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Chiropractic Students Versus Emergency Care Practitioners in Simulated Musculoskeletal Emergencies

By Frank M. Painter|November 11, 2025|All About Chiropractic, Care Plans, Cervical Disk Herniation, Chiropractic Education, Chiropractic Management, Diagnosis, Escalation of Care, Evidence-based Medicine|

Chiropractic Students Versus Emergency Care Practitioners in Simulated Musculoskeletal Emergencies

The Chiro.Org Blog

SOURCE: Health SA 2025 (Oct 31): 30: 3195

Ivanna Balanco • Helen Slabber • Christopher Yelverton

Department of Chiropractic,
Faculty of Health Sciences,
University of Johannesburg,
Johannesburg, South Africa.

Background: As primary contact practitioners, chiropractors and emergency care practitioners (ECPs are first points of access for patients with musculoskeletal (MSK) complaints. A comparison of their diagnostic competency in distinguishing these presentations from underlying emergency pathologies remains an understudied area.

Aim: To compare the diagnostic abilities of Master of Health Science (MHSc) chiropractic students and ECPs in distinguishing MSK from emergency conditions.

Setting: The research was conducted at the University of Johannesburg, Faculty of Health Sciences, simulation laboratory.

Methods: First-year (n = 10) and second-year Master’s (n = 10) chiropractic students and ECPs (n = 10) were assessed using standardised patient scenarios: meningitis, disc herniation and stroke, and assessed on diagnostic assessment, diagnosis and clinical and diagnostic investigation referrals.

Results: Second-year MHSc students outperformed ECPs in the clinical management of a disc herniation case (Case 2; p < 0.01). Diagnostic accuracy was high (> 90%) for meningitis and stroke across all groups. Differences in investigation preferences emerged, with chiropractic students favouring advanced imaging and ECPs recommending more basic tests. No significant performance differences were found in the other two cases.

Conclusion: Based on a simulated assessment, chiropractic students demonstrated equivalent competence to emergency care practitioners (ECPs) in diagnosing emergencies, but outperformed them in managing an MSK condition. These preliminary findings suggest chiropractors could contribute to the management of MSK burden in emergency departments.

Contribution: MHSc chiropractic training enhances diagnostic proficiency in differentiating MSK disorders from emergent pathologies, an important competency for safe and effective practice as primary contact practitioners.

Keywords: chiropractic; clinical competence; diagnosis; emergency medical services; musculoskeletal disease; simulation.

From the FULL TEXT Article:

Introduction

Musculoskeletal (MSK) conditions represent a significant global health burden, ranking as the second leading cause of disability worldwide and affecting approximately one in five working-age adults (Lowe, Taylor & Hill 2017; Weinstein 2016). Back pain, a prevalent MSK complaint, contributes substantially to reduced work productivity, absenteeism and healthcare costs (Ingram & Symmons 2018; Menke 2003). This high prevalence strains healthcare systems, leading to long wait times for specialist care, including surgery (Joshipura & Gosselin 2020).

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Chiropractic Care Plans for Common Low Back Conditions

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SOURCE: Chiropractic Technique 1993 (Aug); 5 (3): 119-125

by Robert D. Mootz, D.C. and V. Thomas Waldorf, D.C.

Our thanks to Robert D. Mootz, D.C. and to Dana Lawrence, D.C., the editor of Chiropractic Technique, for permission to reprint this FULL-TEXT article article, and its extensive collection of Care Plans, exclusively at Chiro.Org

A detailed description of chiropractic care parameters used at a large occupational medicine center is presented. The algorithms were derived from clinical needs of the facility, expert opinion, and reviews of several contemporary written protocols. Twelve of the most common industrially related low back conditions are included. The algorithms are grouped according to nondiscogenic and discogenic conditions. The guidelines are consistent with many third party chiropractic review policies, as well as the recently published Chiropractic Quality Assurance Guidelines and Practice Parameters. The first algorithm is based on uncomplicated joint dysfunction, and is considered the base algorithm. Other, more complicated conditions follow, and a preface is included for each describing specific issues relevant to each condition. The purpose of these algorithms was to help standardize care in the clinic, to foster interdisciplinary communication, and to provide consistency in administration for research purposes.

Occupational Low back injuries make up a major component of industrial expenditures in the United States. [1] A number of retrospective studies have suggested that conservative chiropractic management may be more cost effective than other approaches. [2-3] Although a number of general practice guidelines have been developed [4-6], none have (yet) provided “condition specific” guidelines. (more…)