D) data were collected at baseline, 6 and 12 months. At baseline, patients were classified as reporting

(1)   LBP only

(2)   LBP and leg pain above the knee only (LBP + AK) or

(3)   LBP and leg pain extending below the knee (LBP + BK).

RESULTS:   Self-reported leg pain was common; at baseline 645 (41%) reported LBP only, 392 (25%) reported LBP + AK and 544 (34%) reported LBP + BK. Patients with LBP + BK, compared to those with LBP only, were significantly more likely to be unemployed, take time off work, consult their family doctor, receive physical therapy, or be referred to other health care practitioners. There were statistically significant decrements in EQ-5D scores for LBP + AK compared to LBP only, and for LBP + BK compared to LBP + AK (p ≤ 0.05 for all comparisons).

There are more articles like this @ our:

Radiculopathy and Chiropractic Page and the:

Low Back Pain and Chiropractic Page

Continue reading Pain Location Matters: The Impact of Leg Pain on Health Care Use, Work Disability and Quality of Life in Patients with Low Back Pain

Complementary and Alternative Medicine Use by Children with Pain in the United States

Complementary and Alternative Medicine Use by Children with Pain in the United States

The Chiro.Org Blog


SOURCE:   Acad Pediatr. 2017 (Feb 20).  pii: S1876-2859(17)30063-3

Cornelius B. Groenewald, MBChB, Sarah E. Beals-Erickson, PhD, Jaime Ralston-Wilson, DAOM, LAc, Jennifer A. Rabbitts, MB, ChB, Tonya M. Palermo, PhD

Department of Anesthesiology and Pain Medicine,
University of Washington School of Medicine and Seattle Children’s Hospital.
M/S MB.11.500, 4800 Sand Point Way NE,
Seattle, WA 98105, USA.


OBJECTIVE:   Chronic pain is reported by 15-25% of children. Growing evidence from clinical samples suggests that complementary and alternative medicine (CAM) therapies are desired by families and may benefit some children with pain conditions. The objective of this study is to provide estimates of CAM use by children with pain in the United States.

METHODS:   We analyzed data from the 2012 National Health Interview Survey (NHIS) to estimate patterns, predictors, and perceived benefits of CAM use among children 4-17 years of age with and without painful conditions in the US. We used χ2 tests to compare the prevalence rates of CAM use among children with pain to CAM use among children without pain. Multivariable logistic regression was used to examine factors associated with CAM use within the group of children with pain conditions.

RESULTS:   Parents reported that 26.6% of children had pain conditions (e.g. headache, abdominal, musculoskeletal pain) in the past year; of these children, 21.3% used CAM. In contrast only 8.1% of children without pain conditions used CAM (χ2: p< .001). CAM use among children with pain was associated with female sex (adjusted odds ratio (aOR)=1.49, p=0.005), higher income (aOR=1.61, p=0.027), and presence of 4+ comorbidities (aOR=2.01, p=0.013). Among children with pain who used CAM the 2 most commonly used CAM modalities were biologically-based therapies (47.3%) (e.g., special diets and herbal supplements) and manipulative or body-based therapies (46.3%) (e.g., chiropractic and massage).

There are more articles like this @ our:

Chiropractic Pediatrics Page and the:

Chiropractic and Spinal Pain Page

Continue reading Complementary and Alternative Medicine Use by Children with Pain in the United States

Core Competencies of the Certified Pediatric Doctor of Chiropractic

Core Competencies of the Certified Pediatric Doctor of Chiropractic: Results of a Delphi Consensus Process

The Chiro.Org Blog


J Evid Based Comp Altern Med. 2016 (Apr); 21 (2): 110–114

Elise Hewitt, DC, DICCP, FICC, Lise Hestbaek, DC, PhD,
Katherine A. Pohlman, DC, MS, DICCP, PhD(c)

Portland Chiropractic Group and University of Western States,
Portland, OR, USA


An outline of the minimum core competencies expected from a certified pediatric doctor of chiropractic was developed using a Delphi consensus process. The initial set of seed statements and substatements was modeled on competency documents used by organizations that oversee chiropractic and medical education. These statements were distributed to the Delphi panel, reaching consensus when 80% of the panelists approved each segment.

