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Clinical Indicators for Recommending Continued Care to Patients with Neck Pain in Chiropractic Practice: A Cohort Study

By Frank M. Painter|January 1, 2024|Maintenance Care, Patient Satisfaction|

Clinical Indicators for Recommending Continued Care to Patients with Neck Pain in Chiropractic Practice: A Cohort Study

SOURCE: Chiropractic & Manual Therapies 2023 (Aug 31); 31: 33

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Birgitte Lawaetz Myhrvold • Nina K Vøllestad • Pernille Irgens • Hilde Stendal Robinson • Iben Axén

Department of Interdisciplinary Health Sciences,
Institute of Health and Society,
University of Oslo, P.O. Box 1089,
0317, Blindern, Oslo, Norway.

Background: Chiropractors’ clinical indicators for recommending preventive continued care to patients with low back pain include previous pain episodes, a history of long pain duration and improvement after initial treatment. Our objectives were, in a cohort of patients with neck pain, to examine whether these clinical indicators were associated with being recommended continued care beyond 4 weeks, and if so whether this recommendation was dependent of chiropractor characteristics, as well as if the number of clinical indicators influenced this recommendation.

Methods: In this multi-center observational study, 172 patients seeking care for a new episode of neck pain in chiropractic practice in Norway were included between September 2015 and May 2016. The chiropractors treated their patients as per usual, and for this study, baseline data and 4-week follow-up data were used.

Patient data included the clinical indicators

(1) previous episodes of neck pain,
(2) a history of long duration neck pain and
(3) improvement four weeks after initial treatment.

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MAINTENANCE CARE Section and the

CHRONIC NECK PAIN Section

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Chiropractic Care for Workers with Low Back Pain

By Frank M. Painter|December 31, 2023|Chiropractic Management, Cost-Effectiveness of Chiropractic, Workers' Compensation|

Chiropractic Care for Workers with Low Back Pain

The Chiro.Org Blog

SOURCE: Workers Compensation Research Institute (May 17, 2022)
Dongchun Wang, Kathryn Mueller, Randall Lea, M.D., Donald R. Murphy

Related Topics: Medical Costs, Outcomes for Injured Workers, Physical Medicine, Utilization

Cambridge, MA, May 17, 2022 — Today, the Workers Compensation Research Institute (WCRI) announced the release of a new study on chiropractic care for low back pain. The study reveals substantial variation in the use of chiropractic care across 28 states and offers insights into the patterns and outcomes of chiropractic care.

“Chiropractors often participate in the delivery of physical medicine services for low back pain, but few workers received chiropractic care in states where employers or insurers control the selection of providers,” said John Ruser, WCRI’s president and CEO. “This study will be helpful for policymakers and stakeholders who are interested in re-evaluating the role of chiropractors, especially those who have been adopting evidence-based practices and contributing to cost-effective care.”

This study, Chiropractic Care for Workers with Low Back Pain, describes the prevalence of chiropractic care and provider patterns of physical medicine treatment for workers with low back pain. It provides some evidence as to how different provider patterns of physical medicine treatment are associated with variations in overall medical and indemnity costs, and the duration of temporary disability. The study also looks at the utilization of medical services, including magnetic imaging studies, opioid prescriptions, and pain management injections.

The following is a sample of the study’s key findings:

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WORKERS’ COMPENSATION Section

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International Peer-reviewed Chiropractic Pediatric History and Examination Forms for the Infant, Child, and Adolescent

By Frank M. Painter|December 29, 2023|Chiropractic Assessment, Office Forms|

International Peer-reviewed Chiropractic Pediatric History and Examination Forms for the Infant, Child, and Adolescent

The Chiro.Org Blog

SOURCE: J Clinical Chiropractic Pediatrics 2023 (Jun); 22 (1): 1958

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Sue A. Weber BSc, DC, MScAPP

Chairperson/faculty European Academy Chiropractic
special interest group in pediatrics (FEAC)
Faculty Royal College of Chiropractors Pediatrics (FRCC)
Practitioner, Stockholm Sweden

The assessment of the pediatric patient is a specialized area of chiropractic practice, requiring additional knowledge and skills. In recognition of this, European Academy of Chiropractors’ special interest group for pediatrics together with an international group of pediatric musculoskeletal experts have expanded on the previously published basic history and examination forms for infants, children and adolescents. The aim of these forms is to further assist the chiropractor in identifying red flags and differentially diagnosing problems in musculoskeletal and mental health as they present throughout growth and development. The process of development of the forms is outlined, and the three forms are presented in this article.

