Frank M. Painter

Joint Manipulation: Toward a General Theory

By Frank M. Painter|May 14, 2017|Chiropractic Technique|

Joint Manipulation: Toward a General Theory of High-Velocity, Low-Amplitude Thrust Techniques

SOURCE: J Chiropractic Humanities 2017 (Mar); 20 (1): 1–9

Andrew S. Harwich, D.O.

The Bridge House Practice,
154 Caledonian Road,
Kings Cross, London, UK, N1 9RD

Objective The objective of this study was to describe the initial stage of a generalized theory of high-velocity, low-amplitude thrust (HVLAT) techniques for joint manipulation.

Methods This study examined the movements described by authors from the fields of osteopathy, chiropractic, and physical therapy to produce joint cavitation in both the metacarpophalangeal (MCP) joint and the cervical spine apophysial joint. This study qualitatively compared the kinetics, the similarities, and the differences between MCP cavitation and cervical facet joint cavitation. A qualitative vector analysis of forces and movements was undertaken by constructing computer-generated, simplified graphical models of the MCP joint and a typical cervical apophysial joint and imposing the motions dictated by the clinical technique.

Results Comparing the path to cavitation of 2 modes of HVLAT for the MCP joint, namely, distraction and hyperflexion, it was found that the hyperflexion method requires an axis of rotation, the hinge axis, which is also required for cervical HVLAT. These results show that there is an analogue of cervical HVLAT in one of the MCP joint HVLATs.

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AMI Model Working in Florida

By Frank M. Painter|May 12, 2017|Chiropractic Care, Integrative Care|

AMI Model Working in Florida: Functional Improvements, Reduced Utilization Costs
by Medicaid Patients

The Chiro.Org Blog

SOURCE: Dynamic Chiropractic

Background: Alternative Medicine Integration (AMI) originally achieved recognition within the chiropractic community for its unique HMO model that utilized doctors of chiropractic as primary-care physicians (PCPs) and the portal of entry into an integrated health care delivery system, inclusive of hospitals, MDs and MD specialists and outpatient facilities. Contracted with Blue Cross Blue Shield’s HMO-Illinois, AMI’s integrated IPA demonstrated excellent clinical and cost outcomes.

These outcomes were published in the June 2007 issue of JMPT and reviewed in the June 4, 2007 issue of DC. [1] In July 2007, AMI received the national endorsement of the Congress of Chiropractic State Associations (COCSA) for its outcomes-based model of chiropractic medical management.

AMI also has been documenting the clinical and cost outcomes of its holistic, patient-centered disease management program for chronic pain patients enrolled in the Florida Medicaid system. While pharmaceutically oriented disease-management programs for diabetes, hypertension, COPD and heart disease have become staples of compliance-driven, cost-containment measures offered by insurance companies and managed-care organizations, largely unnoticed by media and consumers is the growth of costs associated with chronic pain, which has become the number-one cost driver for Medicaid and the commercial populations. Coupled with the national health care trend of increased pharmaceutical usage and its associated issues of prescription drug complications, contraindications, addiction to painkillers and accidental death inherent and measurable within the conventional medical model, treatment costs for chronic pain-related diagnoses continue to escalate.

AMI’s initial three-year findings suggest integrating complementary and alternative medicine with conventional care management approaches in the Florida Medicaid system reduces the cost of care for the payer and improves the quality of life for the patient. All indications point to the conclusion that an integrative approach to treating the “whole” person is effective in this patient population.

To chiropractors and other practitioners of natural medicine, this is not a surprise. Chances are you have anecdotal stories of patient improvement within this vulnerable and challenging population. However, what is noteworthy is that since April 2004, AMI has successfully worked with the state of Florida to provide services to those beneficiaries who have been diagnosed with chronic fatigue syndrome, chronic back pain, chronic neck pain and/or fibromyalgia. AMI’s holistic nurse case managers integrate the conventional medical care these beneficiaries receive with CAM services from providers including chiropractors, acupuncturists, massage therapists, nutritionists, pharmacists and registered nurse care managers.

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An Integrated Approach to Chronic Pain

By Frank M. Painter|May 11, 2017|Chiropractic Care, Integrative Care|

An Integrated Approach to Chronic Pain

The Chiro.Org Blog

SOURCE: Dynamic Chiropractic ~ May 2017

By Peter W. Crownfield, Executive Editor

A Rhode Island Medicaid pilot program is yielding
significant benefits and savings.

Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state’s Department of Health, [1] demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.

Since 2012, Rhode Island Medicaid “Community of Care” enrollees suffering from chronic pain have participated in an integrated chronic pain program administered by Advanced Medicine Integration. Longtime readers will recall that for nearly two decades, AMI has been coordinating chiropractic and integrated care services in various states to help address the chronic pain epidemic in a community-based, integrated fashion. [2-3]

AMI’s integrated chronic pain program is designed to “reduce pain levels, improve function and overall health outcomes, reduce emergency room costs, and through a holistic approach and behavioral change models, educate members in self-care and accountability.”

The program features holistic nurse case management with referrals to CAM providers including chiropractors, massage therapists and acupuncturists; and patient education including stress-reduction tips and more.