The panel consisted of 23 specialists in chiropractic pediatrics (14 females) from across the broad spectrum of the chiropractic profession. Sixty-one percent of panelists had postgraduate pediatric certifications or degrees, 39% had additional graduate degrees, and 74% were faculty at a chiropractic institution and/or in a postgraduate pediatrics program. The panel were initially given 10 statements with related substatements formulated by the study’s steering committee. On all 3 rounds of the Delphi process the panelists reached consensus; however, multiple rounds occurred to incorporate the valuable qualitative feedback received.

There are more articles like this @ our:

Chiropractic Pediatrics Section

Continue reading Core Competencies of the Certified Pediatric Doctor of Chiropractic

Self-reported Attitudes, Skills and Use of Evidence-based Practice Among Canadian Doctors of Chiropractic

Self-reported Attitudes, Skills and Use of Evidence-based Practice Among Canadian Doctors of Chiropractic: A National Survey

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc. 2015 (Dec); 59 (4): 332–348

André E. Bussières, DC, PhD, Lauren Terhorst, PhD,
Matthew Leach, RN, BN (Hons), ND, PhD,
Kent Stuber, DC, MSc, Roni Evans, DC, PhD, and
Michael J. Schneider, DC, PhD

Assistant Professor,
School of Physical and Occupational Therapy,
McGill University
Département Chiropratique,
Université du Québec à Trois-Rivières.


OBJECTIVES:   To identify Canadian chiropractors’ attitudes, skills and use of evidence based practice (EBP), as well as their level of awareness of previously published chiropractic clinical practice guidelines (CPGs).

OBJECTIVES:   7,200 members of the Canadian Chiropractic Association were invited by e-mail to complete an online version of the Evidence Based practice Attitude & utilisation SurvEy (EBASE); a valid and reliable measure of participant attitudes, skills and use of EBP.

RESULTS:   Questionnaires were completed by 554 respondents. (7.7% of those invited) Most respondents (>75%) held positive attitudes toward EBP. Over half indicated a high level of self-reported skills in EBP, and over 90% expressed an interest in improving these skills. A majority of respondents (65%) reported over half of their practice was based on evidence from clinical research, and only half (52%) agreed that chiropractic CPGs significantly impacted on their practice.

There are more articles like this @ our:

The Evidence-based Practice Page

Continue reading Self-reported Attitudes, Skills and Use of Evidence-based Practice Among Canadian Doctors of Chiropractic

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

Attitudes and Opinions of Doctors of Chiropractic Specializing in Pediatric Care Toward Patient Safety: A Cross-sectional Survey

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2016 (Sep); 39 (7): 487–493

Katherine A. Pohlman, DC, MS, Linda Carroll, PhD,
Lisa Hartling, PhD, MSc, Ross Tsuyuki, PharmD, MSc,
Sunita Vohra, MD, MSc

Research Institute,
Parker University,
Dallas, TX.


OBJECTIVE:   The purpose of this cross-sectional survey was to evaluate attitudes and opinions of doctors of chiropractic (DCs) specializing in pediatric care toward patient safety.

METHODS:   The Medical Office Survey on Patient Safety Culture of the Agency for Healthcare Research and Quality was adapted for providers who use spinal manipulation therapy and sent out to 2 US chiropractic organizations’ pediatric council members (n = 400) between February and April 2014. The survey measured 12 patient safety dimensions and included questions on patient safety items and quality issues, information exchange, and overall clinic ratings. Data analyses included a percent composite average and a nonrespondent analysis.

RESULTS:   The response rate was 29.5% (n = 118). Almost one- third of respondents’ patients were pediatric (≤17 years of age). DCs with a pediatric certification were 3 times more likely to respond (P < .001), but little qualitative differences were found in responses. The patient safety dimensions with the highest positive composite percentages were Organizational Learning (both administration and clinical) and Teamwork (>90%). Patient Care Tracking/Follow-up and Work Pressure and Pace were patient safety dimensions that had the lowest positive composite scores (<85%). The responses also indicated that there was concern regarding information exchange with insurance/third-party payors. Two quality issues identified for improvement were (1) updating a patient’s medication list and (2) following up on critically abnormal results from a laboratory or imaging test within 1 day. The average overall patient safety rating score indicated that 83% of respondents rated themselves as “very good” or “excellent.”