Keywords: chiropractic pediatric, pediatric history form, pediatric examination form, pediatric red flags, pediatric musculoskeletal health.

From the Full-Text Article:

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PEDIATRICS Section

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A Systems Approach for Assessing Low Back Pain Care Quality in Veterans Health Administration Chiropractic Visits: A Cross-Sectional Analysis

By Frank M. Painter|December 28, 2023|Chiropractic Management, Veterans|

A Systems Approach for Assessing Low Back Pain Care Quality in Veterans Health Administration Chiropractic Visits: A Cross-Sectional Analysis

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther 2023 (Dec 22) [EPUB]

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Ryan D. Muller, DC, MS • Sarah E. Graham, DC • Xiwen Zhao, MSPH • Anna R. Sites, MSN, RN • Kelsey L. Corcoran, DC • Anthony J. Lisi, DC

VA Connecticut Healthcare System,
West Haven, Connecticut;
Yale School of Medicine,
Yale University,
New Haven, Connecticut.

Objective: The purpose of this study was to explore a systemwide process for assessing components of low back pain (LBP) care quality in Veterans Health Administration (VHA) chiropractic visits using electronic health record (EHR) data.

thods: MeWe performed a cross-sectional quality improvement project. We randomly sampled 1000 on-station VHA chiropractic initial visits occurring from October 1, 2017, to September 30, 2018, for patients with no such visits within the prior 12 months. Characteristics of LBP visits were extracted from VHA national EHR data via structured data queries and manual chart review. We developed quality indicators for history and/or examination and treatment procedures using previously published literature and calculated frequencies of visits meeting these indicators.

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LOW BACK PAIN Section and

CHIROPRACTIC CARE FOR VETERANS Section

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The Physical Impact of Migraines on Female Chiropractic Patients: A Qualitative Study

By Frank M. Painter|December 27, 2023|Chiropractic Management, Chiropractic Research, Headache, Migraine|

The Physical Impact of Migraines on Female Chiropractic Patients: A Qualitative Study

The Chiro.Org Blog

SOURCE: Health SA 2023 (Oct 25): 28: 2283

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Ashalya Pirthiraj and Raisuyah Bhagwan

Department of Chiropractic,
Faculty of Health Sciences,
Durban University of Technology,
Durban, South Africa.

Background: Migraines are highly prevalent among the female population and have a significant burden on one’s quality of life and physical functioning.

Aim: The study explored the physical impact and contributory factors of migraines on women and their experience of chiropractic treatment for migraine pain management.

Setting: The study was conducted in the eThekwini region of KwaZulu-Natal, South Africa.

Methods: The study used a qualitative descriptive design and adopted purposive sampling. The data were collected through 12 semi-structured interviews, between March and September 2021, and analysed using thematic analysis.

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HEADACHE Section

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Joint Assessment – P.A.R.T.S.

By Frank M. Painter|November 12, 2023|Joint Dysfunction, Motion Palpation, Subluxation|

Joint Assessment – P.A.R.T.S.

The Chiro.Org Blog

SOURCE: Topics in Clinical Chiropractic 2000; 7 (3): 1–10
Thomas F. Bergmann, DC, Bradley A. Finer, DC, DACAN

Professor, Clinical Science Division
Northwestern Health Sciences University
College of Chiropractic
Bloomington, Minnesota

Purpose: An approach to systematically perform clinical work-up for chiropractic subluxation is proposed. Literature on assessment approaches is reviewed and a discussion is presented.

Method: A qualitative review of clinical and scientific literature related to assessment methodologies for subluxation was performed.

Summary: Variation in assessment techniques exists for identification of spinal and other articular joint dysfunction. Useful scientific data also are limited to only a few approaches, and there is a need for a more systematic assessment approach profession wide.

Key words: Articular range of motion, chiropractic, Medicare, palpation, physical examination, subluxation

From the FULL TEXT Article

Background

Doctors of chiropractic are portals of entry to the health care system for many patients seeking health care services. As such, they must maintain broad and thorough assessment/diagnostic skills. Before employing any therapy, a clinician must first determine if there is a need for treatment. Therefore, the clinical information that any primary contact provider would want, including a case history, physical examination, clinical laboratory findings, radiographic findings, and any other tests necessary to check for suspected health problems, is needed. Having gathered and interpreted this information, it must be processed in order to arrive at a sound clinical conclusion.

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LOCATING SUBLUXATIONS Section

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