Chiropractic Care

An Integrated Approach to Chronic Pain

By Frank M. Painter|May 11, 2017|Chiropractic Care, Integrative Care|

An Integrated Approach to Chronic Pain

SOURCE: Dynamic Chiropractic ~ May 2017

By Peter W. Crownfield, Executive Editor

A Rhode Island Medicaid pilot program is yielding
significant benefits and savings.

Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state’s Department of Health, [1] demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.

Since 2012, Rhode Island Medicaid “Community of Care” enrollees suffering from chronic pain have participated in an integrated chronic pain program administered by Advanced Medicine Integration. Longtime readers will recall that for nearly two decades, AMI has been coordinating chiropractic and integrated care services in various states to help address the chronic pain epidemic in a community-based, integrated fashion. [2-3]

AMI’s integrated chronic pain program is designed to “reduce pain levels, improve function and overall health outcomes, reduce emergency room costs, and through a holistic approach and behavioral change models, educate members in self-care and accountability.”

The program features holistic nurse case management with referrals to CAM providers including chiropractors, massage therapists and acupuncturists; and patient education including stress-reduction tips and more.

There are more articles like this @ our:

Chiropractic and Spinal Pain Management

(more…)

0

New Canadian Opioid Guidelines Recommends Chiropractic

By Frank M. Painter|May 9, 2017|Chiropractic Care, Opioid Epidemic, Opioid Guidelines|

Guideline for Opioid Therapy and Chronic Noncancer Pain

The Chiro.Org Blog

SOURCE: CMAJ 2017 (May 8); 189 (18): E659–E666

Jason W. Busse, DC PhD, Samantha Craigie, MSc, David N. Juurlink, MD PhD, D. Norman Buckley, MD, Li Wang, PhD, Rachel J. Couban, MA MISt, Thomas Agoritsas, MD PhD, Elie A. Akl, MD PhD, Alonso Carrasco-Labra, DDS MSc, Lynn Cooper, BES, Chris Cull, Bruno R. da Costa, PT PhD, Joseph W. Frank, MD MPH, Gus Grant, AB LLB MD, Alfonso Iorio, MD PhD, Navindra Persaud, MD MSc, Sol Stern, MD, Peter Tugwell, MD MSc, Per Olav Vandvik, MD PhD, Gordon H. Guyatt, MD MSc

Jason W. Busse
Department of Anaesthesia
McMaster University

New Canadian Opioid Guidelines Recommends
Chiropractic As Care OptionFROM: World Federation of Chiropractic
Monday, May 8, 2017A new Canadian guideline published today (May 8, 2017) in the Canadian Medical Association Journal (CMAJ) strongly recommends doctors to consider non-pharmacologic therapy, including chiropractic, in preference to opioid therapy for chronic non-cancer pain.The guideline is the product of an extensive review of evidence involving stakeholders from medical, non-medical, regulatory, and patient stakeholders.The lead author, Dr Jason Busse DC, PhD is a graduate of Canadian Memorial Chiropractic College and is an Associate Professor in the Department of Anaesthesia at McMaster University. Other authors of the guideline include those from the fields of physiotherapy, dentistry, public health and medicine.

Chronic non-cancer pain (CNCP) is defined as pain lasting more than 3 months that is not associated with malignancy. It is estimated that up to 20% of adult Canadians suffer with CNCP and, the guideline says, is the leading cause of health resource utilization and disability among working age adults.

Behind the USA, Canada has the second-highest level of opioid prescribing in the world. It is an enormous issue, with a doubling of admissions to publicly-funded opioid-related treatment programs between 2004 and 2012. In 2015, over 2000 Canadians died of opioid overdose, with final figures expected to be higher in 2016. Many of these deaths were associated with Fentanyl, the same opioid cited as being the cause of death of the musician Prince in 2016. Other commonly used opioid drugs are Percocet, OxyContin, Dilaudid and morphine.

There are more articles like this @ our:

Chiropractic and Spinal Pain Management Page

(more…)

0

For Bad Backs, It May Be Time to Rethink Biases

By Frank M. Painter|May 1, 2017|Chiropractic Care, Nonpharmacologic Therapies|

For Bad Backs, It May Be Time to Rethink Biases About Chiropractors

The Chiro.Org Blog

SOURCE: The New York Times ~ 5-01-2017

Aaron E. Carroll, MD, MS

Indiana University School of Medicine

About two of every three people will probably experience significant low back pain at some point. A physician like me might suggest any number of potential treatments and therapies. But one I never considered was a referral for spinal manipulation.

It appears I may have been mistaken. For initial treatment of lower back pain, it may be time for me (and other physicians) to rethink our biases.

Spinal manipulation — along with other less traditional therapies like heat, meditation and acupuncture — seems to be as effective as many other more medical therapies we prescribe, and as safe, if not safer.

Most back pain resolves over time, so interventions that focus on relief of symptoms and allow the body to heal are ideal. Many of these can be nonpharmacological in nature, like the work done by chiropractors or physical therapists.

Physicians are traditionally wary of spinal manipulation (applying pressure on bones and joints), in part because the practitioners are often not doctors and also because a few chiropractors have claimed they can address conditions that have little to do with the spine. Patients with back pain haven’t seemed as skeptical. A large survey of them from 2002 through 2008 found that more than 30 percent sought chiropractic care, significantly more than those who sought massage, acupuncture or homeopathy.

(more…)

0

Areas of Capsaicin-Induced Secondary Hyperalgesia

By Frank M. Painter|April 29, 2017|Chiropractic Care, Pain Relief|

Areas of Capsaicin-Induced Secondary Hyperalgesia and Allodynia Are Reduced by a Single Chiropractic Adjustment: A Preliminary Study

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2004 (Jul); 27 (6): 381–387

Parvaneh Mohammadian, PhD, Antonio Gonsalves, DC,
Chris Tsai, DC Thomas Hummel, MD, Thomas Carpenter, DC

School of Medicine,
University of California,
Los Angeles, Calif 90024, USA.

