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Where the U.S. Spends its Spine Dollars

By |June 6, 2012|Chiropractic Care, Cost-Effectiveness, Public Health, Spinal Manipulation|

Where the U.S. Spends its Spine Dollars: Expenditures on Different Ambulatory Services for the Management of Back and Neck Conditions

The Chiro.Org Blog


SOURCE:   Spine (Phila Pa 1976). 2012 (Mar 16)


Davis, Matthew A. DC, MPH; Onega, Tracy PhD;
Weeks, William MD, MBA; Lurie, Jon MD, MS

The Dartmouth Institute for Health Policy and Clinical Practice,
Lebanon, NH 03766, USA


Study Design   Serial, cross-sectional, nationally representative surveys of non-institutionalized adults.

Objective   To examine expenditures on common ambulatory health services for the management of back and neck conditions.

Summary of Background Data   Although it is well recognized that national costs associated with back and neck conditions have grown considerably in recent years, little is known about the costs of care for specific ambulatory health services that are used to manage this population.

Methods   We used the Medical Expenditure Panel Survey (MEPS) to examine adult (age ≥ 18 years) respondents from 1999 to 2008 who sought ambulatory health services for the management of back and neck conditions. We used complex survey design methods to make national estimates of mean inflation-adjusted annual expenditures on medical care, chiropractic care, and physical therapy per user for back and neck conditions.

Results   Approximately 6% of US adults reported an ambulatory visit for a primary diagnosis of a back or neck condition (13.6 million in 2008).

  • Between 1999 and 2008, the mean inflation-adjusted annual expenditures on medical care for these patients increased by 95% (from $487 to $950); most of the increase was accounted for by increased costs for medical specialists, as opposed to primary care physicians. (more…)

Use of Post-isometric Relaxation in the Chiropractic Management of a 55-year-old Man with Cervical Radiculopathy

By |June 5, 2012|Chiropractic Care, Post-isometric Relaxation, Radiculopathy|

Use of Post-isometric Relaxation in the Chiropractic Management of a 55-year-old Man with Cervical Radiculopathy

The Chiro.Org Blog


SOURCE:   J Canadian Chiropractic Assoc. 2012 (Mar); 56 (1): 9-17


Peter Emary, BSc, DC

Private practice: Parkway Back Clinic, 201C Preston Parkway, Cambridge, Ontario, N3H 5E8. Phone: 519-653-2101. E-mail: drpeter@parkwaybackclinic.ca


Introduction

Cervical radiculopathy (CR) is an impingement or inflammatory irritation of the cervical spine nerve root(s), resulting in pain (or numbness) radiating along nerves of the upper extremity; [1,2] the C6 and C7 levels are most often affected. [1,3] Limited research is available on the incidence and prevalence of CR; however, the incidence rate (in Rochester, Minnesota) has been reported at 83.2 cases per 100,000 people per year (107.3/100,000 for males vs. 63.5/100,000 for females), with peak incidence in those aged 50–54 years. [1] A history of physical exertion or major trauma precedes the onset of symptoms in less than 15% of cases. The most common causes are cervical spondylosis and intervertebral disc herniation, [1,3] accounting for approximately 70% and 20% of cases, respectively. [1] In the former, posterior vertebral body osteophytes and/or facet joint/ligamentum flavum hypertrophy encroach upon the intervertebral foramen; posterolateral herniation of disc material results in foraminal encroachment in the latter. In either case, cervical nerve root pain and dysfunction can occur. [4]

There are other similar articles at the:

Radiculopathy and Chiropractic Page

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Cervical Radiculopathy: A Systematic Review on Treatment by Spinal Manipulation and Measurement with the Neck Disability Index

By |June 4, 2012|Chiropractic Care, Patient Satisfaction, Radiculopathy|

Cervical Radiculopathy: A Systematic Review on Treatment by Spinal Manipulation and Measurement with the Neck Disability Index

The Chiro.Org Blog


SOURCE:   J Can Chiro Assoc. 2012 (Mar); 56 (1): 18–28 ~ FULL TEXT


Robert J. Rodine, BSc, DC, Howard Vernon, DC, PhD, FCCS(C)

Graduate Education and Research Programs,
Canadian Memorial Chiropractic College,
Toronto, Ontario.


Cervical radiculopathy (CR), while less common than conditions with neck pain alone, can be a significant cause of neck pain and disability; thus the determination of adequate treatment options for patients is essential. Currently, inadequate scientific literature restricts specific conservative management recommendations for CR. Despite a paucity of evidence for high-velocity low-amplitude (HVLA) spinal manipulation in the treatment for CR, this strategy has been frequently labeled as contraindicated. Scientific support for appropriate outcome measures for CR is equally deficient. While more scientific data is needed to draw firm conclusions, the present review suggests that spinal manipulation may be cautiously considered as a therapeutic option for patients suffering from CR. With respect to outcome measures, the Neck Disability Index appears well-suited for spinal manipulative treatment of CR.

