Chiropractic Care

The Association of Complementary and Alternative Medicine Use and Health Care Expenditures for Back and Neck Problems

By Frank M. Painter|November 17, 2012|Chiropractic Care, Complementary and Alternative Medicine, Cost-Effectiveness|

The Association of Complementary and Alternative Medicine Use and Health Care Expenditures for Back and Neck Problems

SOURCE: Med Care. 2012 (Dec); 50 (12): 1029–1036

The Geisel School of Medicine at Dartmouth & Dartmouth-Hitchcock Medical Center, Department of Orthopaedics, Lebanon, NH

BACKGROUND: Health care costs associated with use of complementary and alternative medicine (CAM) by patients with spine problems have not been studied in a national sample.

OBJECTIVES: To estimate the total and spine-specific medical expenditures among CAM and non-CAM users
with spine problems.

RESEARCH DESIGN: Analysis of the 2002-2008 Medical Expenditure Panel Survey.

SUBJECTS: Adults (above 17 y) with self-reported neck and back problems who did or did not use CAM services.

MEASURES: Survey-weighted generalized linear regression and propensity matching to examine penditure differences between CAM users and non-CAM users while controlling for patient, socioeconomic, and health characteristics.

RESULTS: A total of 12,036 respondents with spine problems were included, including 4306 (35.8%) CAM users (40.8% in weighted sample). CAM users had significantly better self-reported health, education, and comorbidity compared with non-CAM users. (more…)

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Orthopedic and Neurologic Procedures in Chiropractic

By Frank M. Painter|November 15, 2012|Chiropractic Care, Diagnosis, Neurology, Orthopedic Tests, Rehabilitation|

Orthopedic and Neurologic Procedures in Chiropractic

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 3 from RC’s best-selling book:
“Basic Chiropractic Procedural Manual”

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 3: Orthopedic and Neurologic Procedures in Chiropractic

This chapter presents the general diagnostic methods currently used in differential diagnosis of selected orthopedic and neurologic conditions.

SELECTED NEUROLOGIC PROBLEMS

Overview

The typical patient presents the challenge of differential diagnosis of a number of neurologic conditions. These range from a variety of peripheral neuritides that may be completely reversible to serious degenerations of the central nervous system.

The tendency of the geriatric patient to develop neurologic problems is often related to the aging process: loss of tissue elasticity, particularly that of the musculoskeletal system. This is manifested by greater rigidity of the spinal column with the appearance of fixation subluxations. These, together with dehydration and subsequent thinning of the intervertebral discs, predispose to radiculitis, neuritis, and vasomotor disturbances and metabolic effects on the cord and brain. The neurologic disturbances can be superimposed on already degenerating arteriosclerotic vessels and alter metabolism of the gastrointestinal and other systems, which may cause serious problems unless recognized early and prompt corrective measures are administered.

Types of Neuritides

Peripheral Neuritis

Peripheral neuritis is a general peripheral neuritis such as that which may be present in such disorders as diabetes, anemia, and vitamin deficiency. Diminution of all sensation will be noted, with proprioception affected most. A stocking distribution with an ill-defined border is commonly witnessed. Glove distribution may appear later, along with paresthesias in the distal areas of sensory distribution. The clinical picture does not conform to either dermatome or nerve patterns of distribution. The cause for this is unknown.

Local Neuritis (more…)

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Conservative Management of a 31 Year Old Male With Left Sided Low Back and Leg Pain

By Frank M. Painter|November 11, 2012|Chiropractic Care, McKenzie, Rehabilitation, Spinal Manipulation|

Conservative Management of a 31 Year Old Male With Left Sided Low Back and Leg Pain: A Case Report

The Chiro.Org Blog

SOURCE: J Can Chiropr Assoc. 2012 (Sep); 56 (3): 225-232

Emily R. Howell, BPHE(Hons), DC, FCCPOR(C)

Ashbridge’s Health Centre,
1522 Queen St. East,
Toronto, ON M4L 1E3.
dremilyhowell@hotmail.com

OBJECTIVE: This case study reported the conservative management of a patient presenting with left sided low back and leg pain diagnosed as a left sided L5-S1 disc prolapse/herniation.

