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Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain

By |March 14, 2020|Spinal Pain|

Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain

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SOURCE:   Pain Med. 2020 (Mar 6) [Epub]

James M. Whedon, DC, MS, Andrew W. J. Toler, MS, Louis A. Kazal, MD, Serena Bezdjian, PhD, Justin M. Goehl, DC, MS et al.

Southern California University of Health Sciences,
Whittier, California.


OBJECTIVE:   Utilization of nonpharmacological pain management may prevent unnecessary use of opioids. Our objective was to evaluate the impact of chiropractic utilization upon use of prescription opioids among patients with spinal pain.

DESIGN AND SETTING:   We employed a retrospective cohort design for analysis of health claims data from three contiguous states for the years 2012-2017.

SUBJECTS:   We included adults aged 18-84 years enrolled in a health plan and with office visits to a primary care physician or chiropractor for spinal pain. We identified two cohorts of subjects: Recipients received both primary care and chiropractic care, and nonrecipients received primary care but not chiropractic care.

METHODS:   We performed adjusted time-to-event analyses to compare recipients and nonrecipients with regard to the risk of filling an opioid prescription. We stratified the recipient populations as: acute (first chiropractic encounter within 30 days of diagnosis) and nonacute (all other patients).

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Patient-reported Improvements of Pain, Disability, and Health-related Quality of Life Following Chiropractic Care for Back Pain

By |May 20, 2019|Spinal Pain|

Patient-reported Improvements of Pain, Disability, and Health-related Quality of Life Following Chiropractic Care for Back Pain – A National Observational Study in Sweden

The Chiro.Org Blog


SOURCE:   J Bodyw Mov Ther. 2019 (Apr);   23 (2):   241–246

Gedin F, MSc; Dansk V, MSc; Egmar A-C, PhD; Sundberg T, PhD; Burström K, PhD

Health Economics and Economic Evaluation Research Group,
Medical Management Centre,
Karolinska Institutet,
Stockholm, Sweden


BACKGROUND:   Chiropractic care is a common but not often investigated treatment option for back pain in Sweden. The aim of this study was to explore patient-reported outcomes (PRO) for patients with back pain seeking chiropractic care in Sweden.

METHODS:   Prospective observational study. Patients 18 years and older, with non-specific back pain of any duration, seeking care at 23 chiropractic clinics throughout Sweden were invited to answer PRO questionnaires at baseline with the main follow-up after four weeks targeting the following outcomes: Numerical Rating Scale for back pain intensity (NRS), Oswestry Disability Index for back pain disability (ODI), health-related quality of life (EQ-5D index) and a visual analogue scale for self-rated health (EQ VAS).

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Change in Young People’s Spine Pain Following Chiropractic Care at a Publicly Funded Healthcare Facility in Canada

By |May 7, 2019|Pediatrics, Spinal Pain|

Change in Young People’s Spine Pain Following Chiropractic Care at a Publicly Funded Healthcare Facility in Canada

The Chiro.Org Blog


SOURCE:   Complement Ther Clin Pract. 2019 (May); 35: 301–307

Christian Manansala, DC, MSc(c), Steven Passmore, DC, PhD, Katie Pohlman, DC, PhD(c), Audrey Toth, DC, Gerald Olin, BSc, DC, CDir

Faculty of Kinesiology and Recreation Management,
University of Manitoba, Canada.



BACKGROUND:   The presence of spinal pain in young people has been established as a risk factor for spinal pain later in life. Recent clinical practice guidelines recommend spinal manipulation (SM), soft tissue therapy, acupuncture, and other modalities that are common treatments provided by chiropractors, as interventions for spine pain. Less is known specifically on the response to chiropractic management in young people with spinal pain. The purpose of this manuscript was to describe the impact, through pain measures, of a pragmatic course of chiropractic management in young people’s spinal pain at a publicly funded healthcare facility for a low-income population.

METHODS:   The study utilized a retrospective analysis of prospectively collected quality assurance data attained from the Mount Carmel Clinic (MCC) chiropractic program database. Formal permission to conduct the analysis of the database was acquired from the officer of records at the MCC. The University of Manitoba’s Health Research Ethics Board approved all procedures.

RESULTS:   Young people (defined as 10-24 years of age) demonstrated statistically and clinically significant improvement on the numeric rating scale (NRS) in all four spinal regions following chiropractic management.

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Use of Non-Pharmacological Pain Treatment Modalities Among Veterans with Chronic Pain

By |May 6, 2019|Spinal Pain, Veterans|

Use of Non-Pharmacological Pain Treatment Modalities Among Veterans with Chronic Pain:

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SOURCE:   J Gen Intern Med. 2018 (May); 33 (Sup 1): 54–60

Sara N. Edmond, Ph.D., William C. Becker, M.D., Mary A. Driscoll, Ph.D., Suzanne E. Decker, Ph.D., Diana M. Higgins, Ph.D., Kristin M. Mattocks, Ph.D., M.P.H., Robert D. Kerns, Ph.D., and Sally G. Haskell, M.D.

Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center/11ACSLG,
VA Connecticut Healthcare System,
950 Campbell Avenue, West Haven, CT, 06516, USA.



