Frank M. Painter

Spinal Pain and Co-occurrence with Stress

By Frank M. Painter|December 26, 2018|Pediatrics|

Spinal Pain and Co-occurrence with Stress and General Well-being Among Young Adolescents: A Study Within the Danish National Birth Cohort

SOURCE: European Journal of Pediatrics 2017 (Jun); 176 (6): 807–814

Sandra Elkjær Stallknecht & Katrine Strandberg-Larsen & Lise Hestbæk & Anne-Marie Nybo Andersen

Department of Public Health, Section of Social Medicine,
University of Copenhagen,
Øster Farimagsgade 5, 1014, Copenhagen, Denmark.

This study aims to describe the patterns in low back, mid back, and neck pain complaints in young adolescents from the Danish National Birth Cohort (DNBC) and to investigate the co-occurrence of spinal pain and stress and general well-being, respectively. Cross-sectional data from the 11-year follow-up of DNBC were used. As part of a web-based survey, a total of 45,371 young adolescents between 10 and 14 years old completed the Young Spine Questionnaire, the Stress in Children Questionnaire, and a one-item question on general well-being. Associations between spinal pain and, respectively, stress and general well-being were estimated by means of multiple logistic regression models. Almost one fifth of boys and one quarter of girls reported spinal pain. Compared with adolescents who reported no stress, adolescents reporting medium and high values of stress had odds ratios (OR) of 2.19 (95% CI 2.08-2.30) and 4.73 (95% CI 4.28-5.23), respectively, of reporting spinal pain (adjusted for age, gender, and maternal education). Adolescents who reported poor general well-being had an OR of 2.50 (95% CI 2.31-2.72) for reporting spinal pain compared to adolescents with good general well-being.

CONCLUSION: Spinal pain in childhood and adolescence is strongly associated with spinal pain and generalized pain in adulthood. [2, 7, 11]. Therefore, it is of great importance to seek to treat and prevent spinal pain in children both to prevent discomfort for the child but also to reduce the individual and social costs of spinal pain in adulthood. If spinal pain among children and adolescents involves psychosocial well-being, then treatment as well as preventive initiatives might include psychosocial approaches, e.g., psycho education and development of appropriate coping strategies.

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Neck-tongue Syndrome

By Frank M. Painter|December 23, 2018|Neck-Tongue Syndrome|

Neck-tongue Syndrome

The Chiro.Org Blog

SOURCE: BMJ Case Rep. 2018 (Dec 4); 11 (1). pii: e227483

Eric Chun Pu Chu and Andy Fu Chieh Lin

Chiropractic and Physiotherapy Department,
New York Medical Group,
Mong Kok, Hong Kong, Hong Kong.

Neck-tongue syndrome (NTS) is a rarely reported disorder characterised by paroxysmal episodes of intense pain in the upper cervical or occipital areas associated with ipsilateral hemiglossal dysaesthesia brought about by sudden neck movement. The most likely cause of this clinical entity is a temporary subluxation of the lateral atlantoaxial joint with impaction of the C2 ventral ramus against the articular processes on head rotation. NTS is an under-recognised condition that can be debilitating for patients and challenging for the treating physicians. Here, we report a 47-year-old man who fulfilled the International Classification of Headache Disorders, third edition criteria for a diagnosis of NTS was treated successfully with a chiropractic approach. There are currently no consensus guidelines for dealing with this disorder. Reassuringly, chiropractic care for uncomplicated NTS appears highly effective.

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Evidence Based Chiropractic Care For Lower Back Pain

By Frank M. Painter|December 3, 2018|Chiropractic Research|

Evidence Based Chiropractic Care For Lower Back Pain

The Chiro.Org Blog

SOURCE: Texas Chiropractic Association 2018

Our thanks to the TCA, Andrea Howard and Chris Dalrymple, D.C., F.I.C.C. for giving us permission to display their PowerPoint in an interactive fashion on Chiro.Org.

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Special thanks to Michael Beattie, D.C. for rendering the PPT as a Google Doc that works!

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Comparison of Treatment Outcomes in Nonspecific Low-Back Pain

By Frank M. Painter|December 1, 2018|Disc Derangement, Modic Changes|

Comparison of Treatment Outcomes in Nonspecific Low-Back Pain Patients With and Without Modic Changes Who Receive Chiropractic Treatment

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2018 (Sep); 41 (7): 561–570

Michèle Annen, MChiroMed, Cynthia Peterson, DC, MMedEd, B. Kim Humphreys, DC, PhD

Chiropractic Medicine Department,
Faculty of Medicine, University of Zurich,
Orthopaedic University Hospital Balgrist,
Zürich, Switzerland.

OBJECTIVE: The aim of this study was to determine if there was a difference in outcomes in patients with nonspecific low back pain, both with and without Modic changes (MCs), who received chiropractic care.

METHODS: This prospective outcomes study included 112 patients with low back pain without disc herniation on magnetic resonance imaging. All patients were treated with spinal manipulative therapy. At baseline, the numerical rating scale (NRS) and Bournemouth Questionnaire (BQ) for disability were collected. The NRS, BQ, and Patient’s Global Impression of Change (primary outcome) were collected at the follow-up time points of 1 week, 1 month, and 3 months to assess overall improvement. Magnetic resonance imaging scans were analyzed for the presence of MCs and, if present, classified as Modic I or II. The χ² test was used to compare the proportion of patients reporting clinically relevant “improvement” between patients with and without MCs and between Modic I and Modic II patients. The unpaired Student t test was used to compare NRS and BQ at baseline and change scores at all follow-up time points.

