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Frank M. Painter

About Frank M. Painter

I was introduced to Chiro.Org in early 1996, where my friend Joe Garolis helped me learn HTML, the "mark-up language" for websites. We have been fortunate that journals like JMPT have given us permission to reproduce some early important articles in Full-Text format. Maintaining the Org website has been, and remains, my favorite hobby.
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Prevalence and Characteristics of Chronic Spinal Pain Patients with Different Hopes (Treatment Goals) for Ongoing Chiropractic Care

By |January 14, 2022|Chronic Low Back Pain, Chronic Neck Pain, Spinal Pain Management|

Prevalence and Characteristics of Chronic Spinal Pain Patients with Different Hopes (Treatment Goals) for Ongoing Chiropractic Care

The Chiro.Org Blog

SOURCE:   J Alternative and Complementary Medicine 2019 (Oct 1); 25 (10): 1015–1025

Patricia M. Herman, ND, PhD, Sarah E. Edgington, MA, Gery W. Ryan, PhD, and Ian D. Coulter, PhD

RAND Corporation,
Santa Monica, CA.

Objectives:   The treatment goals of patients successfully using ongoing provider-based care for chronic spinal pain

Design:   Multinomial logistical hierarchical linear models were used to examine the characteristics of patients with

Settings/Location:   Observational data from a large national sample of patients from 125 chiropractic clinics clustered in 6 U.S. regions.

Subjects:   Patients with nonwork-injury-related nonspecific chronic low-back pain (CLBP) and chronic neck pain (CNP).

Interventions:   All were receiving ongoing chiropractic care.

Outcome measures:   Primary outcomes were patient endorsement of one of four goals for their treatment. Explanatory variables included pain characteristics, pain beliefs, goals for mobility/flexibility, demographics, and other psychological variables.

Results:   Across our sample of 1614 patients (885 with CLBP and 729 with CNP) just under one-third endorsed a treatment goal of having their pain go away permanently (cure). The rest had goals of preventing their pain from coming back (22% CLBP, 16% CNP); preventing their pain from getting worse (14% CLBP, 12% CNP); or temporarily relieving their pain (31% CLBP, 41% CNP). In univariate analysis across these goals, patients differed significantly on almost all variables. In the multinomial logistic models, a goal of cure was associated with shorter pain duration and more belief in a medical cure; a goal of preventing pain from coming back was associated with lower pain levels; and those with goals of preventing their pain from getting worse or temporarily relieving pain were similar, including in having their pain longer.

There is more like this @ our:

CHRONIC NECK PAIN Page and our

SPINAL PAIN MANAGEMENT Page and our

NON-PHARMACOLOGIC THERAPY Page

(more…)

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Effects of Spinal Manipulative Therapy on Inflammatory Mediators in Patients with Non-specific Low Back Pain: A Non-randomized Controlled Clinical Trial

By |January 13, 2022|Low Back Pain|

Effects of Spinal Manipulative Therapy on Inflammatory Mediators in Patients with Non-specific Low Back Pain: A Non-randomized Controlled Clinical Trial

The Chiro.Org Blog

SOURCE:   Chiropractic & Manual Therapies 2021 (Jan 8); 29 (1): 3

Julita A. Teodorczyk-Injeyan, John J. Triano, Robert Gringmuth, Christopher DeGraauw, Adrian Chow & H.

Graduate Education and Research Programs,
Canadian Memorial Chiropractic College,
Toronto, Ontario, Canada

Background:   The inflammatory profiles of patients with acute and chronic nonspecific low back pain (LBP) patients are distinct. Spinal manipulative therapy (SMT) has been shown to modulate the production of nociceptive chemokines differently in these patient cohorts. The present study further investigates the effect(s) of SMT on other inflammatory mediators in the same LBP patient cohorts.

Methods:   Acute (n = 22) and chronic (n = 25) LBP patients with minimum pain scores of 3 on a 10-point numeric scale, and asymptomatic controls (n = 24) were recruited according to stringent exclusion criteria. Blood samples were obtained at baseline and after 2 weeks during which patients received 6 SMTs in the lumbar or lumbosacral region. The in vitro production of tumor necrosis factor (TNFα), interleukin-1 β (IL-1β), IL-6, IL-2, interferon γ (IFNγ), IL-1 receptor antagonist (IL-1RA), TNF soluble receptor type 2 (sTNFR2) and IL-10 was determined by specific immunoassays. Parametric as well as non-parametric statistics (PAST 3.18 beta software) was used to determine significance of differences between and within study groups prior and post-SMT. Effect size (ES) estimates were obtained using Cohen’s d.

