Frank M. Painter

Characteristics of Chiropractic Patients Being Treated

By Frank M. Painter|September 1, 2018|Chronic Neck Pain, Low Back Pain|

Characteristics of Chiropractic Patients Being Treated for Chronic Low Back and Neck Pain

SOURCE: J Manipulative Physiol Ther. 2018 (Aug 15) [Epub]

Scott Haldeman, Claire D. Johnson, Roger Chou, Margareta Nordin, Pierre Côté, Eric L. Hurwitz, Bart N. Green, Christine Cedraschi et. al.

RAND Corporation,
Santa Monica, California.

OBJECTIVES: Chronic low back pain (CLBP) and chronic neck pain (CNP) are the most common types of chronic pain, and chiropractic spinal manipulation is a common nonpharmacologic treatment. This study presents the characteristics of a large United States sample of chiropractic patients with CLBP and CNP.

METHODS: Data were collected from chiropractic patients using multistage systematic stratified sampling with 4 sampling levels: regions and states, sites (ie, metropolitan areas), providers and clinics, and patients. The sites and regions were San Diego, California; Tampa, Florida; Minneapolis, Minnesota; Seneca Falls and Upstate New York; Portland, Oregon; and Dallas, Texas. Data were collected from patients through an iPad-based prescreening questionnaire in the clinic and emailed links to full screening and baseline online questionnaires. The goal was 20 providers or clinics and 7 patients with CLBP and 7 with CNP from each clinic.

RESULTS: We had 6342 patients at 125 clinics complete the prescreening questionnaire, 3333 patients start the full screening questionnaire, and 2024 eligible patients completed the baseline questionnaire: 518 with CLBP only, 347 with CNP only, and 1159 with both. In general, most of this sample were highly-educated, non-Hispanic, white females with at least partial insurance coverage for chiropractic care who have been in pain and using chiropractic care for years. Over 90% reported high satisfaction with their care, few used narcotics, and avoiding surgery was the most important reason they chose chiropractic care.

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Chronic Neck Pain and Chiropractic
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Low Back Pain and Chiropractic

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Importance of the Type of Provider Seen

By Frank M. Painter|August 11, 2018|Cost-Effectiveness of Chiropractic|

Importance of the Type of Provider Seen to Begin Health Care for a New Episode Low Back Pain: Associations with Future Utilization and Costs

The Chiro.Org Blog

SOURCE: J Eval Clin Pract. 2016 (Apr); 22 (2): 247–252

Julie M. Fritz PhD PT FAPTA, Jaewhan Kim PhD, and Josette Dorius BSN MPH

Department of Physical Therapy,
College of Health,
University of Utah,
Salt Lake City, UT, USA.

Editorial Comment

This article is the perfect example of how mis-leading an Abstract can be, when it fails to reflect what the study actually reveals. (see it below)

The RESULTS portion of this Abstract only partially discusses the findings, comparing 3 different professions’ treatment, costs, and outcomes for low back pain.

In it they only mention the costs associated with medical management, while in reviewing chiropractic care vs. physical thereapy portions, they choose to emphasize:

Entry in chiropractic was associated with
an increased episode of care duration

whereas

Entry in physical therapy
no patient entering in physical therapy had surgery.

That *seems* to suggest that physical therapy *may* entail less expense, or shorter durations of care, or that chiropractic patients are more likely to end up with surgery. None of that is true. Their own Table 2 plainly reveals that chiropractic care was the least expensive form of care provided to the 3 groups.

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The Cost-Effectiveness of Chiropractic Page

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Spontaneous Cervical Artery Dissection

By Frank M. Painter|August 2, 2018|Stroke, Vertebral Artery|

Spontaneous Cervical Artery Dissection:
A Fluoroquinolone Induced Connective Tissue Disorder?

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2018 (Jul 9); 26: 22

James S. Demetrious, DC, FACO

Wilmington, NC, USA.