BACKGROUND:   Despite strong evidence for the effectiveness of non-pharmacological pain treatment modalities (NPMs), little is known about the prevalence or correlates of NPM use.

OBJECTIVE:   This study examined rates and correlates of NPM use in a sample of veterans who served during recent conflicts.

DESIGN:   We examined rates and demographic and clinical correlates of self-reported NPM use (operationalized as psychological/behavioral therapies, exercise/movement therapies, and manual therapies). We calculated descriptive statistics and examined bivariate associations and multivariable associations using logistic regression.

PARTICIPANTS:   Participants were 460 veterans endorsing pain lasting ≥ 3 months who completed the baseline survey of the Women Veterans Cohort Study (response rate 7.7%.

MAIN MEASURES:   Outcome was self-reported use of NPMs in the past 12 months.

KEY RESULTS:   Veterans were 33.76 years old (SD = 10.72), 56.3% female, and 80.2% White. Regarding NPM use,

22.6%   reported using psychological/behavioral,
50.9%   used exercise/movement and
51.7%   used manual therapies.

Veterans with a college degree (vs. no degree; OR = 2.51, 95% CI = 1.46, 4.30, p = 0.001) or those with worse mental health symptoms (OR = 2.88, 95% CI = 2.11, 3.93, p < 0.001) were more likely to use psychological/behavioral therapies.

Veterans who were female (OR = 0.63, 95% CI = 0.43, 0.93, p = 0.02) or who used non-opioid pain medications (OR = 1.82, 95% CI = 1.146, 2.84, p = 0.009) were more likely to use exercise/movement therapies.

Veterans who were non-White (OR = 0.57, 95% CI = 0.5, 0.94, p = 0.03), with greater educational attainment (OR = 2.11, 95% CI = 1.42, 3.15, p < 0.001), or who used non-opioid pain medication (OR = 1.71, 95% CI = 1.09, 2.68, p = 0.02) were more likely to use manual therapies.

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The Association Between Psychological and Social Factors and Spinal Pain in Adolescents

By |November 29, 2018|Pediatrics, Spinal Pain|

The Association Between Psychological and Social Factors and Spinal Pain in Adolescents

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SOURCE:   Eur J Pediatr. 2018 (Nov 21) [Epub]

Sarah Batley & Ellen Aartun & Eleanor Boyle & Jan Hartvigsen & Paula J. Stern & Lise Hestbæk

Graduate Studies,
Canadian Memorial Chiropractic College,
6100 Leslie Street,
Toronto, M2H 3J1, Canada.


Spinal pain, back pain, and/or neck pain begins early in life and is strongly associated with spinal pain in adulthood. Understanding the relationship between psychological and social factors and adolescent spinal pain may be important in both the prevention and treatment of spinal pain in this age group. We aimed to determine if psychological and social factors were associated with spinal pain in a cross-sectional study of a school-based cohort of 1279 Danish adolescents aged 11–13, who were categorized into “any” and “substantial” spinal pain.

“Substantial spinal pain” was defined as a lifetime frequency of “sometimes” or “often” and a pain intensity of at least two on the revised Faces Pain Scale. Logistic regression analyses, stratified by sex, were conducted for single and all variables together. Eighty-six percent of participants reported “any spinal pain” and 28% reported “substantial spinal pain”. Frequency of psychological and social factors was significantly higher in those with spinal pain compared to those without. As the frequency of psychological and social factors increased, the odds of both “any spinal pain” and “substantial spinal pain” also increased.

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Association Between Utilization of Chiropractic Services for Treatment of Low Back Pain and Risk of Adverse Drug Events

By |June 7, 2018|Spinal Pain|

Association Between Utilization of Chiropractic Services for Treatment of Low Back Pain and Risk of Adverse Drug Events

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2018 (May 26) [Epub]

James M. Whedon, DC, MS, Andrew W.J. Toler, MS, Justin M. Goehl, DC, MS, Louis A. Kazal, MD

Health Services Research,
Southern California University of Health Sciences,
Whittier, California.


OBJECTIVES:   Mortality rates due to adverse drug events (ADEs) are escalating in the United States. Analgesics are among the drug classes most often associated with occurrence of an ADE. Utilization of nonpharmacologic chiropractic services for treatment of low back pain could lead to reduced risk of an ADE. The objective of this investigation was to evaluate the association between utilization of chiropractic services and likelihood of an ADE.

METHODS:   We employed a retrospective cohort design to analyze health insurance claims data from the state of New Hampshire. After inversely weighting each participant by their propensity to be in their cohort, we employed logistic regression to compare recipients of chiropractic services to nonrecipients with regard to likelihood of occurrence of an ADE in an outpatient setting.

RESULTS:   The risk of an ADE was significantly lower among recipients of chiropractic services as compared with nonrecipients. The adjusted likelihood of an ADE occurring in an outpatient setting within 12 months was 51% lower among recipients of chiropractic services as compared to nonrecipients (OR 0.49; P = .0002). The reported ADEs were nonspecific with regard to drug category in the majority of incidents that occurred in both cohorts.

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