CLINICAL FEATURES: A 31-year-old male recreational worker presented with left sided low back and leg pain for the previous 3-4 months that was exacerbated by prolonged sitting.

INTERVENTION AND OUTCOME: The plan of management included interferential current, soft tissue trigger point and myofascial therapy, lateral recumbent manual low velocity, low amplitude traction mobilizations and pelvic blocking as necessary. Home care included heat, icing, neural mobilizations, repeated extension exercises, stretching, core muscle strengthening, as well as the avoidance of prolonged sitting and using a low back support in his work chair. The patient responded well after the first visit and his leg and back pain were almost completely resolved by the third visit.

SUMMARY: Conservative chiropractic care appears to reduce pain and improve mobility in this case of a L5-S1 disc herniation. Active rehabilitative treatment strategies are recommended before surgical referral.

Recent Studies Have Also Shown That:

Back Surgery Fails 74% of the Time

From the FULL TEXT Article

Introduction:

Low back pain has been reported as the chief complaint for 23.6% of patients presenting to chiropractic offices. [1] Disc herniations that lead to nerve-root compromise account for less than 15% of chronic low back pain cases. [2] Over 95% of lumbar disc herniations occur at L4–5 or L5-S1 levels, and only 2% of herniations require surgery, 4% have compression fractures, 0.7% have spinal malignant neoplasms, 0.3% have ankylosing spondylitis and 0.1% have spinal infections. [2, 3]

Leg pain is estimated to be found in 25–57% of all low back pain cases and accounts for large costs, disability, chronicity and severity. [4, 5, 6] Many conservative treatments have been shown to be effective in the management of this condition and are favorable to pursue before considering any surgical interventions, such as: modalities, soft tissue therapy, spinal manipulations or mobilizations, pelvic blocking, McKenzie/end-range loading exercises, lumbar stabilization exercises and neural mobilizations, patient education, reassurance, short-term use of acetaminophen, and nonsteroidal antiinflammatory drugs. [2, 3, 7–24] The purpose of this case report is to describe the successful management of a patient with low back and leg pain.

Discussion:

There are more articles like this @ our:

Low Back Pain and Chiropractic Page and the:

Chiropractic and Sciatica Page

(more…)

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Introduction to Chiropractic Physiologic Therapeutics

By Frank M. Painter|November 10, 2012|Chiropractic Care, Diagnosis, Education, Physical Therapy|

Introduction to Chiropractic Physiologic Therapeutics

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 10 from RC’s best-selling book:

“Basic Chiropractic Procedural Manual”

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 10: Introduction to Chiropractic Physiologic Therapeutics

The use of physiotherapy and physical therapy to enhance the effects of the chiropractic adjustment in treatment can be significant in many cases. Superficial heat, diathermy, cold, microwaves, ultrasound, ultraviolet rays, galvanic and sinusoidal currents, traction, hydrotherapy, or therapeutic massage and exercise are among the therapies that may benefit the patient when properly applied. These procedures may help to reduce stiffness in joints, relieve tension, relax muscle spasm, and offer many other physiologic benefits.

Special precautions, however, must be observed when treating patients of advanced age. Special consideration must also be given to indications and contraindications, patient sensitivity, intensity, and duration of treatment.

Special caution must be used with patients that have heart and blood pressure problems, renal failure, diminished sensation or circulation, or an inability to tolerate heat or cold. For example, patients with Raynaud’s disease do not tolerate cold. Patients with other circulatory problems do not tolerate thermotherapy because they have less ability to dissipate the heat. Patients with a distinct loss of sensation will not realize if an area is being overheated or even being burned.

A patient’s tolerance cannot be the only guide to intensities and duration of treatment. Frequent checking, both visually for redness and by palpation to determine over heating, must be done during the treatment period. Reasonable examination, monitoring, and care by the doctor can avoid problems in most instances.