Results:   Compared with asymptomatic controls, SMT-related change scores were significant (P = 0.03–0.01) in reducing the production levels of TNFα in both patient cohorts and those of IL-6, IFNγ and sTNFR2 (P = 0.001–0.02) in patients with chronic LBP. Above-moderate to large ES (d > 0.6–1.4) was observed for these mediators. Compared with respective baselines, a significant post-SMT reduction (P = 0.01) of IL-6 production was detected only in patients with chronic LBP while a significant increase of IL-2 production (P = 0.001 vs. control, and P = 0.004 vs. chronic LBP group) and a large ES (d = 0.87) were observed in patients with acute LBP. Pain and disability scores declined significantly (P < 0.001) in all LBP patients, and were positively correlated (P = 0.03) with IFNγ and IL-2 levels in the acute LBP cohort.

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LOW BACK PAIN Section

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Risk Factors Associated With Transition From Acute to Chronic Low Back Pain in US Patients Seeking Primary Care

By |January 12, 2022|Chronic Low Back Pain|

Risk Factors Associated With Transition From Acute to Chronic Low Back Pain in US Patients Seeking Primary Care

The Chiro.Org Blog

SOURCE:   JAMA Netw Open 2021 (Feb 1); 4 (2): e2037371

Joel M. Stevans, DC, PhD, Anthony Delitto, PT, PhD, Samannaaz S. Khoja, PT, PhD, Charity G. Patterson, PhD, Clair N. Smith, MS, Michael J. Schneider, DC, PhD, Janet K. Freburger, PT, PhD, et. al.

School of Health and Rehabilitation Sciences,
University of Pittsburgh,
Pittsburgh, Pennsylvania

Importance:   Acute low back pain (LBP) is highly prevalent, with a presumed favorable prognosis; however, once chronic, LBP becomes a disabling and expensive condition. Acute to chronic LBP transition rates vary widely owing to absence of standardized operational definitions, and it is unknown whether a standardized prognostic tool (ie, Subgroups for Targeted Treatment Back tool [SBT]) can estimate this transition or whether early non-guideline concordant treatment is associated with the transition to chronic LBP.

Objective:   To assess the associations between the transition from acute to chronic LBP with SBT risk strata; demographic, clinical, and practice characteristics; and guideline nonconcordant processes of care.

Design, setting, and participants:   This inception cohort study was conducted alongside a multisite, pragmatic cluster randomized trial. Adult patients with acute LBP stratified by SBT risk were enrolled in 77 primary care practices in 4 regions across the United States between May 2016 and June 2018 and followed up for 6 months, with final follow-up completed by March 2019. Data analysis was conducted from January to March 2020.

Exposures:   SBT risk strata and early LBP guideline nonconcordant processes of care (eg, receipt of opioids, imaging, and

Main outcomes and measures:   Transition from acute to chronic LBP at 6 months using the National Institutes of Health Task Force on Research Standards consensus definition of chronic LBP. Patient demographic characteristics, clinical factors, and LBP process of care were obtained via electronic medical records.

There are more articles like this @ our:

LOW BACK PAIN Section

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Doctors of Chiropractic Working with or within Integrated Healthcare Delivery Systems: A Scoping Review Protocol

By |January 11, 2022|Chiropractic Management, Integrative Care|

Doctors of Chiropractic Working with or within Integrated Healthcare Delivery Systems: A Scoping Review Protocol

The Chiro.Org Blog

SOURCE:   BMJ Open 2021 (Jan 25); 11 (1): e043754

Eric J Roseen, Bolanle Aishat Kasali, Kelsey Corcoran, Kelsey Masselli, Lance Laird, Robert B Saper, Daniel P Alford, Ezra Cohen, Anthony Lisi, Steven J Atlas, Jonathan F Bean, Roni Evans, André Bussières

Department of Family Medicine,
Boston University School of Medicine and
Boston Medical Center,
Boston, MA, USA

Introduction:   Back and neck pain are the leading causes of disability worldwide. Doctors of chiropractic (DCs) are trained to manage these common conditions and can provide non-pharmacological treatment aligned with international clinical practice guidelines. Although DCs practice in over 90 countries, chiropractic care is rarely available within integrated healthcare delivery systems. A lack of DCs in private practice, particularly in low-income communities, may also limit access to chiropractic care. Improving collaboration between medical providers and community-based DCs, or embedding DCs

Methods and analyses:   This scoping review will map studies of DCs working with or within integrated healthcare delivery systems. We will use the recommended six-step approach for scoping reviews. We will search three electronic data bases including Medline, Embase and Web of Science. Two investigators will independently review all titles and abstracts to identify relevant records, screen the full-text articles of potentially admissible records, and systematically extract data from selected articles. We will include studies published in English from 1998 to 2020 describing medical settings that have established formal relationships with community-based DCs (eg, shared medical record) or where DCs practice in medical settings. Data extraction and reporting will be guided by the Proctor Conceptual Model for Implementation Research, which has three domains: clinical intervention, implementation strategies and outcome measurement. Stakeholders from diverse clinical fields will offer feedback on the implications of our findings via a web-based

There is more like this @ our:

INTEGRATED HEALTH CARE Section and the:

NON-PHARMACOLOGIC THERAPY Section and the:

