2016 – Page 3 – Chiropractic Resource Organization

Spine Care as a Framework for the Chiropractic Identity

By Frank M. Painter|November 6, 2016|Chiropractic Identity, Professional Identity|

Spine Care as a Framework for the Chiropractic Identity

SOURCE: Journal of Chiropractic Humanities 2016 (Nov 4)

Michael Schneider, DC, PhD, Donald Murphy, DC,
Jan Hartvigsen, DC, PhD

Department of Physical Therapy,
University of Pittsburgh,
Pittsburgh, PA

Objective The purpose of this commentary is to provide an argument for the role and identity of chiropractors as spine care providers within the context of the greater health care system.

Discussion Surveys of the general public and chiropractors indicate that the majority of patients seek chiropractic services for back and neck pain. Insurance company utilization data confirm these findings. Regulatory and legal language found in chiropractic practice acts reveals that most jurisdictions define the chiropractic scope of practice as based on a foundation of spine care. Educational accrediting and testing organizations have been shaped around a chiropractic education that produces graduates who focus on the diagnosis and treatment of spine and musculoskeletal disorders. Spine care is thus the common denominator and theme throughout all aspects of chiropractic practice, legislation, and education globally.

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Chiropractors as the Spinal Health Care Experts Page

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Regular Use of Medication for Musculoskeletal Pain and Risk of Long-term Sickness Absence: A Prospective Cohort Study Among the General Working Population

By Frank M. Painter|November 4, 2016|Iatrogenic Injury, Pain Medication|

Regular Use of Medication for Musculoskeletal Pain and Risk of Long-term Sickness Absence:

A Prospective Cohort Study Among the General Working Population

The Chiro.Org Blog

SOURCE: Eur J Pain. 2016 (Aug 26) [Epub]

E. Sundstrup, M.D. Jakobsen, S.V. Thorsen, L.L. Andersen

National Research Centre for the Working Environment,
Copenhagen, Denmark.

Physical Activity and Human Performance group, SMI,
Department of Health Science and Technology,
Aalborg University, Denmark.

BACKGROUND: The aim was to determine the prospective association between use of pain medication – due to musculoskeletal pain in the low back, neck/shoulder and hand/wrist – and long-term sickness absence.

METHODS: Cox-regression analysis was performed to estimate the prospective association between regular use of pain medication and long-term sickness absence (LTSA; at least 6 consecutive weeks) among 9,544 employees from the general working population (Danish Work Environment Cohort Study 2010) and free from LTSA during 2009-2010. The fully adjusted model was controlled for age, gender, body mass index, smoking, leisure physical activity, job group, physical activity at work, psychosocial work environment, pain intensity, mental health and chronic disease.

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Chiropractic and Pain Management Page

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Parker University Inaugurates William E. Morgan, D.C. as Their New President

By Frank M. Painter|November 3, 2016|ADHD, Announcement|

Parker University Inaugurates William E. Morgan, D.C. as Their New President

The Chiro.Org Blog

SOURCE: Yahoo! News ~ November 2, 2016

DALLAS, TX–(Marketwired – November 02, 2016) – The Board of Trustees, Faculty, Staff, Students, and Alumni of Parker University are pleased to announce and celebrate the inauguration of their new president, William E. Morgan, DC. As the seventh president of Parker University, Dr. Morgan will begin his term presiding over an expanding roster of both programs and students as Parker University pursues its mission of comprehensive education dedicated to research, service, and education.

The inauguration was held at 1:30pm on the Parker University main campus in Dallas, Texas at the Standard Process Student Activity Center on October 7, 2016. General Walter E. Boomer was present as a special guest of the president, who invited him to make a special presentation on his behalf.

General Boomer is a retired four-star general and assistant commandant of the United States Marine Corps and a business executive. He led all Marines in Operations Desert Shield and Desert Storm during the Gulf War. He later served as the Chairman and CEO of Rogers Corporation, retiring in 2004. He is the current lead director of Baxter International. General Boomer is a 1960 graduate of Duke University; he later earned a master’s degree from American University.