BACKGROUND: Spontaneous cervical artery dissections more often manifest in young people and have been associated with catastrophic consequences. Some indeterminate risk factors have been identified, making the diagnosis of developing dissections quite difficult. Fluoroquinolone antibiotics have been recognized for their degradative effects on connective tissue. Recent studies have implicated fluoroquinolones in the genesis of aortic artery aneurysms. It is the purpose of this paper to provide reasoning for a testable hypothesis of whether fluoroquinolones constitute a risk factor associated with cervical artery dissections.

METHODS: A PubMed search was conducted to investigate whether cervical artery dissection has been associated with fluoroquinolone use. An assessment of risk factors was made of hereditary connective tissue disorders, infection, and seasonal predisposition related to cervical artery dissection. These factors were considered in conjunction with reports of connective tissue toxicity associated with fluoroquinolone medications.

RESULTS: It appears that no reported cases of cervical artery dissection have previously been correlated with fluoroquinolone use. Heritable connective tissue disorders, infection, seasonal predisposition and condition latencies are associated with fluoroquinolone medications. Several recent articles have implicated fluoroquinolones with aortic dissections and aneurysm.

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Stroke and Chiropractic Page

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Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy

By Frank M. Painter|July 31, 2018|Low Back Pain, Pregnancy|

Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy: A Retrospective Case Series

The Chiro.Org Blog

SOURCE: J Midwifery Womens Health 2006 (Jan); 51 (1): e7-10

Anthony J. Lisi

University of Bridgeport College of Chiropractic.

Low back pain is a common complaint in pregnancy, with a reported prevalence of 57% to 69% and incidence of 61%. Although such pain can result in significant disability, it has been shown that as few as 32% of women report symptoms to their prenatal provider, and only 25% of providers recommend treatment. Chiropractors sometimes manage low back pain in pregnant women; however, scarce data exist regarding such treatment. This retrospective case series was undertaken to describe the results of a group of pregnant women with low back pain who underwent chiropractic treatment including spinal manipulation. Seventeen cases met all inclusion criteria.

The overall group average Numerical Rating Scale pain score decreased from 5.9 (range 2-10) at initial presentation to 1.5 (range 0-5) at termination of care. Sixteen of 17 (94.1%) cases demonstrated clinically important improvement. The average time to initial clinically important pain relief was 4.5 (range 0-13) days after initial presentation, and the average number of visits undergone up to that point was 1.8 (range 1-5). No adverse effects were reported in any of the 17 cases. The results suggest that chiropractic treatment was safe in these cases and support the hypothesis that it may be effective for reducing pain intensity.

From the FULL TEXT Article:

INTRODUCTION

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Female Issues and Chiropractic Page and the:

Pregnancy-related Pain and Chiropractic Page

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Can a Bothersome Course of Pelvic Pain From Mid-pregnancy

By Frank M. Painter|July 29, 2018|Low Back Pain, Pregnancy|

Can a Bothersome Course of Pelvic Pain From Mid-pregnancy to Birth be Predicted? A Norwegian Prospective Longitudinal SMS-Track Study

The Chiro.Org Blog

SOURCE: BMJ Open. 2018 (Jul 25); 8 (7): e021378

Stefan Malmqvist, Inger Kjaermann, Knut Andersen, Anne Marie Gausel, Inger Økland, Jan Petter Larsen, Kolbjorn S Bronnick

The Norwegian Centre for Movement Disorders,
Stavanger University Hospital,
Stavanger, Norway.

OBJECTIVE: To explore if pregnant women with pelvic girdle pain (PGP), subgrouped following the results from two clinical tests with high validity and reliability, differ in demographic characteristics and weekly amount of days with bothersome symptoms through the second half of pregnancy.

DESIGN: A prospective longitudinal cohort study.

PARTICIPANTS: Pregnant women with pelvic and lumbopelvic pain due for their second-trimester routine ultrasound examination.

SETTING: Obstetric outpatient clinic at Stavanger University Hospital, Norway.

