Frank M. Painter

Stability: From Biomechanical Concept to Chiropractic Practice

By Frank M. Painter|November 21, 2019|Spinal Stability|

Stability: From Biomechanical Concept to Chiropractic Practice

SOURCE: J Can Chiropr Assoc 1999 (Jun); 43 (2): 75–88

Stuart M McGill, PhD

Faculty of Applied Health Sciences,
Department of Kinesiology,
University of Waterloo,
Waterloo, Ontario, Canada N2L 3G1.

This paper formalizes stability in a clinician-friendly way and then discusses ways for chiropractors to ensure stability of spinal joints that may have their stability compromized from manipulation.

KEY WORDS: lumbar stability, chiropractic, exercise, manipulation.

From the FULL TEXT Article:

Introduction

The purpose of this paper is to develop a scientific foundation and formalize the notion of stability as it pertains to the spine, and then discuss some implications of stability for advancing spine rehabilitation and clinical practice. The intention was to write a reader-friendly synthesis where only minimal references were provided. This invited review will complement my last review written for this journal 10 years ago. Over the intervening time we have established the UW-CMCC Chiropractic Research Clinic and have been conducting research with CMCC researchers. While we have been investigating the biomechanical effects of manipulation, we will need to perform additional experiments to provide a synthesis of sufficient utility for chiropractic practice. Look forward to this report in another couple of years.

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Musculoskeletal Healthcare: Have we Over-egged the Pudding?

By Frank M. Painter|November 16, 2019|Musculoskeletal Complaints|

Musculoskeletal Healthcare: Have we Over-egged the Pudding?

The Chiro.Org Blog

SOURCE: International J Rheumatic Diseases 2019 (Nov); 22 (11): 1957–1960

Christopher G. Maher Mary O’Keeffe Rachelle Buchbinder I. A. Harris

Institute for Musculoskeletal Health,
Sydney, NSW, Australia

Editorial Comment:

This paper details significant issues with the current allopathic approach to managing musculoskeletal (MSK) complaints. The authors pull no punches, and are to be commended. We have discussed some the underflying issues previously.

The reality is that medical schools do not devote enough time to reviewing the MSK system. In 1998 the Journal of Bone and Joint Surgery decried this problem, and numerous articles followed over the next 11 years, when I finally lost interest in compiling them.

You may want to review that review the series of 12 more articles on the subject, but I prefer the idea of offering chiropractic as a referral option for busy MDs who are swamped with patients with MSK comlaints, who often don’t respond well to pain killers or passive therapies. Think how much happier those MDs will be when their patients thank them for making the referral.

From the FULL TEXT Article:

INTRODUCTION

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Nonpharmacological Treatment of Army Service Members

By Frank M. Painter|November 12, 2019|Low Back Pain, Veterans|

Nonpharmacological Treatment of Army Service Members with Chronic Pain Is Associated with Fewer Adverse Outcomes After Transition to the Veterans Health Administration

The Chiro.Org Blog

SOURCE: J Gen Intern Med. 2019 (Oct 28) [Epub]

Esther L. Meerwijk, PhD, MSN , Mary Jo Larson, PhD, MPA, Eric M. Schmidt, PhD, Rachel Sayko Adams, PhD, MPH, Mark R. Bauer, MD, Grant A. Ritter, PhD, Chester Buckenmaier III, MD, and Alex H. S. Harris, PhD, MS

VA Health Services Research & Development,
Center for Innovation to Implementation (Ci2i),
VA Palo Alto Health Care System,
Menlo Park, CA, USA.

BACKGROUND: Potential protective effects of nonpharmacological treatments (NPT) against long-term pain-related adverse outcomes have not been examined.

OBJECTIVE: To compare active duty U.S. Army service members with chronic pain who did/did not receive NPT in the Military Health System (MHS) and describe the association between receiving NPT and adverse outcomes after transitioning to the Veterans Health Administration (VHA).

DESIGN AND PARTICIPANTS: A longitudinal cohort study of active duty Army service members whose MHS healthcare records indicated presence of chronic pain after an index deployment to Iraq or Afghanistan in the years 2008-2014 (N = 142,539). Propensity score-weighted multivariable Cox proportional hazard models tested for differences in adverse outcomes between the NPT group and No-NPT group.

EXPOSURES: NPT received in the MHS included acupuncture/dry needling, biofeedback, chiropractic care, massage, exercise therapy, cold laser therapy, osteopathic spinal manipulation, transcutaneous electrical nerve stimulation and other electrical manipulation, ultrasonography, superficial heat treatment, traction, and lumbar supports.

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Association Between Chiropractic Use and Opioid Receipt

By Frank M. Painter|October 25, 2019|Chiropractic Care, Opioid Epidemic|

Association Between Chiropractic Use and Opioid Receipt Among Patients with Spinal Pain: A Systematic Review and Meta-analysis

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SOURCE: Pain Medicine 2019 (Sep 27) [Epub]

Kelsey L Corcoran, DC, Lori A Bastian, MD, Craig G Gunderson, MD, Catherine Steffens, Alexandria Brackett, MA, MLIS, Anthony J Lisi, DC

Kelsey L. Corcoran, DC,
Yale Center for Medical Informatics,
300 George St., Suite 501,
New Haven, CT 06511, USA.

OBJECTIVE: To investigate the current evidence to determine if there is an association between chiropractic use and opioid receipt.

DESIGN: Systematic review and meta-analysis.

METHODS: The protocol for this review was registered on PROSPERO (CRD42018095128). The MEDLINE, PubMed, EMBASE, AMED, CINAHL, and Web of Science databases were searched for relevant articles from database inception through April 18, 2018. Controlled studies, cohort studies, and case-control studies including adults with noncancer pain were eligible for inclusion. Studies reporting opioid receipt for both subjects who used chiropractic care and nonusers were included. Data extraction and risk of bias assessment were completed independently by pairs of reviewers. Meta-analysis was performed and presented as an odds ratio with 95% confidence interval.

