Chiropractic Care

The Nordic Maintenance Care Program: The Clinical Use of Identified Indications for Preventive Care

By Frank M. Painter|March 7, 2013|Chiropractic Care, Guidelines, Low Back Pain, Maintenance Care|

The Nordic Maintenance Care Program: The Clinical Use of Identified Indications for Preventive Care

Chiropractic & Manual Therapies 2013 (Mar 6); 21: 10

Iben Axén and Lennart Bodin

Intervention & Implementation Research, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, Stockholm 171 77, Sweden

Background Low back pain (LBP) is a prevalent condition and has been found to be recurrent and persistent in a majority of cases. Chiropractors have a preventive strategy, maintenance care (MC), aimed towards minimizing recurrence and progression of such conditions. The indications for recommending MC have been identified in the Nordic countries from hypothetical cases. This study aims to investigate whether these indications are indeed used in the clinical encounter.

Methods Data were collected in a multi-center observational study in which patients consulted a chiropractor for their non-specific LBP. Patient baseline information was a) previous duration of the LBP, b) the presence of previous episodes of LBP and c) early improvement with treatment. The chiropractors were asked if they deemed each individual patient an MC candidate. Logistic regression analyses (uni– and multi-level) were used to investigate the association of the patient variables with the chiropractor’s decision.

Results The results showed that “previous episodes” with LBP was the strongest predictor for recommending MC, and that the presence of all predictors strengthens the frequency of this recommendation. However, there was considerable heterogeneity among the participating chiropractors concerning the recommendation of MC.

Conclusions The study largely confirms the clinical use of the previously identified indications for recommending MC for recurrent and persistent LBP. Previous episodes of LBP was the strongest indicator.

There are many similar studies in our new

Maintenance Care, Wellness and Chiropractic Page

From the Full-Text Article:

Background

In the past few decades, the prevalence of low back pain, LBP, has been found to be extremely high [1] and the resulting costs of the condition are substantial [2] . Upon further scrutiny, the condition has been found to be recurrent in most cases and persistent in some [3-5] . These facts invite preventive approaches, both from a personal and societal perspective. Secondary prevention, to minimize the recurrences or the impact of episodic LBP, and tertiary prevention, to minimize the effects of persistent LBP, seem warranted.

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Combination of Acupuncture and Spinal Manipulative Therapy: Management of a 32-year-old Patient With Chronic Tension-type Headache and Migraine

By Frank M. Painter|March 6, 2013|Chiropractic Care, Headache, Migraine, Spinal Manipulation|

Combination of Acupuncture and Spinal Manipulative Therapy: Management of a 32-year-old Patient With Chronic Tension-type Headache and Migraine

The Chiro.Org Blog

J Chiropr Med. 2012 (Sep); 11 (3): 192–201

Bahia A. Ohlsen

Chiropractic, Acupuncture and Yoga Center,
Buffalo Grove, IL.

OBJECTIVE: The purpose of this case study is to describe the treatment using acupuncture and spinal manipulation for a patient with a chronic tension-type headache and episodic migraines.

CLINICAL FEATURES: A 32-year-old woman presented with headaches of 5 months’ duration. She had a history of episodic migraine that began in her teens and had been controlled with medication. She had stopped taking the prescription medications because of gastrointestinal symptoms. A neurologist diagnosed her with mixed headaches, some migrainous and some tension type. Her headaches were chronic, were daily, and fit the International Classification of Headache Disorders criteria of a chronic tension-type headache superimposed with migraine.

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Posturing for Wellness: Good Health Begins with Good Posture

By Frank M. Painter|February 13, 2013|Backpacks, Chiropractic Care, Posture|

Posturing for Wellness: Good Health Begins with Good Posture

The Chiro.Org Blog

SOURCE: The ACA

Doctors of chiropractic have long emphasized the importance of posture and other lifestyle factors in the body’s ability to function optimally. In a broad sense, good posture can be considered an ongoing battle against bad habits. “The body endures hundreds of insults each day,” says Scott W. Donkin, DC, DACBOH, “but we have the choice of controlling how they affect us. Once destructive habits are identified, people can change, prevent, and relieve both present and future physical problems. The quality of our later years can be enhanced and many physical problems prevented if we understand and deal early on with the underlying issues.” Dr. Donkin is the author of Sitting on the Job. [1]

Lifetime Regimen

What most people don’t know is that the following should be a lifetime regimen-for everyone-and not just when the back hurts. ACA Council on Chiropractic Orthopedics vice president Gary L. Carver, DC, DABCO, says that when they first get up in the morning, “People should use their hands and arms for support to get into a seated position. Next, they should swing their legs to the floor and stand up-using the hinge of the hips, rather than the back.”

