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Cost-Efficiency and Effectiveness of Including Doctors of Chiropractic

By Frank M. Painter|January 7, 2020|Cost-Effectiveness|

Cost-Efficiency and Effectiveness of Including Doctors of Chiropractic to Offer Treatment Under Medicaid: A Critical Appraisal of Missouri Inclusion of Chiropractic Under Missouri Medicaid

SOURCE: Journal of Chiropractic Humanities 2019 (Dec 10)

John R. McGowan, PhD, Leonard Suiter, DC, FICC

Department of Accounting,
Richard A. Chaifetz School of Business,
Saint Louis University,
St. Louis, Missouri

OBJECTIVES: The objectives of this study were to critically evaluate the methodology and conclusions of the fiscal notes prepared by the state of Missouri for including doctors of chiropractic (DCs) under Missouri Medicaid and to develop a dynamic scoring model that calculates the savings if DCs were allowed to offer treatment under Missouri Medicaid.

METHODS: We used a secondary analysis to determine the cost-saving assumptions to be incorporated into a dynamic model. We reviewed the literature on efficiency and effectiveness of DC–delivered care regarding the most reliable assumptions concerning cost savings and utilization. The assumptions for percentage savings from DC–provided care and the avoidance of spinal surgeries were then combined in the dynamic scoring model to determine projected cost savings from adding DCs as covered providers under Missouri Medicaid. The actual cost of opioid abuse in Missouri was then determined as a basis to measure cost savings from adding DC care as an alternative therapy for the management of neck and low back pain.

DISCUSSION: The Missouri Health Division initially used the static scoring approach to evaluate proposals to cover DC care under Missouri Medicaid. This approach only considers added costs from a legislative change.

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Approach to Cervicogenic Dizziness: A Comprehensive Review of its Aetiopathology and Management

By Frank M. Painter|December 26, 2019|Cervicogenic Dizziness|

Approach to Cervicogenic Dizziness: A Comprehensive Review of its Aetiopathology and Management

The Chiro.Org Blog

SOURCE: Eur Arch Otorhinolaryngol. 2018 (Oct)

K. Devaraja

Department of Otorhinolaryngology,
Kasturba Medical College,
Manipal Academy of Higher Education,
Manipal, Udupi, Karnataka, 576104, India.

PURPOSE: Though there is abundant literature on cervicogenic dizziness with at least half a dozen of review articles, the condition remains to be enigmatic for clinicians dealing with the dizzy patients. However, most of these studies have studied the cervicogenic dizziness in general without separating the constitute conditions. Since the aetiopathological mechanism of dizziness varies between these cervicogenic causes, one cannot rely on the universal conclusions of these studies unless the constitute conditions of cervicogenic dizziness are separated and contrasted against each other.

METHODS: This narrative review of recent literature revisits the pathophysiology and the management guidelines of various conditions causing the cervicogenic dizziness, with an objective to formulate a practical algorithm that could be of clinical utility.

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Cervicogenic Dizziness

By Frank M. Painter|December 26, 2019|Cervicogenic Dizziness|

Cervicogenic Dizziness

The Chiro.Org Blog

SOURCE: Oxford Medical Case Reports 2019 (Dec 9)

Eric Chun Pu Chu, Wui Ling Chin, and Amiya Bhaumik

New York Chiropractic & Physiotherapy Center,
New York Medical Group

Cervical muscles have numerous connections with vestibular, visual and higher centres, and their interactions can produce effective proprioceptive input. Dysfunction of the cervical proprioception because of various neck problems can alter orientation in space and cause a sensation of disequilibrium. Cervicogenic dizziness (CGD) is a clinical syndrome characterized by the presence of dizziness and associated neck pain in patients with cervical pathology. Here, we report a 24–year-old female, who was diagnosed with CGD based on the correlating episodes of neck pain and dizziness. Both symptoms improved with targeted chiropractic adjustment and ultrasound therapy. CGD is a seemingly simple complaint for patients, but tends to be a controversial diagnosis because there are no specific tests to confirm its causality. For CGD to be considered, an appropriate management for the neck pain should not be denied any patient.