RESULTS: In all, 874 articles were identified. After detailed selection, 26 articles were reviewed in full, and six met the inclusion criteria. Five studies focused on back pain and one on neck pain. The prevalence of chiropractic care among patients with spinal pain varied between 11.3% and 51.3%. The proportion of patients receiving an opioid prescription was lower for chiropractic users (range = 12.3–57.6%) than nonusers (range = 31.2–65.9%). In a random-effects analysis, chiropractic users had a 64% lower odds of receiving an opioid prescription than nonusers (odds ratio = 0.36, 95% confidence interval = 0.30–0.43, P < 0.001, I² = 92.8%).

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Awareness of Axial Spondyloarthritis Among Chiropractors

By Frank M. Painter|October 20, 2019|Low Back Pain|

Awareness of Axial Spondyloarthritis Among Chiropractors and Osteopaths: Findings From a UK Web-based Survey

The Chiro.Org Blog

SOURCE: Rheumatol Adv Pract. 2019 (Sep 30)

Cee Y Yong, Jill Hamilton, Jatinder Benepal, Katie Griffiths, Zoë E Clark, Amanda Rush, Raj Sengupta, Jane Martindale, and Karl Gaffney

Department of Rheumatology,
North West Anglia NHS Foundation Trust,
Huntingdon.

OBJECTIVE: Chiropractors and osteopaths are important professional partners in the management of axial spondyloarthritis (axSpA). In view of recent advances in diagnosis and treatment, we sought to understand their current knowledge and working practices.

METHODS: A Web-based survey was advertised to chiropractors and osteopaths via the Royal College of Chiropractors and the Institute of Osteopathy.

RESULTS: Of 382 completed responses [237 chiropractors (62%) and 145 osteopaths (38%)], all were familiar with AS, but only 63 and 25% were familiar with the terms axSpA and non-radiographic axSpA, respectively. Seventy-seven per cent were confident with inflammatory back pain. Respondents routinely asked about IBD (91%), psoriasis (81%), acute anterior uveitis (49%), peripheral arthritis (71%), genitourinary/gut infection (56%), enthesitis (30%) and dactylitis (20%). Eighty-seven per cent were aware of the association between axSpA and HLA-B27. Only 29% recognized that axSpA was common in women. Forty per cent recommend an X-ray (pelvic in 80%) and, if normal, 27% would recommend MRI of the sacroiliac joints and whole spine. Forty-four per cent were aware of biologic therapies. Forty-three per cent were confident with the process of onward referral to rheumatology via the general practitioner (GP). The principal perceived barrier to onward referral was reluctance by the GP to accept their professional opinion.

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The Nordic Maintenance Care Program: Does Psychological Profile

By Frank M. Painter|October 13, 2019|Maintenance Care|

The Nordic Maintenance Care Program: Does Psychological Profile Modify the Treatment Effect of a Preventive Manual Therapy Intervention? A Secondary Analysis of a Pragmatic Randomized Controlled Trial

The Chiro.Org Blog

SOURCE: PLoS One. 2019 (Oct 10); 14 (10): e0223349

Andreas Eklund ,Irene Jensen,Charlotte Leboeuf-Yde,Alice Kongsted,Mattias Jonsson, Peter Lövgren,Jakob Petersen-Klingberg,Christian Calvert,Iben Axén

Karolinska Institutet,
Institute of Environmental Medicine,
Unit of Intervention and Implementation Research for Worker Health,
Stockholm, Sweden.

A recent single blinded placebo controlled study, conducted by the Mansoura Faculty of Medicine, conclusively demonstrates that maintenance care provides significant benefits for those with chronic low back pain.

BACKGROUND: Chiropractic maintenance care is effective as secondary/tertiary prevention of non-specific low back pain (LBP), but the potential effect moderation by psychological characteristics is unknown. The objective was to investigate whether patients in specific psychological sub-groups had different responses to MC with regard to the total number of days with bothersome pain and the number of treatments.

METHOD: Data from a two-arm randomized pragmatic multicenter trial with a 12–month follow up, designed to investigate the effectiveness of maintenance care, was used. Consecutive patients, 18–65 years of age, with recurrent and persistent LBP seeking chiropractic care with a good effect of the initial treatment were included. Eligible subjects were randomized to either maintenance care (prescheduled care) or to the control intervention, symptom-guided care.

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About Frank M. Painter

Stability: From Biomechanical Concept to Chiropractic Practice

Stability: From Biomechanical Concept to Chiropractic Practice

Musculoskeletal Healthcare: Have we Over-egged the Pudding?

Musculoskeletal Healthcare: Have we Over-egged the Pudding?

Nonpharmacological Treatment of Army Service Members

Nonpharmacological Treatment of Army Service Members with Chronic Pain Is Associated with Fewer Adverse Outcomes After Transition to the Veterans Health Administration

Association Between Chiropractic Use and Opioid Receipt

Association Between Chiropractic Use and Opioid Receipt Among Patients with Spinal Pain: A Systematic Review and Meta-analysis

Awareness of Axial Spondyloarthritis Among Chiropractors

Awareness of Axial Spondyloarthritis Among Chiropractors and Osteopaths: Findings From a UK Web-based Survey

The Nordic Maintenance Care Program: Does Psychological Profile

The Nordic Maintenance Care Program: Does Psychological Profile Modify the Treatment Effect of a Preventive Manual Therapy Intervention? A Secondary Analysis of a Pragmatic Randomized Controlled Trial