Frank M. Painter

Finally! FDA Limits Acetaminophen in Prescription Analgesics

By Frank M. Painter|January 20, 2011|Iatrogenic Injury|

Finally! FDA Limits Acetaminophen in Prescription Analgesics

SOURCE: Medscape Medical News

By Robert Lowes

January 13, 2011 — The US Food and Drug Administration (FDA) today announced that it is asking drug makers to limit the amount of acetaminophen in prescription combination pain relievers to no more than 325 mg per tablet or capsule to reduce overdoses and the severe liver injury that can follow.

The decision, to be phased in over 3 years, affects dozens of prescription analgesics that contain both acetaminophen and another ingredient, typically opioids such as codeine, oxycodone, and hydrocodone. Some of these combination products now have as much as 750 mg of acetaminophen per dose. (more…)

1

Primary Care MDs Decline Training In Pain Management

By Frank M. Painter|January 20, 2011|Health Care Reform|

Primary Care MDs Decline Training In Pain Management

The Chiro.Org Blog

The following survey reveals a depressing new trend in medicine. Although primary care physicians (PCPs) see the largest percentage of chronic pain patients (52%), they are also the least likely to feel confident in their ability to manage musculoskeletal and neuropathic pain conditions, and are least likely to favor mandatory pain education for all PCPs.

How bizarre is that?

Here’s the abstract for your review:

Pain Management by Primary Care Physicians, Pain Physicians, Chiropractors, and Acupuncturists: A National Survey (more…)

4

SPECT/CT Imaging of the Lumbar Spine in Chronic Low Back Pain

By Frank M. Painter|January 11, 2011|Low Back Pain, SPECT/CT Imaging|

SPECT/CT Imaging of the Lumbar Spine in Chronic Low Back Pain

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2011 (Jan 11) ~ FULL TEXT

Michael H. Carstensen, Mashael Al-Harbi,
Jean-Luc Urbain, Tarik-Zine Belhocine

Department of Medical Imaging, St Joseph´s Hospital,
268 Grosvenor Street, N6A 4V2, London, Ontario, Canada

Abstract

Mechanical low back pain is a common indication for Nuclear Medicine imaging. Whole-body bone scan is a very sensitive but poorly specific study for the detection of metabolic bone abnormalities. The accurate localisation of metabolically active bone disease is often difficult in 2D imaging but single photon emission computed tomography/computed tomography (SPECT/CT) allows accurate diagnosis and anatomic localisation of osteoblastic and osteolytic lesions in 3D imaging. We present a clinical case of a patient referred for evaluation of chronic lower back pain with no history of trauma, spinal surgery, or cancer. Planar whole-body scan showed heterogeneous tracer uptake in the lumbar spine with intense localization to the right lateral aspect of L3. Integrated SPECT/CT of the lumbar spine detected active bone metabolism in the right L3/L4 facet joint in the presence of minimal signs of degenerative osteoarthrosis on CT images, while a segment demonstrating more gross degenerative changes was quiescent with only mild tracer uptake. The usefulness of integrated SPECT/CT for anatomical and functional assessment of back pain opens promising opportunities both for multi-disciplinary clinical assessment and treatment for manual therapists and for research into the effectiveness of manual therapies.

Background

The concept of lumbar facet joints causing or contributing to mechanical low back pain syndromes has been debated in the health care literature for decades [1]. Practitioners of the various manual therapies commonly treat patients presenting with low back pain but are faced with the diagnostic challenge of trying to identify a tissue source of low back pain. While this complaint may be the result of any of a number of pathologies, the vast majority of low back pain falls under the diagnostic umbrella of ‘‘ mechanical low back pain ’’ [2]. We present here the case of a patient with radiological signs of marked lumbosacral junction facet joint osteoarthrosis and clinical symptoms supportive of pathology in this region but with SPECT/CT findings suggestive of an active bony lesion at a more remote spinal segment.