CHIROPRACTIC CARE FOR VETERANS Section

(more…)

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Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain

By |January 10, 2022|Chronic Neck Pain, Cost-Effectiveness of Chiropractic, Low Back Pain, Spinal Pain Management|

Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain

The Chiro.Org Blog

SOURCE:   Frontiers in Pain Ressearch 2021 (Oct 25); 2: 765921

Carlos Gevers-Montoro, Benjamin Provencher, Martin Descarreaux, Arantxa Ortega de Mues and Mathieu Piche

Department of Anatomy,
Université du Québec à Trois-Rivières,
Trois-Rivières, QC, Canada

Spine pain is a highly prevalent condition affecting over 11% of the world’s population. It is the single leading cause of activity limitation and ranks fourth in years lost to disability globally, representing a significant personal, social, and economic burden. For the vast majority of patients with back and neck pain, a specific pathology cannot be identified as the cause for their pain, which is then labeled as non-specific. In a growing proportion of these cases, pain persists beyond 3 months and is referred to as chronic primary back or neck pain. To decrease the global burden of spine pain, current data suggest that a conservative approach may be preferable. One of the conservative management options available is spinal manipulative

The aim of this narrative review is to highlight the most relevant and up-to-date evidence on the effectiveness (as it compares to other interventions in more pragmatic settings) and efficacy (as it compares to inactive controls under highly controlled conditions) of SMT for the management of neck pain and low back pain. Additionally, a perspective on the current recommendations on SMT for spine pain and the needs for future research will be

In summary, SMT may be as effective as other recommended therapies for the management of non-specific and chronic primary spine pain, including standard medical care or physical therapy. Currently, SMT is recommended in combination with exercise for neck pain as part of a multimodal approach. It may also be recommended as a frontline intervention for low back pain. Despite some remaining discrepancies, current clinical practice guidelines almost universally recommend the use of SMT for spine pain. Due to the low quality of evidence, the efficacy of SMT compared with a placebo or no treatment remains uncertain. Therefore, future research is needed to clarify the specific effects of SMT to further validate this intervention. In addition, factors that predict these effects remain to be determined to target patients who are more likely to obtain positive outcomes from SMT.

There is more like this @ our:

LOW BACK PAIN Section and the:

CHRONIC NECK PAIN Section and the:

COST-EFFECTIVENESS Section and the:

SPINAL PAIN MANAGEMENT Section

(more…)

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Efficiency of Primary Spine Care as Compared to Conventional Primary Care: A Retrospective Observational Study at an Academic Medical Center

By |January 8, 2022|Cost-Effectiveness of Chiropractic, Primary Spine Care|

Efficiency of Primary Spine Care as Compared to Conventional Primary Care: A Retrospective Observational Study at an Academic Medical Center

The Chiro.Org Blog

SOURCE:   Chiropractic & Manual Therapies 2022 (Jan 6); 30 (1): 1

Serena Bezdjian, James M. Whedon, Robb Russell, Justin M. Goehl & Louis A. Kazal Jr.

Southern California University of Health Sciences,
Whittier, CA, 90604, USA.



Opioid use was 389% higher in the Medical group than the PSC group,
who’s care was provided by a Doctor of Chiropractic.

Background:   Primary Spine Care (PSC) is an innovative model for the primary management of patients with spine-related disorders (SRDs), with a focus on the use of non-pharmacological therapies which now constitute the recommended first-line approach to back pain. PSC clinicians serve as the initial or early point of contact for spine patients and utilize evidence-based spine care pathways to improve outcomes and reduce escalation of care (EoC) [e.g., spinal injections, diagnostic imaging, hospitalizations, referrals to a specialist]. The present study examined 6-month outcomes to evaluate the efficiency of care for patients who received PSC as compared to conventional primary care. We h

Methods:   This was a retrospective observational study. We evaluated 6-month outcomes for two groups seen and treated for an SRD between February 01, 2017 and January 31, 2020. Patient groups were comprised of N = 1,363 PSC patients (Group A) and N = 1,329 PC patients (Group B). We conducted Pearson chi-square and logistic regression (adjusting for patient characteristics that were unbalanced between the two groups) to determine associations between the two groups and 6-month outcomes.

Results:   Within six months of an initial visit for an SRD, a statistically significantly smaller proportion of PSC patients utilized healthcare resources for spine care as compared to the PC patients. When adjusting for patient characteristics, those who received care from the PSC clinician were less likely within 6 months of an initial visit to be

hospitalized (OR = .47, 95% CI .23-.97),
fill a prescription for an opioid analgesic (OR = .43; 95% CI .29-.65),
receive a spinal injection (OR = .56, 95% CI .33-.95), or
have a visit with a specialist (OR = .48, 95% CI .35-.67)

as compared to those who received usual primary care.

There is more like this @ our:

LOW BACK PAIN Section and the:

COST-EFFECTIVENESS Section

(more…)

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