INTRODUCTION: The aim of the study was to investigate the hypoalgesic effects of a single spinal manipulation treatment on acute inflammatory reactions and pain induced by cutaneous application of capsaicin.

METHODS: Twenty healthy subjects participated in the experiment, which consisted of 2 sessions. In both sessions, following control measurements, topical capsaicin was applied to the right or left forearm to induce cutaneous inflammatory reactions. The cream was removed after 20 minutes. Then subjects received either spinal manipulation treatment (SMT) or “nonspinal manipulation treatment” (N-SMT), respectively. In control as well as pretreatment and posttreatment intervals, the following tests were performed: measurement of the areas of mechanical hyperalgesia and stroking allodynia, assessment of spontaneous pain, and measurement of blood flow.

RESULTS: The results confirmed that topical capsaicin induced inflammatory reactions based on occurrence of hyperalgesia and allodynia, augmented pain perception, and increased blood flow following capsaicin application compared with the control session. When compared with N-SMT, spontaneous pain was rated significantly lower post-SMT (P <.014). In addition, areas of both secondary hyperalgesia and allodynia decreased after SMT (hyperalgesia: P <.007; allodynia: P <.003). However, there was no significant treatment effect for local blood flow.

There are more articles like this @ our:

Subluxation Neurology Section

(more…)

0

A Qualitative Study of Changes in Expectations Over Time Among Patients with Chronic Low Back Pain Seeking Four CAM Therapies

By Frank M. Painter|April 16, 2017|Chiropractic Care, Chronic Pain|

A Qualitative Study of Changes in Expectations Over Time Among Patients with Chronic Low Back Pain Seeking Four CAM Therapies

The Chiro.Org Blog

SOURCE: BMC Complement Altern Med. 2015 (Feb 5); 15: 12

Emery R Eaves, Karen J Sherman, Cheryl Ritenbaugh,
Clarissa Hsu, Mark Nichter, Judith A Turner,
and Daniel C Cherkin

Department of Family and Community Medicine &
School of Anthropology,
University of Arizona,
Tucson, AZ, USA.

BACKGROUND: The relationship between patient expectations about a treatment and the treatment outcomes, particularly for Complementary and Alternative Medicine (CAM) therapies, is not well understood. Using qualitative data from a larger study to develop a valid expectancy questionnaire for use with participants starting new CAM therapies, we examined how participants’ expectations of treatment changed over the course of a therapy.

METHODS: We conducted semi-structured qualitative interviews with 64 participants initiating one of four CAM therapies (yoga, chiropractic, acupuncture, massage) for chronic low back pain. Participants just starting treatment were interviewed up to three times over a period of 3 months. Interviews were transcribed verbatim and analyzed using a qualitative mixed methods approach incorporating immersion/crystallization and matrix analysis for a decontexualization and recontextualization approach to understand changes in thematic emphasis over time.

RESULTS: Pre-treatment expectations consisted of conjecture about whether or not the CAM therapy could relieve pain and improve participation in meaningful activities. Expectations tended to shift over the course of treatment to be more inclusive of broader lifestyle factors, the need for long-term pain management strategies and attention to long-term quality of life and wellness. Although a shift toward greater acceptance of chronic pain and the need for strategies to keep pain from flaring was observed across participants regardless of therapy, participants varied in their assessments of whether increased awareness of the need for ongoing self-care and maintenance strategies was considered a “positive outcome”. Regardless of how participants evaluated the outcome of treatment, participants from all four therapies reported increased awareness, acceptance of the chronic nature of pain, and attention to the need to take responsibility for their own health.

There are more articles like this @ our:

Alternative Medicine Articles Section and the:

Chiropractic and Spinal Pain Page

(more…)

0

Characteristics of Chiropractic Practitioners and Patients

By Frank M. Painter|April 13, 2017|Chiropractic Care|

Characteristics of Chiropractic Practitioners, Patients, and Encounters in Massachusetts and Arizona

The Chiro.Org Blog

J Manipulative Physiol Ther. 2005 (Nov); 28 (9): 645–653

Robert D. Mootz, DC, Daniel C. Cherkin, PhD,
Carson E. Odegard, DC, MPH, David M. Eisenberg, MD,
James P. Barassi, DC, Richard A. Deyo, MD, MPH

State of Washington,
Department of Labor and Industries,
Olympia 98504-4321, USA

OBJECTIVE: To describe chiropractic care using data collected at the time of each patient visit.

METHODS: Random samples of chiropractors licensed in Arizona and Massachusetts were recruited to participate in interviews about their training, demographics, and practice characteristics. Interviewees were then recruited to record information about patient condition, evaluation, care, and visit disposition on 20 consecutive patient visits.

RESULTS: Data for 2,550 chiropractic patient visits were recorded. Care for low back, head and neck pain accounted for almost three quarters of visits. Extremity conditions and wellness care accounted for approximately half of the remaining visits. Spinal and soft tissue examinations were the most frequently reported diagnostic procedures (80% and 56% of visits, respectively), and high-velocity spinal manipulation techniques were the most frequently reported therapeutic procedures (almost 85% of visits). Rehabilitation exercises, thermal modalities, electric stimulation, and counseling/education/self-care were each performed during approximately 25% of visits. Approximately 85% of patients seen were self-referred, whereas only approximately 5% came from medical physicians. Approximately 35% of visits had an expected source of payment directly from the patient. Approximately 80% of visits ended with a plan for the patient to return at a specified time.

(more…)

0