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Yearly Archives: 2016

Bladder Metastasis Presenting as Neck, Arm and Thorax Pain

By |May 9, 2016|Cancer|

Bladder Metastasis Presenting as Neck, Arm and Thorax Pain: A Case Report

The Chiro.Org Blog

SOURCE:   Chiropractic & Manual Therapies 2016 (May 4); 24: 14

Clinton J. Daniels, Pamela J. Wakefield
and Glenn A. Bub

Chiropractic Clinic,
VA St. Louis Healthcare System

Background   A case of metastatic carcinoma secondary to urothelial carcinoma presenting as musculoskeletal pain is reported. A brief review of urothelial and metastatic carcinoma including clinical presentation, diagnostic testing, treatment and chiropractic considerations is discussed.

Case presentation   This patient presented in November 2014 with progressive neck, thorax and upper extremity pain. Computed tomography revealed a destructive soft tissue mass in the cervical spine and additional lytic lesion of the 1st rib. Prompt referral was made for surgical consultation and medical management.

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Regional Supply of Chiropractic Care and Visits to Primary Care Physicians for Back and Neck Pain

By |May 8, 2016|Medicare|

Regional Supply of Chiropractic Care and Visits to Primary Care Physicians for Back and Neck Pain

The Chiro.Org Blog

SOURCE:   J Am Board Fam Med. 2015 (Jul); 28 (4): 481–490

Matthew A. Davis, MPH, DC, PhD, Olga Yakusheva, PhD,
Daniel J. Gottlieb, MS and Julie P.W. Bynum, MD, MPH

Dartmouth Institute for Health Policy and Clinical Practice,
Dartmouth College,
Geisel School of Medicine,
Hanover, NH

BACKGROUND:   Whether availability of chiropractic care affects use of primary care physician (PCP) services is unknown.

METHODS:   We performed a cross-sectional study of 17.7 million older adults who were enrolled in Medicare from 2010 to 2011. We examined the relationship between regional supply of chiropractic care and PCP services using Spearman correlation. Generalized linear models were used to examine the association between regional supply of chiropractic care and number of annual visits to PCPs for back and/or neck pain.

RESULTS:   We found a positive association between regional supply of chiropractic care and PCP services (rs = 0.52; P <.001). An inverse association between supply of chiropractic care and the number of annual visits to PCPs for back and/or neck pain was apparent. The number of PCP visits for back and/or neck pain was 8% lower (rate ratio, 0.92; 95% confidence interval, 0.91-0.92) in the quintile with the highest supply of chiropractic care compared to the lowest quintile. We estimate chiropractic care is associated with a reduction of 0.37 million visits to PCPs nationally, at a cost of $83.5 million.

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Cross-Sectional Analysis of Per Capita Supply of Doctors of Chiropractic and Opioid Use

By |May 7, 2016|Medicare|

Cross-Sectional Analysis of Per Capita Supply of Doctors of Chiropractic and Opioid Use in Younger Medicare Beneficiaries

The Chiro.Org Blog

SOURCE:   J Manipulative Physiol Ther. 2016 (Mar 28) [Epub]

William B Weeks, MD, PhD, MBA, Christine M Goertz, DC, PhD

The Dartmouth Institute for
Health Policy and Clinical Practice,
Lebanon, NH

OBJECTIVE:   The purpose of this study was to determine whether the per-capita supply of doctors of chiropractic (DCs) or Medicare spending on chiropractic care was associated with opioid use among younger, disabled Medicare beneficiaries.

METHODS:   Using 2011 data, at the hospital referral region level, we correlated the per-capita supply of DCs and spending on chiropractic manipulative therapy (CMT) with several measures of per-capita opioid use by younger, disabled Medicare beneficiaries.

RESULTS:   Per-capita supply of DCs and spending on CMT were strongly inversely correlated with the percentage of younger Medicare beneficiaries who had at least 1, as well as with 6 or more, opioid prescription fills. Neither measure was correlated with mean daily morphine equivalents per opioid user or per chronic opioid user.