There are more articles like this @ our:

Chiropractic Pediatrics Section

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

Primary Prevention in Chiropractic Practice: A Systematic Review

Primary Prevention in Chiropractic Practice:
A Systematic Review

The Chiro.Org Blog


SOURCE:   Chiropractic & Manual Therapies 2017 (Mar 14); 25: 9

Guillaume Goncalves, Christine Le Scanff1, and
Charlotte Leboeuf-Yde

CIAMS,
University of Paris-Sud,
University of Paris-Saclay


Background   Chiropractors are primarily concerned with musculoskeletal disorders but have the responsibility to deal also with prevention in other areas.

Objectives   To establish the prevalence of chiropractors who have a positive opinion on the use of primary prevention (PP), their actual use of PP, and the proportion of patients who consult for PP in relation to

(i)   musculoskeletal disorders,
(ii)   public health issues, or
(iii)   chiropractic treatment for wellness.

Method   A systematic search for literature was done using PubMed, Embase, Index to Chiropractic Literature, and and updated on February 15th 2017. Inclusion criteria were: surveys on chiropractors and/or chiropractic patients, information had to be present on PP in relation to the percentage of patients who consult for PP in chiropractic practice or in a chiropractic student clinic, and/or the percentage of chiropractors who reported using PP, and/or information on chiropractors’ opinions of the use of PP, in the English, French, or Scandinavian languages. The review followed the PRISMA guidelines. Articles were classified as ‘good’, ‘acceptable’ and ‘unacceptable’ based on scores of quality items. Results from the latter group were not taken into account.

Results   Twenty-five articles were included, reporting on twenty-six studies, 19 of which dealt with wellness. The proportion of chiropractors who stated that they had a positive opinion on primary prevention (PP) was generally higher than the proportion of chiropractors offering PP. Most chiropractors offered some type of PP for musculoskeletal disorders and more than a half stated that they did so in the public health area but also for wellness. For all types of PP, however, it was rarely stated to be the reason for patients consulting. Regardless the type of PP, the proportion of patients who actually consulted specifically for PP was much smaller than the proportion of chiropractors offering PP.

There are more articles like this @ our:

Health Promotion & Wellness Page

Continue reading Primary Prevention in Chiropractic Practice: A Systematic Review

A Videofluoroscopy-based Tracking Algorithm for Quantifying the Time Course of Human Intervertebral Displacements

A Videofluoroscopy-based Tracking Algorithm for Quantifying the Time Course of Human Intervertebral Displacements

The Chiro.Org Blog


Comput Methods Biomech Biomed Engin. 2017 (Mar 15): 1-9

Christian Balkovec, Jim H. Veldhuis,
John W. Baird, G. Wayne Brodland &
Stuart M. McGill

Department of Kinesiology,
University of Waterloo,
Waterloo, Canada.


The motions of individual intervertebral joints can affect spine motion, injury risk, deterioration, pain, treatment strategies, and clinical outcomes. Since standard kinematic methods do not provide precise time-course details about individual vertebrae and intervertebral motions, information that could be useful for scientific advancement and clinical assessment, we developed an iterative template matching algorithm to obtain this data from videofluoroscopy images.

To assess the bias of our approach, vertebrae in an intact porcine spine were tracked and compared to the motions of high-contrast markers. To estimate precision under clinical conditions, motions of three human cervical spines were tracked independently ten times and vertebral and intervertebral motions associated with individual trials were compared to corresponding averages. Both tests produced errors in intervertebral angular and shear displacements no greater than 0.4° and 0.055 mm, respectively.

There are more articles like this @ our:

Spinal Alignment and Cervical Curve Page

Continue reading A Videofluoroscopy-based Tracking Algorithm for Quantifying the Time Course of Human Intervertebral Displacements

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

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

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2011 (Feb); 34 (2): 88–97

Heidi Haavik, PhD, BSc (Chiro),
Bernadette Murphy, PhD, DC

New Zealand College of Chiropractic,
Auckland, New Zealand.
heidi.haavik@nzchiro.co.nz


OBJECTIVE:   The objectives of this study were to investigate whether elbow joint position sense (JPS) accuracy differs between participants with a history of subclinical neck pain (SCNP) and those with no neck complaints and to determine whether adjusting dysfunctional cervical segments in the SCNP group improves their JPS accuracy.

