Chiropractic Management

One- and Two-year Follow-up of a Randomized Trial of Neck-specific Exercise with or without a Behavioural Approach Compared with Prescription of Physical Activity in Chronic Whiplash Disorder

By Frank M. Painter|October 6, 2022|Chiropractic Management, Whiplash|

One- and Two-year Follow-up of a Randomized Trial of Neck-specific Exercise with or without a Behavioural Approach Compared with Prescription of Physical Activity in Chronic Whiplash Disorder

SOURCE: J Rehabil Med 2016 (Jan); 48 (1): 56–64

OPEN ACCESS

Maria Landén Ludvigsson, MSc, Gunnel Peterson MSc, Åsa Dedering, PhD and Anneli Peolsson, PhD

Department of Medical and Health Sciences,
Division of Physiotherapy,
Linköping University,
SE-581 83 Linköping, Sweden.

Objective: To explore whether neck-specific exercise, with or without a behavioural approach, has benefits after 1 and 2 years compared with prescribed physical activity regarding pain, self-rated functioning/disability, and self-efficacy in management of chronic whiplash.

Patients A total of 216 volunteers with chronic whiplash-associated disorders, grades 2 or 3.

Methods: Participants were randomized to 1 of 3 exercise interventions: neck-specific exercise with or without a behavioural approach, or physical activity prescription. Self-rated pain (visual analogue scale), disability/functioning (Neck Disability Index/Patient Specific Functional Scale) and self-efficacy (Self-Efficacy Scale) were evaluated after 1 and 2 years.

Results: Both neck-specific exercise groups maintained more improvement regarding disability/functioning than the prescribed physical activity group at both time-points (p ≤ 0.02). At 1 year, 61% of subjects in the neck-specific group reported at least 50% pain reduction, compared with 26% of those in the physical activity prescription group (p < 0.001), but at 2 years the difference was not significant.

There is more like this @ our:

WHIPLASH Section and the:

EXERCISE AND CHIROPRACTIC Section

(more…)

0

Concurrent Bell’s Palsy and Facial Pain Improving with Multimodal Chiropractic Therapy: A Case Report and Literature Review

By Frank M. Painter|October 3, 2022|Bell's Palsy, Chiropractic Management|

Concurrent Bell’s Palsy and Facial Pain Improving with Multimodal Chiropractic Therapy: A Case Report and Literature Review

The Chiro.Org Blog

SOURCE: Am J Case Rep 2022 (Sep 19); 23: e937511

OPEN ACCESS

Eric Chun-Pu Chu, Robert J Trager, Alan Te-Chang Chen

New Chiropractic and Physiotherapy Centre,
EC Healthcare,
Kowloon, Hong Kong.

BACKGROUND Bell’s palsy, also called facial nerve palsy, occasionally co-occurs with trigeminal neuropathy, which presents as additional facial sensory symptoms and/or neck pain. Bell’s palsy has a proposed viral etiology, in particular when occurring after dental manipulation.

CASE REPORT A 52-year-old Asian woman presented to a chiropractor with a 3-year history of constant neck pain and left-sided maxillary, eyebrow, and temporomandibular facial pain, paresis, and paresthesia, which began after using a toothpick, causing possible gum trauma. She had previously been treated with antiviral medication and prednisone, Chinese herbal medicine, and acupuncture, but her recovery plateaued at 60% after 1 year. The chiropractor ordered cervical spine magnetic resonance imaging, which demonstrated cervical spondylosis, with no evidence of myelopathy or major pathology. Treatment involved cervical and thoracic spinal manipulation, cervical traction, soft-tissue therapy, and neck exercises. The patient responded positively. At 1-month follow-up, face and neck pain and facial paresis were resolved aside from residual eyelid synkinesis. A literature review identified 12 additional cases in which chiropractic spinal manipulation with multimodal therapies was reported to improve Bell’s palsy. Including the current case, 85% of these patients also had pain in the face or neck.

There are more articles like this @ our:

CONDITIONS Section

(more…)

0

Low-value Care in Musculoskeletal Health Care: Is There a Way Forward?