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New Canadian Opioid Guidelines Recommends Chiropractic

By Frank M. Painter|May 9, 2017|Chiropractic Care, Opioid Epidemic, Opioid Guidelines|

Guideline for Opioid Therapy and Chronic Noncancer Pain

The Chiro.Org Blog

SOURCE: CMAJ 2017 (May 8); 189 (18): E659–E666

Jason W. Busse, DC PhD, Samantha Craigie, MSc, David N. Juurlink, MD PhD, D. Norman Buckley, MD, Li Wang, PhD, Rachel J. Couban, MA MISt, Thomas Agoritsas, MD PhD, Elie A. Akl, MD PhD, Alonso Carrasco-Labra, DDS MSc, Lynn Cooper, BES, Chris Cull, Bruno R. da Costa, PT PhD, Joseph W. Frank, MD MPH, Gus Grant, AB LLB MD, Alfonso Iorio, MD PhD, Navindra Persaud, MD MSc, Sol Stern, MD, Peter Tugwell, MD MSc, Per Olav Vandvik, MD PhD, Gordon H. Guyatt, MD MSc

Jason W. Busse
Department of Anaesthesia
McMaster University

New Canadian Opioid Guidelines Recommends
Chiropractic As Care OptionFROM: World Federation of Chiropractic
Monday, May 8, 2017A new Canadian guideline published today (May 8, 2017) in the Canadian Medical Association Journal (CMAJ) strongly recommends doctors to consider non-pharmacologic therapy, including chiropractic, in preference to opioid therapy for chronic non-cancer pain.The guideline is the product of an extensive review of evidence involving stakeholders from medical, non-medical, regulatory, and patient stakeholders.The lead author, Dr Jason Busse DC, PhD is a graduate of Canadian Memorial Chiropractic College and is an Associate Professor in the Department of Anaesthesia at McMaster University. Other authors of the guideline include those from the fields of physiotherapy, dentistry, public health and medicine.

Chronic non-cancer pain (CNCP) is defined as pain lasting more than 3 months that is not associated with malignancy. It is estimated that up to 20% of adult Canadians suffer with CNCP and, the guideline says, is the leading cause of health resource utilization and disability among working age adults.

Behind the USA, Canada has the second-highest level of opioid prescribing in the world. It is an enormous issue, with a doubling of admissions to publicly-funded opioid-related treatment programs between 2004 and 2012. In 2015, over 2000 Canadians died of opioid overdose, with final figures expected to be higher in 2016. Many of these deaths were associated with Fentanyl, the same opioid cited as being the cause of death of the musician Prince in 2016. Other commonly used opioid drugs are Percocet, OxyContin, Dilaudid and morphine.

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The Return of Color Vision Secondary to Macular

By Frank M. Painter|May 2, 2017|Macular Degeneration, Visual Disorders|

The Return of Color Vision Secondary to Macular Degeneration After Chiropractic Care

The Chiro.Org Blog

SOURCE: Chiropractic J Australia 2017; 45 (1): 38–43

Thomas A. Brozovich D.C

Palmer College of Chiropractic,
1000 Brady St,
Davenport, IA 52803, USA

Objective: To discuss the chiropractic management of a patient whose unilateral color vision loss associated with macular degeneration resolved after treatment.

Clinical Features: A 66-year-old female with a history of cervical, thoracic and lumbar pain and a four-year history of macular degeneration of the left eye resulting in a loss of color vision sought chiropractic care for primarily her spinal pain. Initially she was not requesting care for her loss of color vision. She reported having multiple recent traumas (falls) injuring her cervical, thoracic and lumbar region.

Intervention and Outcome: The patient was adjusted based on location of her subluxations (intersegmental joint dysfunction). She had 17 treatments over 8 month. A thermography study was performed of the face before and after treatment and a more symmetrical thermal pattern was obtained. Her spinal pain reduced. She also unexpectedly had a return of color vision in her left eye.

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For Bad Backs, It May Be Time to Rethink Biases

By Frank M. Painter|May 1, 2017|Chiropractic Care, Nonpharmacologic Therapies|

For Bad Backs, It May Be Time to Rethink Biases About Chiropractors

The Chiro.Org Blog

SOURCE: The New York Times ~ 5-01-2017

Aaron E. Carroll, MD, MS

Indiana University School of Medicine

About two of every three people will probably experience significant low back pain at some point. A physician like me might suggest any number of potential treatments and therapies. But one I never considered was a referral for spinal manipulation.

It appears I may have been mistaken. For initial treatment of lower back pain, it may be time for me (and other physicians) to rethink our biases.

Spinal manipulation — along with other less traditional therapies like heat, meditation and acupuncture — seems to be as effective as many other more medical therapies we prescribe, and as safe, if not safer.

Most back pain resolves over time, so interventions that focus on relief of symptoms and allow the body to heal are ideal. Many of these can be nonpharmacological in nature, like the work done by chiropractors or physical therapists.

Physicians are traditionally wary of spinal manipulation (applying pressure on bones and joints), in part because the practitioners are often not doctors and also because a few chiropractors have claimed they can address conditions that have little to do with the spine. Patients with back pain haven’t seemed as skeptical. A large survey of them from 2002 through 2008 found that more than 30 percent sought chiropractic care, significantly more than those who sought massage, acupuncture or homeopathy.

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About Frank M. Painter

Joint Manipulation: Toward a General Theory

Joint Manipulation: Toward a General Theory of High-Velocity, Low-Amplitude Thrust Techniques

AMI Model Working in Florida

AMI Model Working in Florida: Functional Improvements, Reduced Utilization Costs by Medicaid Patients

An Integrated Approach to Chronic Pain

An Integrated Approach to Chronic Pain

New Canadian Opioid Guidelines Recommends Chiropractic

Guideline for Opioid Therapy and Chronic Noncancer Pain

The Return of Color Vision Secondary to Macular

The Return of Color Vision Secondary to Macular Degeneration After Chiropractic Care

For Bad Backs, It May Be Time to Rethink Biases

For Bad Backs, It May Be Time to Rethink Biases About Chiropractors

AMI Model Working in Florida: Functional Improvements, Reduced Utilization Costs
by Medicaid Patients