METHOD:   Twenty-five SCNP participants and 18 control participants took part in this pre-post experimental study. Elbow JPS was measured using an electrogoniometer (MLTS700, ADInstruments, New Zealand). Participants reproduced a previously presented angle of the elbow joint with their neck in 4 positions: neutral, flexion, rotation, and combined flexion/rotation. The experimental intervention was high-velocity, low-amplitude cervical adjustments, and the control intervention was a 5-minute rest period. Group JPS data were compared, and it was assessed pre and post interventions using 3 parameters: absolute, constant, and variable errors.

RESULTS:   At baseline, the control group was significantly better at reproducing the elbow target angle. The SCNP group’s absolute error significantly improved after the cervical adjustments when the participants’ heads were in the neutral and left-rotation positions. They displayed a significant overall decrease in variable error after the cervical adjustments. The control group participants’ JPS accuracy was worse after the control intervention, with a significant overall effect in absolute and variable errors. No other significant effects were detected.

There are more articles like this @ our:

Neurology subsection

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

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

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

The Chiro.Org Blog


SOURCE:   Journal of Occupational Rehabilitation 2016 (Sep 17)

Marc-André Blanchette, Michèle Rivard, Clermont E. Dionne, Sheilah Hogg-Johnson, Ivan Steenstra

Public Health PhD Program,
School of Public Health,
University of Montreal,
Montreal, QC, Canada.


Objective   To compare the duration of financial compensation and the occurrence of a second episode of compensation of workers with occupational back pain who first sought three types of healthcare providers.

Methods   We analyzed data from a cohort of 5,511 workers who received compensation from the Workplace Safety and Insurance Board for back pain in 2005. Multivariable Cox models controlling for relevant covariables were performed to compare the duration of financial compensation for the patients of each of the three types of first healthcare providers. Logistic regression was used to compare the occurrence of a second episode of compensation over the 2-year follow-up period.

Results   Compared with the workers who first saw a physician (reference), those who first saw a chiropractor experienced shorter first episodes of 100 % wage compensation (adjusted hazard ratio [HR] = 1.20 [1.10-1.31], P value < 0.001), and the workers who first saw a physiotherapist experienced a longer episode of 100 % compensation (adjusted HR = 0.84 [0.71-0.98], P value = 0.028) during the first 149 days of compensation. The odds of having a second episode of financial compensation were higher among the workers who first consulted a physiotherapist (OR = 1.49 [1.02-2.19], P value = 0.040) rather than a physician (reference).

There are more articles like this @ our:

Cost-Effectiveness of Chiropractic Page

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

Early Predictors of Lumbar Spine Surgery After Occupational Back Injury

Early Predictors of Lumbar Spine Surgery After Occupational Back Injury: Results From a Prospective Study of Workers in Washington State

The Chiro.Org Blog


SOURCE:   Spine (Phila Pa 1976). 2013 (May 15); 38 (11): 953–964

Benjamin J. Keeney, PhD, Deborah Fulton-Kehoe, PhD, MPH, Judith A. Turner, PhD, Thomas M. Wickizer, PhD, Kwun Chuen Gary Chan, PhD, and Gary M. Franklin, MD, MPH


Department of Orthopaedics,
Geisel School of Medicine at Dartmouth College,
Lebanon, NH 03756, USA.


STUDY DESIGN:   Prospective population-based cohort study.

OBJECTIVE:   To identify early predictors of lumbar spine surgery within 3 years after occupational back injury.

SUMMARY OF BACKGROUND DATA:   Back injuries are the most prevalent occupational injury in the United States. Few prospective studies have examined early predictors of spine surgery after work-related back injury.

METHODS:   Using Disability Risk Identification Study Cohort (D-RISC) data, we examined the early predictors of lumbar spine surgery within 3 years among Washington State workers, with new workers compensation temporary total disability claims for back injuries. Baseline measures included worker-reported measures obtained approximately 3 weeks after claim submission. We used medical bill data to determine whether participants underwent surgery, covered by the claim, within 3 years. Baseline predictors (P < 0.10) of surgery in bivariate analyses were included in a multivariate logistic regression model predicting lumbar spine surgery. The area under the receiver operating characteristic curve of the model was used to determine the model’s ability to identify correctly workers who underwent surgery.