By Frank M. Painter|September 20, 2022|Chiropractic Management, Musculoskeletal Pain|

Low-value Care in Musculoskeletal Health Care: Is There a Way Forward?

The Chiro.Org Blog

SOURCE: Pain Practice 2022 (Sep); 22 (Suppl 2): 65–70

OPEN ACCESS

Jan Hartvigsen PhD, Steven J. Kamper PhD, Simon D. French PhD

Department of Sports Science and Clinical Biomechanics,
Center for Muscle and Joint Health,
University of Southern Denmark,
Odense M, Denmark.

Background: Low-value care that wastes resources and harms patients is prevalent in health systems everywhere.

Methods: As part of an invited keynote presentation at the Pain in Motion IV conference held in Maastricht, Holland, in May 2022, we reviewed evidence for low-value care in musculoskeletal conditions and discussed possible solutions.

Results: Drivers of low-value care are diverse and affect patients, clinicians, and health systems everywhere. We show that low-value care for back pian, neck pain, and osteoarthritis is prevalent in all professional groups involved in caring for people who seek care for these conditions. Implementation efforts that aim to reverse low-value care seem to work better if designed using established conceptual and theoretical frameworks.

There is more like this @ our:

LOW BACK PAIN Section and the:

SPINAL PAIN MANAGEMENT Section

(more…)

0

Chiropractic Management of Neck Pain Complicated by Symptomatic Vertebral Artery Stenosis and Dizziness

By Frank M. Painter|September 15, 2022|Chiropractic Management, Stroke and Chiropractic|

Chiropractic Management of Neck Pain Complicated by Symptomatic Vertebral Artery Stenosis and Dizziness

The Chiro.Org Blog

SOURCE: American Journal of Case Reports (Sep 14) 2022 [Epub]

OPEN ACCESS

Eric Chun-Pu Chu, Robert J. Trager, Cliff Tao, Linda Yin-King Lee

New York Chiropractic and Physiotherapy Centre,
EC Healthcare,
Kowloon, Hong Kong

BACKGROUND Vertebrobasilar insufficiency (VBI) is most often caused by vertebrobasilar atherosclerosis, often presenting with dizziness and occasionally neck pain. Little research or guidelines regarding management of neck pain in affected patients exists.

CASE REPORT A 62–year-old male hypertensive smoker presented to a chiropractor with a 13–year history of insidious-onset neck pain, dizziness, and occipital headache with a Dizziness Handicap Inventory (DHI) of 52%. The patient had known VBI, caused by bilateral vertebral artery plaques, and cervical spondylosis, and was treated with multiple cardiovascular medications. The chiropractor referred patient to a neurosurgeon, who cleared him to receive manual therapies provided manual-thrust cervical spinal manipulative therapy (SMT) was not performed. The chiropractor administered thoracic SMT and cervicothoracic soft tissue manipulation. The neck pain and dizziness mostly resolved by 1 month. At 1–year follow-up, DHI was 0%; at 2 years it was 8%. A literature search revealed 4 cases in which a chiropractor used manual therapies for a patient with VBI. Including the present case, all patients had neck pain, 60% had dizziness, and all were treated with SMT either avoiding manual cervical manipulation altogether or modifying it to avoid or limit cervical rotation, yielding positive outcomes.

There are more articles like this @ our:
STROKE AND CHIROPRACTIC Section

(more…)

0

A Systematic Review of Chiropractic Care for Fall Prevention: Rationale, State of the Evidence, and Recommendations for Future Research

By Frank M. Painter|September 14, 2022|Balance, Chiropractic Management, Fall Prevention|

A Systematic Review of Chiropractic Care for Fall Prevention: Rationale, State of the Evidence, and Recommendations for Future Research

The Chiro.Org Blog

SOURCE: BMC Musculoskelet Disord 2022 (Sep 5); 23 (1): 844

OPEN ACCESS

Weronika Grabowska, Wren Burton, Matthew H. Kowalski, Robert Vining, Cynthia R. Long, Anthony Lisi, Jeffrey M. Hausdorff, Brad Manor, Dennis Muñoz-Vergara & Peter M. Wayne

Brigham and Women’s Hospital and
Harvard Medical School Division of Preventive Medicine,
Osher Center for Integrative Medicine,
900 Commonwealth Avenue, 3rd Floor,
Boston, MA, 02215, USA.