But once the body is upright, is it up right? In other words, are the muscles, joints, and skeleton in a balanced posture? Too often, the answer is “no.” “As long as our body is performing, we take it for granted. We don’t concentrate on what we need to do to maintain good posture habits,” says Leo Bronston, DC, DABCO, DACAN, CCSP, and secretary of the ACA Council on Chiropractic Orthopedics. “Generally, we tend to hunch forward when we should be rolling our shoulders back and opening up the chest wall. That is something we need to practice-activating the proper postural muscles. We see many patients who simply don’t know how to achieve a more balanced trunk and neutral spine. Just as we learned to eat with a fork and that became automatic, we can train our muscles for good posture and balance, whether we’re standing, rising from a seated position, or getting out of bed.”

There are many more articles like this in our:

Backpacks and Children Page

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There Will Never Be Enough Research To Satisfy Our Critics

By Frank M. Painter|January 24, 2013|Chiropractic Care, Evidence-based Medicine, Health Care Reform, Patient Satisfaction, Spinal Manipulation|

There Will Never Be Enough Research To Satisfy Our Critics

The Chiro.Org Blog

A Chiro.Org Editorial

For some, there will never be enough research to support the use of chiropractic. These people will forever hide behind the claim that they wish to protect patients from quackish practices.

For those who may have forgotten, or for those who never knew, organized medicine spent decades and tens of millions of dollars trying to discredit and destroy chiropractic. Today, the vestiges of that oppression is still found on fringe web sites that ignore the body of peer-reviewed research supporting chiropractic care.

The Wilk anti-trust case against the AMA and 20 other named medical groups revealed that the AMA Plan was to:

Undermine Chiropractic schools
Undercut insurance programs for Chiropractic patients
Conceal evidence of the effectiveness of Chiropractic care
Subvert government inquires into the effectiveness of Chiropractic, and
Promote other activities that would control the monopoly that the AMA had on health care
They even threatened their own ranks: any MD who taught in our schools, performed research with chiropractors, or accepted a referral from, or made a referral to a chiropractor, would lose their hospital privileges, leaving them unable to treat patients.

while, all along, they knew that:<

There also was some evidence before the Committee that chiropractic was effective – more effective than the medical profession in treating certain kinds of problems such as workmen’s back injuries.

The Committee on Quackery was also aware that some medical physicians believed chiropractic to be effective and that chiropractors were better trained to deal with musculoskeletal problems than most medical physicians.
(Opinion pp. 7)

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Comparison of Outcomes in Neck Pain Patients With and Without Dizziness

By Frank M. Painter|January 8, 2013|Chiropractic Care, Dizziness, Spinal Manipulation, Whiplash|

Comparison of Outcomes in Neck Pain Patients With and Without Dizziness

The Chiro.Org Blog

Chiropractic & Manual Therapies 2013 (Jan 7); 21: 3

B Kim Humphreys and Cynthia Peterson

University of Zürich and Orthopaedic University Hospital Balgrist, Forchstrasse 340, 8008 Zürich, Switzerland

Background The symptom ‘dizziness’ is common in patients with chronic whiplash related disorders. However, little is known about dizziness in neck pain patients who have not suffered whiplash. Therefore, the purposes of this study are to compare baseline factors and clinical outcomes of neck pain patients with and without dizziness undergoing chiropractic treatment and to compare outcomes based on gender.

Methods This prospective cohort study compares adult neck pain patients with dizziness (n = 177) to neck pain patients without dizziness (n = 228) who presented for chiropractic treatment, (no chiropractic or manual therapy in the previous 3 months). Patients completed the numerical pain rating scale (NRS) and Bournemouth questionnaire (BQN) at baseline. At 1, 3 and 6 months after start of treatment the NRS and BQN were completed along with the Patient Global Impression of Change (PGIC) scale. Demographic information was also collected. Improvement at each follow-up data collection point was categorized using the PGIC as ‘improved’ or ‘not improved’. Differences between the two groups for NRS and BQN subscale and total scores were calculated using the unpaired Student’s t-test. Gender differences between the patients with dizziness were also calculated using the unpaired t-test.

Results Females accounted for 75% of patients with dizziness. The majority of patients with and without dizziness reported clinically relevant improvement at 1, 3 and 6 months with 80% of patients with dizziness and 78% of patients without dizziness being improved at 6 months. Patients with dizziness reported significantly higher baseline NRS and BQN scores, but at 6 months there were no significant differences between patients with and without dizziness for any of the outcome measures. Females with dizziness reported higher levels of depression compared to males at 1, 3 and 6 months (p = 0.007, 0.005, 0.022).

Conclusions Neck pain patients with dizziness reported significantly higher pain and disability scores at baseline compared to patients without dizziness. A high proportion of patients in both groups reported clinically relevant improvement on the PGIC scale. At 6 months after start of chiropractic treatment there were no differences in any outcome measures between the two groups.