About Dr. Morgan, Seventh President of Parker University

In 1998, Dr. Morgan was chosen to establish the first chiropractic clinic at the National Naval Medical Center in Bethesda, Maryland, which later became Walter Reed National Military Medical Center. In 2015, Walter Reed recognized Dr. Morgan with its highest honor for clinical excellence, the Master Clinician’s Award.

During the last 18 years at the military’s most prestigious medical centers, he practiced in an integrative setting providing chiropractic care to the injured troops returning from the wars in Iraq and Afghanistan.

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

By Frank M. Painter|November 2, 2016|Guidelines, Low Back Pain|

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

The Chiro.Org Blog

SOURCE: Annals of Internal Medicine 2007 (Oct 2); 147 (7): 478–491

Roger Chou, MD; Amir Qaseem, MD, PhD, MHA; Vincenza Snow, MD; Donald Casey, MD, MPH, MBA; J. Thomas Cross, Jr, MD, MPH; Paul Shekelle, MD, PhD; Douglas K. Owens, MD, MS

Clinical Efficacy Assessment Subcommittee
of the American College of Physicians
and the American College of Physicians/
American Pain Society Low Back Pain Guidelines Panel*

Review the complete Guideline for the Evaluation and Management of Low Back Pain: Evidence Review
(482 page Adobe Acrobat file)

From the FULL TEXT Article:

The Abstract

Recommendation 1: Clinicians should conduct a focused history and physical examination to help place patients with low back pain into 1 of 3 broad categories: nonspecific low back pain, back pain potentially associated with radiculopathy or spinal stenosis, or back pain potentially associated with another specific spinal cause. The history should include assessment of psychosocial risk factors, which predict risk for chronic disabling back pain (strong recommendation, moderate-quality evidence).

Recommendation 2: Clinicians should not routinely obtain imaging or other diagnostic tests in patients with nonspecific low back pain (strong recommendation, moderate-quality evidence).

Recommendation 3: Clinicians should perform diagnostic imaging and testing for patients with low back pain when severe or progressive neurologic deficits are present or when serious underlying conditions are suspected on the basis of history and physical examination (strong recommendation, moderate-quality evidence).

Recommendation 4: Clinicians should evaluate patients with persistent low back pain and signs or symptoms of radiculopathy or spinal stenosis with magnetic resonance imaging (preferred) or computed tomography only if they are potential candidates for surgery or epidural steroid injection (for suspected radiculopathy) (strong recommendation, moderate–quality evidence).

Recommendation 5: Clinicians should provide patients with evidence–based information on low back pain with regard to their expected course, advise patients to remain active, and provide information about effective self–care options (strong recommendation, moderate–quality evidence).

WARNING: Before following Recommendation #6,
please review the Contra-indications to NSAIDS use.

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Low Back Pain and Chiropractic Page

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Clinical Decision Rule for Primary Care Patient with Acute Low Back Pain at Risk of Developing Chronic Pain

By Frank M. Painter|November 1, 2016|Clinical Decision Rule, Low Back Pain|

Clinical Decision Rule for Primary Care Patient with Acute Low Back Pain at Risk of Developing Chronic Pain

The Chiro.Org Blog

SOURCE: Spine J. 2015 (Jul 1); 15 (7): 1577–1586

Wolf E. Mehling, MD, Mark H. Ebell, MD, MS, Andrew L. Avins, MD, MPH, Frederick M. Hecht, MD

Department of Family Medicine,
University of California-San Francisco,
1545 Divisadero St,
San Francisco, CA 94115, USA

BACKGROUND CONTEXT: Primary care clinicians need to identify candidates for early interventions to prevent patients with acute pain from developing chronic pain.

PURPOSE: We conducted a 2-year prospective cohort study of risk factors for the progression to chronic pain and developed and internally validated a clinical decision rule (CDR) that stratifies patients into low-, medium-, and high-risk groups for chronic pain.

STUDY DESIGN/SETTING: This is a prospective cohort study in primary care.

PATIENT SAMPLE: Patients with acute low back pain (LBP, ≤30 days duration) were included.