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The Influence of Curricular and Extracurricular Learning Activities on Students’ Choice of Chiropractic Technique

By |May 6, 2016|Technique|

The Influence of Curricular and Extracurricular Learning Activities on Students’ Choice of Chiropractic Technique

The Chiro.Org Blog

SOURCE:   J Chiropractic Education 2016 (Mar); 30 (1): 30-36

David M. Sikorski , DC, Anupama KizhakkeVeettil , MAOM and
Gene S. Tobias , PhD, DC

Professor
Southern California University of Health Sciences
16200 E. Amber Valley Dr.
Whittier, CA 90604

Objective:   Surveys for the National Board of Chiropractic Examiners indicate that diversified chiropractic technique is the most commonly used chiropractic manipulation method. The study objective was to investigate the influences of our diversified core technique curriculum, a technique survey course, and extracurricular technique activities on students’ future practice technique preferences.

Methods:   We conducted an anonymous, voluntary survey of 1st, 2nd, and 3rd year chiropractic students at our institution. Surveys were pretested for face validity, and data were analyzed using descriptive and inferential statistics.

Results:   We had 164 students (78% response rate) participate in the survey. Diversified was the most preferred technique for future practice by students, and more than half who completed the chiropractic technique survey course reported changing their future practice technique choice as a result. The students surveyed agreed that the chiropractic technique curriculum and their experiences with chiropractic practitioners were the two greatest bases for their current practice technique preference, and that their participation in extracurricular technique clubs and seminars was less influential.

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Pathological Burst Fracture in the Cervical Spine With Negative Red Flags

By |May 4, 2016|Multiple Myeloma|

Pathological Burst Fracture in the Cervical Spine
With Negative Red Flags: A Case Report

The Chiro.Org Blog

SOURCE:   J Can Chiropr Assoc. 2016 (Mar); 60 (1): 81–87

Jocelyn Cox, DC, Chris DeGraauw, DC FRCCSS(C), and Erik Klein, DC

Department of Graduate Education and Research Program,
Canadian Memorial Chiropractic College,
6100 Leslie Street,
North York, ON, M2H 3J1

OBJECTIVE:   To report on a case of a pathological burst fracture in the cervical spine where typical core red flag tests failed to identify a significant lesion, and to remind chiropractors to be vigilant in the recognition of subtle signs and symptoms of disease processes.

CLINICAL FEATURES:   A 61-year-old man presented to a chiropractic clinic with neck pain that began earlier that morning. After a physical exam that was relatively unremarkable, imaging identified a burst fracture in the cervical spine.

INTERVENTION & OUTCOMES:   The patient was sent by ambulance to the hospital where he was diagnosed with multiple myeloma. No medical intervention was performed on the fracture.

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On The Origin of Atraumatic Neuromusculoskeletal Pain

By |May 3, 2016|Pain Relief|

On The Origin of Atraumatic Neuromusculoskeletal Pain

The Chiro.Org Blog

SOURCE:   Chiropractic J of Australia 2016 (Jan); 44 (1): 1–8

Joe Evans, PhD

CEO, Sense Technology Inc.
1052 Corporate Lane,
Export, PA

The purpose of this study was to examine the possible origins of non-specific or atraumatic back pain by applying the Gate Theory of pain and current physiologic concepts. I present a theory that accounts for the initiation and potential consequences of neuromusculoskeletal pain incorporating failure of the mechanism of muscle relaxation and resulting in pain and compromise of the lymphatic system. The theory provides an alternative to current theories and hypotheses of the cause and consequences of neuromusculoskeletal pain.

Keywords:   Pain; Muscular System; Muscle Relaxation

 

From the FULL TEXT Article:

INTRODUCTION

The incidence of low back and other neuromusculoskeletal pain continues to increase, with low back pain being the leading cause of disability in the world. [1, 2] In addition to the loss of quality of life for those experiencing musculoskeletal pain, the cost to both patients and society is significant and increasing:

  • The annual cost of chronic pain in the United States, including healthcare expenses (direct medical costs), lost income, and lost productivity, is estimated to be $635 billion. This is significantly higher than the estimated annual costs in 2010, dollars of heart disease ($309 billion), cancer ($243 billion), and diabetes ($188 billion).

  • Total estimated medical costs associated with back and neck pain, two of the commonest presentations of patients with chronic pain, increased by 65% between 1997 and 2005, to about $86 billion a year. Overall, pharmaceutical expenditures related to back and neck pain increased by 188% between 1997 and 2005, but costs associated with prescription narcotics rose by an astounding 423%.

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    Chiropractic and Spinal Pain Page   and the:

    What is the Chiropractic Subluxation Page

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