There are many more articles like this @ our:

Vertigo and Chiropractic Page and our:

Whiplash and Chiropractic Page

Introduction

The complaint of neck pain is second only to low back pain in terms of common musculoskeletal problems in society today with a lifetime prevalence of 26-71% and a yearly prevalence of 30-50%. [1, 2] Most concerning is that many patients, particularly those in the working population or who have suffered whiplash trauma, will become chronic and continue to report pain and disability for greater than 6-months. [3-6] In terms of symptoms, dizziness and unsteadiness are the most frequent complaints following pain for chronic whiplash sufferers with up to 70% of patients reporting these problems. [7, 8] Apart from whiplash trauma, little is known about dizziness in the chronic neck pain population and much remains unknown about the etiology of chronic neck pain in general. [9]

Gender differences in reporting pain intensity is currently a topic of debate. Recent research suggests that females report more pain because they feel pain more intensely than males over a variety of musculoskeletal complaints. [10, 11] Furthermore, LeResche suggests that these differences may not be taken into account by health care providers, leading to less than optimal pain management for females. [12] However gender differences in neck pain patients with or without dizziness have not been described with respect to clinical outcomes over time.

Therefore, the purposes of this study on neck pain patients receiving chiropractic care are twofold:

to compare baseline variables and the clinical outcomes of neck pain patients with and without dizziness in terms of clinically relevant ‘improvement’, pain, disability, and psychosocial variables over a 6-month period;

to evaluate gender differences for neck pain patients with dizziness in terms of clinically relevant ‘improvement’, pain, disability, and psychosocial variables in a longitudinal study.

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Clinical Biomechanics: Mechanical Concepts and Terms

By Frank M. Painter|January 6, 2013|Chiropractic Care, Clinical Decision-making, Diagnosis, Education, Evaluation & Management, Spinal Manipulation|

Clinical Biomechanics: Mechanical Concepts and Terms

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 2 from RC’s best-selling book:

“Clinical Biomechanics:
Musculoskeletal Actions and Reactions”

Second Edition ~ Wiliams & Wilkins

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 2: Mechanical Concepts and Terms

All motor activities such as walking, running, jumping, squatting, pushing, pulling, lifting, and throwing are examples of dynamic musculoskeletal mechanics. To better appreciate the sometimes simple and often complex factors involved, this chapter reviews the basic concepts and terms involved in maintaining static equilibrium. Static equilibrium is the starting point for all dynamic activities.

Energy and Mass

Biomechanics is constantly concerned with a quantity of matter (whatever occupies space, a mass) to which a force has been applied. Such a mass is often the body as a whole, a part of the body such as a limb or segment, or an object such as a load to be lifted or an exercise weight. By the same token, the word “body” refers to any mass; ie, the human body, a body part, or any object.

Energy

Energy is the power to work or to act. Body energy is that force which enables it to overcome resistance to motion, to produce a physical effect, and to accomplish work. The body’s kinetic energy, the energy level of the body due to its motion, is reflected solely in its velocity, and its potential energy is reflected solely in its position. Mathematically, kinetic energy is half the mass times the square of the velocity: m/2 X V524. In a closed system where there are no external forces being applied, the law of conservation of mechanical energy states that the sum of kinetic energy and potential energy is equal to a constant for that system.

Potential energy (PE), measured in newton meters or joules, is also stored in the body as a result of tissue displacement or deformation, like a wound spring or a stretched bowstring or tendon. It is expressed mathematically in the equation PE = mass X gravitational acceleration X height of the mass relative to a chosen reference level (eg, the earth’s surface). Thus, a 100-lb upper body balanced on L5 of a 6-ft person has a potential energy of about 300 ft-lb relative the ground.

The Center of Mass

The exact center of an object’s mass is sometimes referred to as the object’s center of gravity. When an object’s mass is evenly distributed throughout, the center of mass is located at the object’s geometric center. In the human body, however, this is infrequently true, and the center of mass is located towards the heavier, often larger, aspect. When considering the body as a whole, the center of mass in the anatomic position, for instance, is constantly shifted during activity when weight is shifted from one area to another during locomotion or when weight is added to or subtracted from the body.

The term weight is not synonymous with the word mass. Body weight refers to the pull of gravity on body mass. Mass is the quotient obtained by dividing the weight of a body by the acceleration due to gravity (32 ft/sec524). Each of these terms has a different unit of measurement. Weight is measured in pounds or kilograms, while mass is measured by a body’s weight divided by the gravitational constant. The potential energy of gravity can be simply visualized as an invisible spring attached between the body’s center of mass and the center of the earth. The pull is always straight downward so that more work is required to move the body upward than horizontally (Fig. 2.1).

Newton’s Laws of Mechanics

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