RESULTS:   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 area under the receiver operating characteristic curve of the multivariate model was 0.93 (95% confidence interval, 0.92-0.95), indicating excellent ability to discriminate between workers who would versus would not have surgery.

There are more articles like this @ our:

Cost-Effectiveness of Chiropractic Page

Continue reading Early Predictors of Lumbar Spine Surgery After Occupational Back Injury

This On-site Chiropractic Clinic Is Saving a Minnesota Manufacturer Big Money

This On-site Chiropractic Clinic Is Saving
a Minnesota Manufacturer Big Money

The Chiro.Org Blog


SOURCE:   The Star Tribune ~ Jan 1, 2017   

By Christopher Cassirer

Northwestern Health Sciences University
Bloomington, MN.


A year into the project, workers report that they are feeling better and like having health care services at their job. Statistics show that they are incurring injuries at much lower rates. They are also recovering quicker when they do get hurt.

And when it comes to the bottom line, the results have been better than Friendship Homes and Northwestern expected. For every $1 that the company has invested in the program, it is saving $8 by avoiding more-costly and less-effective treatments, spending less on insurance payments and keeping more workers on the job in the first place, which generates savings through less lost tine for workers and less overtime to compensate for absences.

As our nation struggles to find an affordable, effective future for health care, some answers may come from an experiment at a midsize employer in Montevideo, Minn.

Friendship Homes, with 180 employees, is one of the largest employers in the town of 5,400 about 130 miles west of the Twin Cities. The company builds prefabricated homes. And like many in construction and related industries, it has struggled to help its employees with back and muscle pain and other injuries caused by strain and overuse.

There are more articles like this @ our:

Cost-Effectiveness of Chiropractic Page

Continue reading This On-site Chiropractic Clinic Is Saving a Minnesota Manufacturer Big Money

Effects of 12 Weeks of Chiropractic Care on Central Integration of Dual Somatosensory Input in Chronic Pain Patients

Effects of 12 Weeks of Chiropractic Care on Central Integration of Dual Somatosensory Input in Chronic Pain Patients: A Preliminary Study

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2017 (Feb 10) [Epub]

Heidi Haavik, PhD, BSc (Chiro), Imran Khan Niazi, PhD,
Kelly Holt, PhD, BSc (Chiro), Bernadette Murphy, PhD, DC

Centre for Chiropractic,
New Zealand College of Chiropractic,
Mount Wellington,
Auckland, New Zealand.


OBJECTIVE:   The purpose of this preliminary study was to assess whether the dual somatosensory evoked potential (SEP) technique is sensitive enough to measure changes in cortical intrinsic inhibitory interactions in patients with chronic neck or upper extremity pain and, if so, whether changes are associated with changes in pain scores.

METHODS:   The dual peripheral nerve stimulation SEP ratio technique was used for 6 subjects with a history of chronic neck or upper limb pain. SEPs were recorded after left or right median and ulnar nerve stimulation at the wrist. SEP ratios were calculated for the N9, N13, P14-18, N20-P25, and P22-N30 peak complexes from SEP amplitudes obtained from simultaneous median and ulnar stimulation divided by the arithmetic sum of SEPs obtained from individual stimulation of the median and ulnar nerves. Outcome measures of SEP ratios and subjects’ visual analog scale rating of pains were recorded at baseline, after a 2-week usual care control period, and after 12 weeks of multimodal chiropractic care (chiropractic spinal manipulation and 1 or more of the following: exercises, peripheral joint adjustments/manipulation, soft tissue therapy, and pain education).

RESULTS:   A significant decrease in the median and ulnar to median plus ulnar ratio and the median and ulnar amplitude for the cortical P22-N30 SEP component was observed after 12 weeks of chiropractic care, with no changes after the control period. There was a significant decrease in visual analog scale scores (both for current pain and for pain last week).

There are more articles like this @ our:

Neurology subsection

Continue reading Effects of 12 Weeks of Chiropractic Care on Central Integration of Dual Somatosensory Input in Chronic Pain Patients

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

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

The Chiro.Org Blog


SOURCE:   Med Care. 2012 (Dec); 50 (12): 1029–1036

Brook I. Martin, PhD MPH, Mary M. Gerkovich, PhD, Richard A. Deyo, MD, MPH, Karen J. Sherman, PhD, MPH, Daniel C. Cherkin, PhD, Bonnie K. Lind, PhD, Christine M. Goertz, DC, PhD, and William E. Lafferty, MD

Department of Orthopaedics,
The Geisel School of Medicine at Dartmouth &
Dartmouth-Hitchcock Medical Center,
Lebanon, NH 03756, USA.


