Frank M. Painter

We Built It, But Did They Come: Veterans’ Use of VA Healthcare System-Provided Complementary and Integrative Health Approaches

By Frank M. Painter|December 8, 2022|Veterans|

We Built It, But Did They Come: Veterans’ Use of VA Healthcare System-Provided Complementary and Integrative Health Approaches

SOURCE: J Gen Intern Med 2022 (Nov 30); 1-8
Stephanie L. Taylor, PhD, Hannah M. Gelman, PhD, Rian DeFaccio, MS, Jamie Douglas, MA, Matthew J. Hawrilenko, PhD, Nathan K. McGinty, BA, Adam Resnick, PhD,et al.

Center for the Study of Healthcare Innovation,
Implementation and Policy, Health Services Research & Development,
Greater Los Angeles VA Healthcare System, MC 151,
11301 Wilshire, Bldg. 206, 2nd Floor,
Los Angeles, CA, 90073, USA.

FROM: Nahin ~ Pain 2017

Background: Interest in complementary and integrative health (CIH) approaches, such as meditation, yoga, and acupuncture, continues to grow. The evidence of effectiveness for some CIH approaches has increased in the last decade, especially for pain, with many being recommended in varying degrees in national guidelines. To offer nonpharmacological health management options and meet patient demand, the nation’s largest integrated healthcare system, the Veterans Health Administration (VA), greatly expanded their provision of CIH approaches recently.

Objective: This paper addressed the questions of how many VA patients might use CIH approaches and chiropractic care if they were available at modest to no fee, and would patients with some health conditions or characteristics be more likely than others to use these therapies.

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Compliance with Clinical Practice Guidelines in Family Physicians Managing Worker’s Compensation Board Patients with Acute Lower Back Pain

By Frank M. Painter|November 23, 2022|Chiropractic Management, Workers' Compensation|

Compliance with Clinical Practice Guidelines in Family Physicians Managing Worker’s Compensation Board Patients with Acute Lower Back Pain

The Chiro.Org Blog

SOURCE: Spine J 2003 (Nov); 3 (6): 442–450

Paul B. Bishop, DC, MD, PhD, Peter C. Wing, MB, MSc, ChB, FRCS(C)

Combined Neurosurgical and Orthopaedic Spine Program,
Heather Pavilion, Vancouver General Hospital,
Vancouver, BC, Canada

Background context: Family physician compliance with acute lower back pain clinical practice guidelines remains uncertain.

Purpose: To determine the degree of guideline compliance of family physicians managing patients with workers’ compensation claims and acute mechanical lower back pain.

Study design: Observational study.

Patient sample: One hundred thirty-nine family physicians in British Columbia.

Outcome measures: Compliance with guideline recommendations for history, examination procedures, diagnostic testing and treatments.

Methods: Physician workers’ compensation board patient reports for acute lower back pain without leg symptoms and not greater than 2 to 3 weeks duration were scored for guideline adherence up until 12 weeks after onset.

Results: Physicians demonstrated a high degree of compliance with the guideline-recommended history, examination procedures and medications, but low compliance with recommended imaging and many treatment recommendations.

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LOW BACK PAIN Section and the:

WORKERS’ COMPENSATION Section

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Treatment of Lower Back Pain-The Gap between Guideline-Based Treatment and Medical Care Reality

By Frank M. Painter|November 17, 2022|Guidelines, Initial Provider, Low Back Pain|

Treatment of Lower Back Pain-The Gap between Guideline-Based Treatment and Medical Care Reality

The Chiro.Org Blog

SOURCE: Healthcare (Basel) 2016 (Jul 15); 4 (3): 44 ~ FULL TEXT

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Andreas Werber and Marcus Schiltenwolf

Department of Orthopedics and Orthopedic Surgery,
University Hospital Giessen,
Klinikstr. 33, 35392
Giessen, Germany

Despite the fact that unspecific low back pain is of important impact in general health care, this pain condition is often treated insufficiently. Poor efficiency has led to the necessity of guidelines addressing evidence-based strategies for treatment of lower back pain (LBP). We present some statements of the German medical care reality. Self-responsible action of the patient should be supported while invasive methods in particular should be avoided due to lacking evidence in outcome efficiency. However, it has to be stated that no effective implementation strategy has been established yet. Especially, studies on the economic impact of different implementation strategies are lacking.