RESULTS: For the primary outcome measure, the proportion of patients reporting relevant “improvement” (Patient’s Global Impression of Change), and for the secondary outcome measures (NRS and BQ change scores), there were no significant differences between Modic positive and Modic negative patients or between Modic I and Modic II patients.

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Disc Herniation and Chiropractic Page

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The Association Between Psychological and Social Factors

By Frank M. Painter|November 29, 2018|Pediatrics, Spinal Pain|

The Association Between Psychological and Social Factors and Spinal Pain in Adolescents

The Chiro.Org Blog

SOURCE: Eur J Pediatr. 2018 (Nov 21) [Epub]

Sarah Batley & Ellen Aartun & Eleanor Boyle & Jan Hartvigsen & Paula J. Stern & Lise Hestbæk

Graduate Studies,
Canadian Memorial Chiropractic College,
6100 Leslie Street,
Toronto, M2H 3J1, Canada.

Spinal pain, back pain, and/or neck pain begins early in life and is strongly associated with spinal pain in adulthood. Understanding the relationship between psychological and social factors and adolescent spinal pain may be important in both the prevention and treatment of spinal pain in this age group. We aimed to determine if psychological and social factors were associated with spinal pain in a cross-sectional study of a school-based cohort of 1279 Danish adolescents aged 11–13, who were categorized into “any” and “substantial” spinal pain.

“Substantial spinal pain” was defined as a lifetime frequency of “sometimes” or “often” and a pain intensity of at least two on the revised Faces Pain Scale. Logistic regression analyses, stratified by sex, were conducted for single and all variables together. Eighty-six percent of participants reported “any spinal pain” and 28% reported “substantial spinal pain”. Frequency of psychological and social factors was significantly higher in those with spinal pain compared to those without. As the frequency of psychological and social factors increased, the odds of both “any spinal pain” and “substantial spinal pain” also increased.

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Global, Regional, and National Burden of Migraine

By Frank M. Painter|November 26, 2018|Migraine|

Global, Regional, and National Burden of Migraine and Tension-type Headache, 1990-2016: A Systematic Analysis for the Global Burden of Disease Study 2016

The Chiro.Org Blog

SOURCE: Lancet Neurol. 2018 (Nov); 17 (11): 954–976

GBD 2016 Headache Collaborators

Prof Lars Jacob Stovner,
Department of Neuromedicine and Movement Science,
Norwegian University of Science and Technology,
Trondheim N-7491, Norway

BACKGROUND: Through the Global Burden of Diseases, Injuries, and Risk Factors (GBD) studies, headache has emerged as a major global public health concern. We aimed to use data from the GBD 2016 study to provide new estimates for prevalence and years of life lived with disability (YLDs) for migraine and tension-type headache and to present the methods and results in an accessible way for clinicians and researchers of headache disorders.

METHODS: Data were derived from population-based cross-sectional surveys on migraine and tension-type headache. Prevalence for each sex and 5–year age group interval (ie, age 5 years to ≥95 years) at different time points from 1990 and 2016 in all countries and GBD regions were estimated using a Bayesian meta-regression model. Disease burden measured in YLDs was calculated from prevalence and average time spent with headache multiplied by disability weights (a measure of the relative severity of the disabling consequence of a disease). The burden stemming from medication overuse headache, which was included in earlier iterations of GBD as a separate cause, was subsumed as a sequela of either migraine or tension-type headache. Because no deaths were assigned to headaches as the underlying cause, YLDs equate to disability-adjusted life-years (DALYs). We also analysed results on the basis of the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility.

FINDINGS: Almost three billion individuals were estimated to have a migraine or tension-type headache in 2016: 1·89 billion (95% uncertainty interval [UI] 1·71–2·10) with tension-type headache and 1·04 billion (95% UI 1·00–1·09) with migraine. However, because migraine had a much higher disability weight than tension-type headache, migraine caused 45·1 million (95% UI 29·0–62·8) and tension-type headache only 7·2 million (95% UI 4·6–10·5) years lived with disability (YLDs) globally in 2016. The headaches were most burdensome in women between ages 15 and 49 years, with migraine causing 20·3 million (95% UI 12·9–28·5) and tension-type headache 2·9 million (95% UI 1·8–4·2) YLDs in 2016, which was 11·2% of all YLDs in this age group and sex. Age-standardised DALYs for each headache type showed a small increase as SDI increased.

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About Frank M. Painter

Spinal Pain and Co-occurrence with Stress

Spinal Pain and Co-occurrence with Stress and General Well-being Among Young Adolescents: A Study Within the Danish National Birth Cohort

Neck-tongue Syndrome

Neck-tongue Syndrome

Evidence Based Chiropractic Care For Lower Back Pain

Evidence Based Chiropractic Care For Lower Back Pain

Comparison of Treatment Outcomes in Nonspecific Low-Back Pain

Comparison of Treatment Outcomes in Nonspecific Low-Back Pain Patients With and Without Modic Changes Who Receive Chiropractic Treatment

The Association Between Psychological and Social Factors

The Association Between Psychological and Social Factors and Spinal Pain in Adolescents

Global, Regional, and National Burden of Migraine

Global, Regional, and National Burden of Migraine and Tension-type Headache, 1990-2016: A Systematic Analysis for the Global Burden of Disease Study 2016