INTRODUCTION

Physiotherapy techniques are frequently used preparatory to the chiropractic adjustment to improve function, relieve spasm, minimize pain, and enhance circulation and drainage. They are often used before primary care to relax the patient and condition tissues, and posttherapy to relive pain and prevent deformities resulting from trauma or disease and to maintain what has been gained in treatment. There are also times when it may be considered primary therapy. Rehabilitation objectives are shown in Table 10.1. (more…)

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Cancer Treatment Centers of America offer integrated treatment approach which includes chiropractic

By John Wiens DC|November 9, 2012|Chiropractic Care|

Sources Foundation for Chiropractic Progress, Cancer Treatment Centers of America

Cancer Treatment Centers of America (CTCA), a national network of hospitals focusing on complex and advanced stage cancer and known for their comprehensive, fully integrated approach to cancer treatment, opened CTCA at Southeastern Regional Medical Center (Southeastern) in Newnan, Georgia with licensed chiropractors offering chiropractic services to all patients. As at CTCA at Southeastern and the other four CTCA hospitals located in Chicago, Philadelphia, Phoenix and Tulsa, chiropractic services are available to all patients as part of the Patient Empowered Care model, where each member of the integrated team comes to the patient – all part of what they call the Mother Standard of care.

Dr. James Rosenberg, National Director of Chiropractic Care at CTCA, encourages patients to make chiropractic care part of their treatment plan.

He says, “Chiropractic care is one of the most commonly practiced and widely accepted therapies utilized today. And at CTCA, it’s a piece of the puzzle. It’s another way in which we’re taking care of the body as a whole.”

“Chiropractic care at CTCA is an important piece to the integrated healthcare approach by providing patients with an evidence-based, low risk approach to care,” shares Dr. Rosenberg, happily interjecting that all CTCA chiropractors currently have a patient waiting list. “A steadfast commitment to excellence continues to fuel the demand for our services.”

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The Treatment Experience of Patients With Low Back Pain During Pregnancy

By Frank M. Painter|October 10, 2012|Chiropractic Care, Pregnancy, Safety|

The Treatment Experience of Patients With Low Back Pain During Pregnancy

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2012 (Oct 9)

Shabnam Sadr, Neda Pourkiani-Allah-Abad and Kent Jason Stuber

Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario M2H 3 J1, Canada

Background Chiropractors regularly treat pregnant patients for low back pain during their pregnancy. An increasing amount of literature on this topic supports this form of treatment; however the experience of the pregnant patient with low back pain and their chiropractor has not yet been explored. The objective of this study is to explore the experience of chiropractic treatment for pregnant women with low back pain, and their chiropractors.

Methods This qualitative study employed semi-structured interviews of pregnant patients in their second or third trimester, with low back pain during their pregnancy, and their treating chiropractors in separate interviews. Participants consisted of 11 patients and 12 chiropractors. The interviews consisted of 10 open-ended questions for patients, and eight open-ended questions for chiropractors, asking about their treatment experience or impressions of treating pregnant patients with LBP, respectively. All interviews were audio-recorded, transcribed verbatim, and reviewed independently by the investigators to develop codes, super-codes and themes. Thematic saturation was reached after the eleventh chiropractor and ninth patient interviews. All interviews were analyzed using the qualitative analysis software N-Vivo 9.

Results Five themes emerged out of the chiropractor and patient interviews. The themes consisted of Treatment and Effectiveness; Chiropractor-Patient Communication; Pregnant Patient Presentation and the Chiropractic Approach to Pregnancy Care; Safety Considerations; and Self-Care.

Conclusions Chiropractors approach pregnant patients with low back pain from a patient-centered standpoint, and the pregnant patients interviewed in this study who sought chiropractic care appeared to find this approach helpful for managing their back pain symptoms.

You may also enjoy our:

Pregnancy and Chiropractic Page

From the Full-Text Article:

Background:

Low back pain (LBP) during pregnancy is reported by approximately 50% to 80% of pregnant women [1-3]. The structural, postural, or hormonal changes that occur during pregnancy, or any combination thereof, may lead to LBP during pregnancy [3]. Treatment options include a range of therapies, such as exercise programs, massage therapy, acupuncture, and chiropractic [4, 5]. Chiropractic care may include spinal manipulative therapy (SMT), mobilizations and soft tissue therapy, as well as exercise prescription. [3] Previous studies and systematic reviews of the literature have indicated the relative safety and effectiveness of chiropractic treatment for LBP during pregnancy. [3, 5, 7]

(more…)

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