There are other similar articles at the:

Radiculopathy and Chiropractic Page

 

From the FULL TEXT Article

Introduction

Cervical radiculopathy (CR) can be a significant cause of neck pain and disability. The reported annual incidence of CR is 83.2/100,000 persons [1], while the reported prevalence is 3.5/1000 persons. [2] Gender preference varies. [2, 3] Individuals are most commonly affected in the 5th and 6th decades of life. [1, 4] Physical exertion or trauma at onset is rare, involving less than 15%. [1] Causal relationship to an automobile accident ranges from 3–23%. [1, 4] (more…)

Visceral Responses to Spinal Manipulation

By |June 3, 2012|Chiropractic Care, Research, Spinal Manipulation, Subluxation|

Visceral Responses to Spinal Manipulation

The Chiro.Org Blog


SOURCE:   J Electromyogr Kinesiol. 2012 (Mar 20)


Philip S. Bolton, Brian Budgell

School of Biomedical Sciences & Pharmacy,
Faculty of Health, University of Newcastle,
Callaghan NSW 2308, Australia;

Centre for Brain and Mental Health Research at the
Hunter Medical Research Institute,
Newcastle, Australia


While spinal manipulation is widely seen as a reasonable treatment option for biomechanical disorders of the spine, such as neck pain and low back pain, the use of spinal manipulation to treat non-musculoskeletal complaints remains controversial. This controversy is due in part to the perception that there is no robust neurobiological rationale to justify using a biomechanical treatment of the spine to address a disorder of visceral function. This paper therefore looks at the physiological evidence that spinal manipulation can impact visceral function. A structured search was conducted, using PubMed and the Index to Chiropractic Literature, to construct of corpus of primary data studies in healthy human subjects of the effects of spinal manipulation on visceral function. The corpus of literature is not large, and the greatest number of papers concerns cardiovascular function. (more…)

Low-Back Pain, Leg Pain, and Chronic Idiopathic Testicular Pain Treated with Chiropractic Care

By |June 2, 2012|Chiropractic Care, Low Back Pain|

Low-Back Pain, Leg Pain, and Chronic Idiopathic Testicular Pain Treated with Chiropractic Care

The Chiro.Org Blog


SOURCE:   J Altern Complement Med. 2012 (Apr); 18 (4): 420-422


Robert M. Rowell, DC, MS, and Steven J. Rylander, DC, MS

Diagnosis and Radiology Department,
Palmer College of Chiropractic,
Davenport, IA 52803, USA.


OBJECTIVES:   The purpose of this article is to report the case of a patient who had low-back pain, leg pain, and idiopathic chronic testicular pain and who sought chiropractic care for his low-back and leg pain and received pain relief including his testicular pain.

SUBJECT:   A 36-year-old male patient had low-back pain, right leg pain, and testicular pain that was worsening. All had been present for 5 years. He had been seen by several medical physicians and had lumbar magnetic resonance imaging and x-rays performed. All were read as normal. Examination revealed tenderness of the testicles bilaterally with no masses or other abnormality of the testicles or scrotum. Orthopedic and neurological testing was unremarkable. Tenderness rated 8 out of 10 was noted at the L4 spinous process.

INTERVENTION:   The patient was treated with Cox Technic (flexion-distraction) of the lumbar spine, receiving a total of 19 treatments over an 8-week time period. (more…)

Initial Case Management Following Trauma

By |June 1, 2012|Chiropractic Care, Chiropractic Education, Clinical Decision-making, Evaluation & Management|

Initial Case Management Following Trauma

The Chiro.Org Blog


Clinical Monograph 2

By R. C. Schafer, DC, PhD, FICC


Without a doubt, no other health-care approach equals the efficacy of chiropractic in the general field of conservative neuromusculoskeletal rehabilitation.

For many centuries, therapeutic rehabilitation was a product of personal experience passed on from clinician to clinician. In the last 20 years, however, it has become an applied science. In its application, of course, much empiricism remains that can be called an intuitive art –and this is true for all forms of professional health care.

INTRODUCTION

The word trauma means more than the injuries so common with falls, accidents, and contact sports. Taber [1] defines it as “A physical injury or wound often caused by an external force or violence” or “an emotional or psychologic shock that may produce disordered feelings or behavior.” This is an extremely narrow definition for trauma can also be caused by intrinsic forces as seen in common strain. In addition to its cause being extrinsic or intrinsic, with a physical and emotional aspect, it also can be the result of either a strong overt force or repetitive microforces. This latter factor, so important in treating a unique patient’s specific pathophysiology, is too often neglected outside the chiropractic profession.

Taber [1] states rehabilitation is “The process of treatment and education that lead the disabled individual to attainment of maximum function, a sense of well being, and a personally satisfying level of independence. The person requiring rehabilitation may be disabled from a birth defect or from an illness. The combined effects of the individual, family, friends, medical, nursing, allied health personnel, and community resources make rehabilitation possible.” It is surprising that Taber excludes trauma as a prerequisite for rehabilitation for it is the most common factor involved.

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