OUTCOME MEASURES: Outcome measures were self-reported perceived nonrecovery and chronic pain.

METHODS: Patients were surveyed at baseline, 6 months, and 2 years. We conducted bivariate and multivariate regression analyses of demographic, clinical, and psychosocial variables for chronic pain outcomes, developed a CDR, and assessed its performance by calculating the bootstrapped areas under the receiver-operating characteristic curve (AUC) and likelihood ratios.

RESULTS: Six hundred five patients enrolled: 13% had chronic pain at 6 months and 19% at 2 years. An eight-item CDR was most parsimonious for classifying patients into three risk levels. Bootstrapped AUC was 0.76 (0.70-0.82) for the 6-month CDR. Each 10-point score increase (60-point range) was associated with an odds ratio of 11.1 (10.8-11.4) for developing chronic pain. Using a less than 5% probability of chronic pain as the cutoff for low risk and a greater than 40% probability for high risk, likelihood ratios were 0.26 (0.14-0.48) and 4.4 (3.0-6.3) for these groups, respectively.

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Clinical Prediction Rule Page and the:

Low Back Pain and Chiropractic Page

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Mechanisms of Low Back Pain: A Guide for Diagnosis and Therapy

By Frank M. Painter|October 30, 2016|Diagnosis, Low Back Pain|

Mechanisms of Low Back Pain: A Guide for Diagnosis and Therapy

The Chiro.Org Blog

SOURCE: F1000Res. 2016 (Oct 11); 5. pii: F1000

Massimo Allegri, Silvana Montella, Fabiana Salici,
Adriana Valente, Maurizio Marchesini, Christian Compagnone,
Marco Baciarello, Maria Elena Manferdini, and Guido Fanelli

Department of Surgical Sciences,
University of Parma,
Parma, Italy

Chronic low back pain (CLBP) is a chronic pain syndrome in the lower back region, lasting for at least 3 months. CLBP represents the second leading cause of disability worldwide being a major welfare and economic problem. The prevalence of CLBP in adults has increased more than 100% in the last decade and continues to increase dramatically in the aging population, affecting both men and women in all ethnic groups, with a significant impact on functional capacity and occupational activities. It can also be influenced by psychological factors, such as stress, depression and/or anxiety. Given this complexity, the diagnostic evaluation of patients with CLBP can be very challenging and requires complex clinical decision-making.

Answering the question “what is the pain generator” among the several structures potentially involved in CLBP is a key factor in the management of these patients, since a mis-diagnosis can generate therapeutical mistakes. Traditionally, the notion that the etiology of 80% to 90% of LBP cases is unknown has been mistaken perpetuated across decades. In most cases, low back pain can be attributed to specific pain generator, with its own characteristics and with different therapeutical opportunity. Here we discuss about radicular pain, facet joint pain, sacro-iliac pain, pain related to lumbar stenosis, discogenic pain. Our article aims to offer to the clinicians a simple guidance to identify pain generators in a safer and faster way, relying a correct diagnosis and further therapeutical approach.

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Low Back Pain and Chiropractic Page

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Yearly Archives: 2016

Spine Care as a Framework for the Chiropractic Identity

Spine Care as a Framework for the Chiropractic Identity

Regular Use of Medication for Musculoskeletal Pain and Risk of Long-term Sickness Absence: A Prospective Cohort Study Among the General Working Population

Regular Use of Medication for Musculoskeletal Pain and Risk of Long-term Sickness Absence:

A Prospective Cohort Study Among the General Working Population

Parker University Inaugurates William E. Morgan, D.C. as Their New President

Parker University Inaugurates William E. Morgan, D.C. as Their New President

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

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

Clinical Decision Rule for Primary Care Patient with Acute Low Back Pain at Risk of Developing Chronic Pain

Clinical Decision Rule for Primary Care Patient with Acute Low Back Pain at Risk of Developing Chronic Pain

Mechanisms of Low Back Pain: A Guide for Diagnosis and Therapy

Mechanisms of Low Back Pain: A Guide for Diagnosis and Therapy