A lack of awareness of common available guidelines and an uneven distribution of existing knowledge throughout the population can be stated: persons with higher risk suffering from LBP by higher professional demands and lower educational level are not skilled in advised management of LBP. Both diagnostic imaging and invasive treatment methods increased dramatically leading to increased costs and doctor workload without being associated with improved patient functioning, severity of pain or overall health status due to the absence of a functioning primary care gate keeping system for patient selection.

Opioids are prescribed on a grand scale and over a long period. Moreover, opioid prescription is not indicated properly, when predominantly persons with psychological distress like somatoform disorders are treated with opioids.

Keywords: guideline-based treatment; low back pain; somatisation.

From the FULL TEXT Article:

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Adolescent Neck and Shoulder Pain–The Association with Depression, Physical Activity, Screen-based Activities, and Use of Health Care Services

By Frank M. Painter|November 11, 2022|Neck Pain, Pediatrics|

Adolescent Neck and Shoulder Pain–The Association with Depression, Physical Activity, Screen-based Activities, and Use of Health Care Services

The Chiro.Org Blog

SOURCE: J Adolesc Health 2014 (Sep); 55 (3): 366–372
Solbjørg Makalani Myrtveit, Børge Sivertsen, Ph.D., Jens Christoffer Skogen, Ph.D., Lisbeth Frostholm, Ph.D. et al

Department of Clinical Science,
University of Bergen,
Bergen, Norway

Purpose: Neck and shoulder pain is frequent in adolescents, and multiple factors seem to affect the risk of such symptoms. We aimed to investigate the prevalence of neck and shoulder pain in Norwegian adolescence and to examine whether behavioral and emotional factors were associated with the risk of neck and shoulder pain. Finally we aimed to investigate whether neck and shoulder pain was related to the use of health services.

Method: Data from the population-based study ung@hordaland were used. Participants were asked how often during the last 6 months they had experienced neck and shoulder pain. The association between frequent neck and shoulder pain and physical activity, symptoms of depression, and screen-based activities was evaluated using logistic regression analyses stratified by gender. The relative risk of visiting health services when reporting neck and shoulder pain was calculated using multiple logistic regression analyses.

Results: Frequent neck and shoulder pain was reported by 20.0% (1,797 of the total 8,990) and more often by girls than boys (p < .001). A high score of depressive symptoms was the strongest risk factor for neck and shoulder pain in both boys and girls (odds ratio = 6.14 [95% confidence interval 4.48-8.42] and odds ratio = 3.10 [95% confidence interval 2.63-3.67], respectively). Frequent screen-based activities slightly increased the risk while physical activity was protective. Individuals reporting neck and shoulder pain more often visited their general practitioner (47.1% vs. 31.8%) and school health services (24.6% vs. 13.5%).

Conclusion: Frequent neck and shoulder pain was reported in 20% of Norwegian adolescents. Symptoms of depression and screen-based activities increased the risk of neck and shoulder pain while physical activity was protective. Individuals reporting neck and shoulder pain visited health services more frequently than others.

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The Vast Majority of Patients With Fibromyalgia Have a Straight Neck Observed on a Lateral View Radiograph of the Cervical Spine: An Aid in the Diagnosis of Fibromyalgia and a Possible Clue to the Etiology

By Frank M. Painter|November 10, 2022|Chiropractic Management, Fibromyalgia, Hypolordosis|

The Vast Majority of Patients With Fibromyalgia Have a Straight Neck Observed on a Lateral View Radiograph of the Cervical Spine: An Aid in the Diagnosis of Fibromyalgia and a Possible Clue to the Etiology

The Chiro.Org Blog

SOURCE: J Clinical Rheumatology 2022 (Nov 3) [EPUB]

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Robert S Katz, MD, Frank Leavitt, PhD, Katya Cherny,MS , Alexandra Katz Small, MD, Ben J Small, MD

From the Rush Medical University.
Rheumatology Associates.
Northwestern University Medical Center,
Chicago, IL.

Objective: A straight cervical spine is an underappreciated and often overlooked finding in fibromyalgia. The aim of this medical records review study was to evaluate the cervical curvature on radiographs of patients with fibromyalgia.

Methods: A consecutive series of 270 cervical spine radiographs of patients with neck pain from 2015 to 2018 were retrospectively analyzed for cervical curvature using the Cobb angle measurement. One hundred fifty-five patients met full American College of Rheumatology criteria for fibromyalgia, whereas 115 subjects with other rheumatic diseases who were similar in age and education served as control subjects.