There are more articles like this @ our:

Chiropractic Radiology Section

(more…)

1

Historical Overview and Update on Subluxation Theories

By Frank M. Painter|January 7, 2011|Research, Subluxation|

Historical Overview and Update on Subluxation Theories

The Chiro.Org Blog

SOURCE: J Chiropractic Humanities 2010 (Dec); 17 (1): 22–32

By Howard Vernon, DC, PhD

Introduction

Manual therapy has, arguably, best been described by a Polish medical manipulation practitioner, Arkuszewski, [1] as “a mechanical therapy with reflex effects.” The phrase mechanical therapy can be further characterized by noting that it is performed in the musculoskeletal (MSK) system. The phrase reflex effects can be further qualified, at the very least, to indicate that these are “health-beneficial.” Therefore, a revised version would read as follows:

“a manually-performed mechanical therapy to the MSK system with health-beneficial reflex effects.”

This formulation also provides a basis for describing the primary disorder posited by chiropractic theory: subluxation. Recognizing that, for chiropractic, the subluxation has always been viewed as the “thing for which adjustment (manual therapy) is done,” a first-pass definition of subluxation, a la Arkuszewski, would be:

“a mechanical problem in the musculoskeletal system with health-deleterious reflex effects.”

Since the founding of chiropractic and the other manual therapy professions, 2 fundamental issues have vexed us:

What kind and location of mechanical problem in the MSK system qualifies as a subluxation (or any of the other terms used as synonyms within and outside of chiropractic)?
What kind of health-deleterious effects are specifically associated with subluxation?

The author recognizes that numerous others have attempted to review the subluxation concept, including recent excellent reviews by Gatterman, [2] Peters, [3] and Ebrall. [4] These previously published discussions are not reviewed here. What follows is a nonsystematic overview of selected developments in the profession that have addressed these 2 questions.

Discussion (more…)

3

Chiropractic: A Profession Coming of Age ~ An Interview with David Chapman-Smith, LL.B.

By Frank M. Painter|January 6, 2011|Education, Health Care Reform|

Chiropractic: A Profession Coming of Age ~
An Interview with David Chapman-Smith, LL.B.

The Chiro.Org Blog

SOURCE: Health Insights Today

Interview by Carl S. Cleveland III, DC

David Chapman-Smith, the Secretary-General of the World Federation of Chiropractic (WFC), is a New Zealand-born attorney who now resides in Toronto, Canada. Chapman-Smith’s introduction to chiropractic came when he represented the New Zealand Chiropractic Association before that nation’s Commission on Inquiry into Chiropractic in the late 1970s. The Commission’s report was the world’s first major independent evaluation of chiropractic and set the stage for many later advances.

For Chapman-Smith, the whirlwind years of the New Zealand Commission were a prelude to what has become a career-long mission on behalf of chiropractic. He has served the WFC since its inception in the late 1980s and is widely recognized as the world’s leading non-chiropractor advocate for the profession. (more…)

2

Whiplash, aka Cervical Acceleration – Deceleration Injury, aka, Whiplash – Associated Disorder

By Frank M. Painter|January 1, 2011|Education, Whiplash|

Whiplash, aka Cervical Acceleration – Deceleration Injury, aka, Whiplash – Associated Disorder

The Chiro.Org Blog

A rose by any other name can still be a thorny experience for our patients, no matter what you call it.

Chiropractic care is very effective at reducing the pain, and for promoting healing, following a whiplash injury. The Whiplash Page combines primary literature sources with journal abstracts to review all aspects of whiplash injury and recovery. (more…)

3

About Frank M. Painter

Finally! FDA Limits Acetaminophen in Prescription Analgesics

Finally! FDA Limits Acetaminophen in Prescription Analgesics

Primary Care MDs Decline Training In Pain Management

Primary Care MDs Decline Training In Pain Management

SPECT/CT Imaging of the Lumbar Spine in Chronic Low Back Pain

SPECT/CT Imaging of the Lumbar Spine in Chronic Low Back Pain

Historical Overview and Update on Subluxation Theories

Historical Overview and Update on Subluxation Theories

Chiropractic: A Profession Coming of Age ~ An Interview with David Chapman-Smith, LL.B.

Chiropractic: A Profession Coming of Age ~ An Interview with David Chapman-Smith, LL.B.

Whiplash, aka Cervical Acceleration – Deceleration Injury, aka, Whiplash – Associated Disorder

Whiplash, aka Cervical Acceleration – Deceleration Injury, aka, Whiplash – Associated Disorder

Chiropractic: A Profession Coming of Age ~
An Interview with David Chapman-Smith, LL.B.