METHODS: Women reporting pelvic and lumbopelvic pain completed a questionnaire on demographic and clinical features. They were clinically examined following a test procedure recommended in the European guidelines for the diagnosis and treatment of PGP. Women without pain symptoms completed a questionnaire on demographic data. All women were followed weekly through an SMS-Track survey until delivery.

PRIMARY AND SECONDARY OUTCOME MEASURES: The outcome measures were the results from clinical diagnostic tests for PGP and the number of days per week with bothersome pelvic pain.

RESULTS: 503 women participated. 42% (212/503) reported pain in the lumbopelvic region and 39% (196/503) fulfilled the criteria for a probable PGP diagnosis. 27% (137/503) reported both the posterior pelvic pain provocation (P4) and the active straight leg raise (ASLR) tests positive at baseline in week 18, revealing 7.55 (95% CI 5.54 to 10.29) times higher mean number of days with bothersome pelvic pain compared with women with both tests negative. They presented the highest scores for workload, depressed mood, pain level, body mass index, Oswestry Disability Index and the number of previous pregnancies. Exercising regularly before and during pregnancy was more common in women with negative tests.

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Chiropractic Pediatrics Section and the:

Clinical Prediction Rule Page and the:

Pregnancy-related Pain and Chiropractic Page

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Prevalence and Incidence of Musculoskeletal Extremity

By Frank M. Painter|July 26, 2018|Musculoskeletal Complaints, Pediatrics|

Prevalence and Incidence of Musculoskeletal Extremity Complaints in Children and Adolescents. A Systematic Review

The Chiro.Org Blog

SOURCE: BMC Musculoskelet Disord. 2017 (Oct 18); 18 (1): 418

Signe Fuglkjer, Kristina Boe Dissing and Lise Hestbaek

Department of Sports Science and Clinical Biomechanics,
Faculty of Health Sciences,
University of Southern Denmark,
Campusvej 55, DK-5230, Odense M, Denmark.

BACKGROUND: It is difficult to gain an overview of musculoskeletal extremity complaints in childhood although this is essential to develop evidence-based prevention and treatment strategies. The objectives of this systematic review were therefore to describe the prevalence and incidence of musculoskeletal extremity complaints in children and adolescents in both general and clinical populations in relation to age, anatomical site and mode of onset.

METHODS: MEDLINE and EMBASE were electronically searched; risk of bias was assessed; and data extraction was individually performed by two authors.

RESULTS: In total, 19 general population studies and three clinical population studies were included with children aged 0–19 years. For most of the analyses, a division between younger children aged 0–12 years, and older children aged 10–19 years was used. Lower extremity complaints were more common than upper extremity complaints regardless of age and type of population, with the most frequent pain site changing from ankle/foot in the youngest to knee in the oldest. There were about twice as many non-traumatic as traumatic complaints in the lower extremities, whereas the opposite relationship was found for the upper extremities in the general population studies. There were relatively more lower extremity complaints in the general population studies than in the clinical population studies. The review showed no pattern of differences in reporting between studies of high and low risk of bias.

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Chiropractic Pediatrics Section

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About Frank M. Painter

Characteristics of Chiropractic Patients Being Treated

Characteristics of Chiropractic Patients Being Treated for Chronic Low Back and Neck Pain

Importance of the Type of Provider Seen

Importance of the Type of Provider Seen to Begin Health Care for a New Episode Low Back Pain: Associations with Future Utilization and Costs

Spontaneous Cervical Artery Dissection

Spontaneous Cervical Artery Dissection: A Fluoroquinolone Induced Connective Tissue Disorder?

Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy

Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy: A Retrospective Case Series

Can a Bothersome Course of Pelvic Pain From Mid-pregnancy

Can a Bothersome Course of Pelvic Pain From Mid-pregnancy to Birth be Predicted? A Norwegian Prospective Longitudinal SMS-Track Study

Prevalence and Incidence of Musculoskeletal Extremity

Prevalence and Incidence of Musculoskeletal Extremity Complaints in Children and Adolescents. A Systematic Review

Spontaneous Cervical Artery Dissection:
A Fluoroquinolone Induced Connective Tissue Disorder?