KEYWORDS: cervical proprioception; cervicogenic dizziness; chiropractic adjustment; neck pain

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Post-Poliomyelitis Syndrome

By Frank M. Painter|December 12, 2019|Chiropractic Care|

Post-Poliomyelitis Syndrome

The Chiro.Org Blog

SOURCE: International Medical Case Reports 2019 (Aug 8); 12: 261–264

Eric Chun Pu Chu, Kary Ka Wai Lam

New York Chiropractic and Physiotherapy Center,
New York Medical Group

Most developed countries eliminated paralytic poliomyelitis (polio) in the 1970s to 1980s. It was believed that after recovery from acute paralytic poliomyelitis, the physical condition of survivors would remain stable for the rest of their lives. However, the elimination of polio does not equate the end of medical management of polio. Hundreds of thousands of polio survivors worldwide are still at risk of developing the late effects of the disease. Here, we report a case of post-polio syndrome who attended our clinic for the presence of new weakness and neuromuscular problems six decades after recovery from paralytic polio. It is essential that health professionals be aware of these conditions and have an understanding of the underlying pathophysiology of the symptoms.

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Why Aren’t Chiropractic Physicians Treating More Children

By Frank M. Painter|December 6, 2019|Pediatrics|

Why Aren’t Chiropractic Physicians Treating More Children with Complex Diagnoses?

A Commentary on Documenting P.A.R.T. for Diagnosing and Treating Special Needs Children

The Chiro.Org Blog

SOURCE: Journal of Clinical Chiropractic Pediatrics 2019 (Nov); 18 (2)

Eric Epstein, DC, Jean Elizabeth Grabowski and Richard Duenas, DC, DABCN

Kentuckiana Children’s Center,
Louisville, KY

According to the Centers for Medicare and Medicaid Services (CMS) guidelines, chiropractors are deemed physicians in the Medicare system and for consistency throughout the term chiropractic physician will encompass chiropractor, chiropractic doctor, doctor of chiropractic and chiropractic physician. Chiropractic physicians must document subluxation of the spine through x-ray or physical examination.

The documentation of subluxation of the spine through physical examination includes the identification of two out of four criteria including:

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PEDIATRICS Section

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The Effect of Spinal Manipulation on Brain Neurometabolites

By Frank M. Painter|December 3, 2019|Low Back Pain, Neurology|

The Effect of Spinal Manipulation on Brain Neurometabolites in Chronic Nonspecific Low Back Pain Patients: A Randomized Clinical Trial

The Chiro.Org Blog

SOURCE: Irish Journal of Medical Science 2019 (Nov 26) [Epub]

Daryoush Didehdar, Fahimeh Kamali, Amin Kordi Yoosefinejad, Mehrzad Lotfi

Department of Physical Therapy,
School of Rehabilitation Sciences,
Shiraz University of Medical Sciences,
Shiraz, Iran.

BACKGROUND: In patients with chronic nonspecific low back pain (NCLBP), brain function changes due to the neuroplastic changes in different regions.

AIM: The current study aimed to evaluate the brain metabolite changes after spinal manipulation, using proton magnetic resonance spectroscopy (1H-MRS).

METHODS: In the current study, 25 patients with NCLBP aged 20-50 years were enrolled. Patients were randomly assigned to lumbopelvic manipulation or sham. Patients were evaluated before and 5 weeks after treatment by the Numerical Rating Scale (NRS), the Oswestry Disability Index (ODI), and 1H-MRS.

RESULTS: After treatment, severity of pain and functional disability were significantly reduced in the treatment group vs. sham group (p < 0.05). After treatment, N-acetyl aspartate (NAA) in thalamus, insula, dorsolateral prefrontal cortex (DLPFC) regions, as well as choline (Cho) in the thalamus, insula, and somatosensory cortex (SSC) regions, had increased significantly in the treatment group compared with the sham group (p < 0.05). A significant increase was further observed in NAA in thalamus, anterior cingulate cortex (ACC), and SCC regions along with Cho metabolite in thalamus and SCC regions after treatment in the treatment group compared with the baseline measures (p < 0.05).

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LOW BACK Section

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