Results: Mean cervical curvature in fibromyalgia was 6.4 ± 5.2 degrees and 13.8 ± 7.4 degrees in control subjects. The more than 7-degree difference was significant (p < 0.001). Curvature in the magnitude of 21 degrees is at the low end of normal. At ≤10 degrees, where the cervical spine is essentially straight, there were 129 fibromyalgia patients (83.2%) and 37 control subjects (32.2%). The 51% difference was significant (p < 0.001).

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Initial Integration of Chiropractic Services into a Provincially Funded Inner City Community Health Centre: A Program Description

By Frank M. Painter|November 7, 2022|Integrative Care|

Initial Integration of Chiropractic Services into a Provincially Funded Inner City Community Health Centre: A Program Description

The Chiro.Org Blog

SOURCE: J Can Chiropr Assoc 2015 (Dec); 59 (4): 363–372

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Steven R. Passmore, DC, PhDm Audrey Toth, DC, Joel Kanovsky, DC. Gerald Olin, BSc, DC

University of Manitoba,
College of Rehabilitation Sciences;
University of Manitoba,
Faculty of Kinesiology & Recreation Management.

Background: The burden of fees for chiropractic services rendered often falls on the patient and must be provided out-of-pocket regardless of their socioeconomic status and clinical need. Universal healthcare coverage reduces the financial barrier to healthcare utilization, thereby increasing the opportunity for the financially disadvantaged to have access to care. In 2011 the Canadian Province of Manitoba initiated a pilot program providing access to chiropractic care within the Mount Carmel Clinic (MCC), a non-secular, non-profit, inner city community health centre.

Objective: To describe the initial integration of chiropractic services into a publically funded healthcare facility including patient demographics, referral patterns, treatment practices and clinical outcomes.

Method: A retrospective database review of chiropractic consultations in 2011 (N=177) was performed.

Results: The typical patient referred for chiropractic care was a non-working (86%), 47.3 (SD=16.8) year old, who self-identified as Caucasian (52.2%), or Aboriginal (35.8%) and female (68.3%) with a body mass index considered obese at 30.4(SD=7.0). New patient consultations were primarily referrals from other health providers internal to the MCC (71.2%), frequently primary care physicians (76%). Baseline to discharge comparisons of numeric rating scale scores for the cervical, thoracic, lumbar, sacroiliac and extremity regions all exceeded the minimally clinically important difference for reduction in musculoskeletal pain. Improvements occurred over an average of 12.7 (SD=14.3) treatments, and pain reductions were also statistically significant at p<0.05.

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About Frank M. Painter

We Built It, But Did They Come: Veterans’ Use of VA Healthcare System-Provided Complementary and Integrative Health Approaches

We Built It, But Did They Come: Veterans’ Use of VA Healthcare System-Provided Complementary and Integrative Health Approaches

Compliance with Clinical Practice Guidelines in Family Physicians Managing Worker’s Compensation Board Patients with Acute Lower Back Pain

Compliance with Clinical Practice Guidelines in Family Physicians Managing Worker’s Compensation Board Patients with Acute Lower Back Pain

Treatment of Lower Back Pain-The Gap between Guideline-Based Treatment and Medical Care Reality

Treatment of Lower Back Pain-The Gap between Guideline-Based Treatment and Medical Care Reality

Adolescent Neck and Shoulder Pain–The Association with Depression, Physical Activity, Screen-based Activities, and Use of Health Care Services

Adolescent Neck and Shoulder Pain–The Association with Depression, Physical Activity, Screen-based Activities, and Use of Health Care Services

The Vast Majority of Patients With Fibromyalgia Have a Straight Neck Observed on a Lateral View Radiograph of the Cervical Spine: An Aid in the Diagnosis of Fibromyalgia and a Possible Clue to the Etiology

The Vast Majority of Patients With Fibromyalgia Have a Straight Neck Observed on a Lateral View Radiograph of the Cervical Spine: An Aid in the Diagnosis of Fibromyalgia and a Possible Clue to the Etiology

Initial Integration of Chiropractic Services into a Provincially Funded Inner City Community Health Centre: A Program Description

Initial Integration of Chiropractic Services into a Provincially Funded Inner City Community Health Centre: A Program Description