This first national study of CAM/chiropractic expenditures for spine conditions finds that neither adds to overall medical spending.

From Page 23:   A recent study of 12,036 records in the Medical Expenditure Panel Survey (MEPS) investigated the costs of treating patients with low back and neck pain (Martin et al., 2012). The study estimated the expenditures for care among complementary and alternative medicine (chiropractic, homeopathy, herbalism, acupuncture, and massage) users relative to non-users. This study included a chiropractic-specific analysis of expenditures for chiropractic users versus non-users, as approximately 75% of all complementary and alternative medicine services were rendered by doctors of chiropractic.

Survey data were analyzed for the years 2002–2008. The
analysis demonstrated that seeing a CAM/chiropractic provider did not add to overall medical spending. In fact,
adjusted annual healthcare costs among chiropractic users were $424 lower for spine-related costs when compared to non-CAM users.

Additionally, those who used complementary and alternative providers, including doctors of chiropractic, had significantly lower hospitalization expenditures.


BACKGROUND:   Health care costs associated with use of complementary and alternative medicine (CAM) by patients with spine problems have not been studied in a national sample.

OBJECTIVES:   To estimate the total and spine-specific medical expenditures among CAM and non-CAM users with spine problems.

RESEARCH DESIGN:   Analysis of the 2002-2008 Medical Expenditure Panel Survey.

SUBJECTS:   Adults (above 17 y) with self-reported neck and back problems who did or did not use CAM services.

MEASURES:   Survey-weighted generalized linear regression and propensity matching to examine expenditure differences between CAM users and non-CAM users while controlling for patient, socioeconomic, and health characteristics.

RESULTS:   A total of 12,036 respondents with spine problems were included, including 4,306 (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, $1,470; 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.

There are more articles like this @ our:

Cost-Effectiveness of Chiropractic Page

and our

Chronic Neck Pain and Chiropractic Page

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

Psychological and Behavioral Differences Between Low Back Pain Populations

Psychological and Behavioral Differences Between Low Back Pain Populations: A Comparative Analysis of Chiropractic, Primary and Secondary Care Patients

The Chiro.Org Blog


SOURCE:   BMC Musculoskelet Disord. 2015 (Oct 19); 16: 306

Andreas Eklund, Gunnar Bergström,
Lennart Bodin and Iben Axén

Karolinska Institutet,
Institute of Environmental Medicine,
Unit of Intervention and Implementation Research,
Nobels väg 13, S-171 77,
Stockholm, Sweden.


BACKGROUND:   Psychological, behavioral and social factors have long been considered important in the development of persistent pain. Little is known about how chiropractic low back pain (LBP) patients compare to other LBP patients in terms of psychological/behavioral characteristics.

METHODS:   In this cross-sectional study, the aim was to investigate patients with LBP as regards to psychosocial/behavioral characteristics by describing a chiropractic primary care population and comparing this sample to three other populations using the MPI-S instrument. Thus, four different samples were compared.

A: Four hundred eighty subjects from chiropractic primary care clinics.

B: One hundred twenty-eight subjects from a gainfully employed population (sick listed with high risk of developing chronicity).

C: Two hundred seventy-three subjects from a secondary care rehabilitation clinic.

D: Two hundred thirty-five subjects from secondary care clinics.

The Swedish version of the Multidimensional Pain Inventory (MPI-S) was used to collect data. Subjects were classified using a cluster analytic strategy into three pre-defined subgroups (named adaptive copers, dysfunctional and interpersonally distressed).

RESULTS:   The data show statistically significant overall differences across samples for the subgroups based on psychological and behavioral characteristics. The cluster classifications placed (in terms of the proportions of the adaptive copers and dysfunctional subgroups) sample A between B and the two secondary care samples C and D.

There are more articles like this @ our:

Biopsychosocial Model Page

Continue reading Psychological and Behavioral Differences Between Low Back Pain Populations