Background: Falls in older adults are a significant and growing public health concern. There are multiple risk factors associated with falls that may be addressed within the scope of chiropractic training and licensure. Few attempts have been made to summarize existing evidence on multimodal chiropractic care and fall risk mitigation. Therefore, the broad purpose of this review was to summarize this research to date.

Main text: Systematic review was conducted following PRISMA guidelines. Databases searched included PubMed, Embase, Cochrane Library, PEDro, and Index of Chiropractic Literature. Eligible study designs included randomized controlled trials (RCT), prospective non-randomized controlled, observational, and cross-over studies in which multimodal chiropractic care was the primary intervention and changes in gait, balance and/or falls were outcomes. Risk of bias was also assessed using the 8-item Cochrane Collaboration Tool. The original search yielded 889 articles; 21 met final eligibility including 10 RCTs. One study directly measured the frequency of falls (underpowered secondary outcome) while most studies assessed short-term measurements of gait and balance. The overall methodological quality of identified studies and findings were mixed, limiting interpretation regarding the potential impact of chiropractic care on fall risk to qualitative synthesis.

There are more articles like this @ our:

VERTIGO and BALANCE Section

(more…)

0

Associations Between Early Chiropractic Care and Physical Therapy on Subsequent Opioid Use Among Persons With Low Back Pain in Arkansas

By Frank M. Painter|July 5, 2022|Chiropractic Management, Nonpharmacologic Therapies|

Associations Between Early Chiropractic Care and Physical Therapy on Subsequent Opioid Use Among Persons With Low Back Pain in Arkansas

The Chiro.Org Blog

SOURCE: J Chiropractic Medicine 2022 (Jun); 21 (2): 67–76
Mahip Acharya, BPharm, Dvyan Chopra, MS, Allen M. Smith, PharmD, Julie M. Fritz, PhD, PT, Bradley C. Martin, PharmD, PhD

Division of Pharmaceutical Evaluation and Policy,
University of Arkansas for Medical Sciences,
Little Rock, Arkansas.

Department of Physical Therapy and Athletic Training,
University of Utah,
Salt Lake City, Utah.

Editorial Comment: These authors are to be praised for publishing this paper. When you look at their pedigrees, it’s reasonable to imagine that they may have been looking to see that physical therapy was associated with reduced opioid use. Numerous studies have shown that chiropractic already has a well-established track record for low- to no-opioid use, so they would be the perfect comparison group for a study like this. We all know that third parties are looking for safe and cost-effective alternatives to “usual care”.

In the past, a study favorable to chiropractic care, particularly one that used physical therapy as a comparison group, would never have been published, because of the long-standing medical bias against chiropractic care. So, let’s tip our hats to this group of researchers for their hard work and honesty!

Objective: The objective of this study was to estimate the association between early use of physical therapy (PT) or chiropractic care and incident opioid use and long-term opioid use in individuals with a low back pain (LBP) diagnosis.

Methods: A retrospective cohort study was conducted using data from Arkansas All Payers’ Claims Database. Adults with incident LBP diagnosed in primary care or emergency departments between July 1, 2013, and June 30, 2017, were identified. Participants were required to be opioid naïve in the 6-month baseline period and without cancer, cauda equina syndrome, osteomyelitis, lumbar fracture, and paraplegia/quadriplegia in the entire study period. PT and chiropractic treatment were documented over the ensuing 30 days starting on the date of LBP. Any opioid use and long-term opioid use (LTOU) in 1-year follow-up were assessed. Multivariable logistic regressions controlling for covariates were estimated.

There are more articles like this @ our:

NON-PHARMACOLOGIC THERAPY Section

(more…)

0