Neck Pain

Application of a Diagnosis-Based Clinical Decision Guide in Patients with Neck Pain

By Frank M. Painter|September 3, 2011|Guidelines, Neck Pain, Spinal Manipulation|

Application of a Diagnosis-Based Clinical Decision Guide in Patients with Neck Pain

SOURCE: Chiropractic & Manual Therapies 2011 (Aug 27)

Donald R Murphy, DC, DACAN, and
Eric L Hurwitz, DC, PhD

Background: Neck pain (NP) is a common cause of disability. Accurate and efficacious methods of diagnosis and treatment have been elusive. A diagnosis-based clinical decision guide (DBCDG; previously referred to as a diagnosis-based clinical decision rule) has been proposed which attempts to provide the clinician with a systematic, evidence-based guide in applying the biopsychosocial model of care. The approach is based on three questions of diagnosis. The purpose of this study is to present the prevalence of findings using the DBCDG in consecutive patients with NP.

Methods: Demographic, diagnostic and baseline outcome measure data were gathered on a cohort of NP patients examined by one of three examiners trained in the application of the DBCDG.

Results: Data were gathered on 95 patients. Signs of visceral disease or potentially serious illness were found in 1%. Centralization signs were found in 27%, segmental pain provocation signs were found in 69% and radicular signs were found in 19%. Clinically relevant myofascial signs were found in 22%. Dynamic instability was found in 40%, oculomotor dysfunction in 11.6%, fear beliefs in 31.6%, central pain hypersensitivity in 4%, passive coping in 5% and depression in 2%.

Conclusion: The DBCDG can be applied in a busy private practice environment. Further studies are needed to investigate clinically relevant means to identify central pain hypersensitivity, oculomotor dysfunction, poor coping and depression, correlations and patterns among the diagnostic components of the DBCDG as well as interexaminer reliability, validity and efficacy of treatment based on the DBCDG.

The FULL TEXT Article

BACKGROUND

There are more articles like this @ our:

Chronic Neck Pain and Chiropractic Page and the

A Clinical Model for the Diagnosis and Management Page

(more…)

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Findings of the Bone and Joint Decade Neck Pain Task Force: Interview with Scott Haldeman, DC, MD, PhD

By Frank M. Painter|September 1, 2011|Neck Pain, Research|

Findings of the Bone and Joint Decade Neck Pain Task Force: Interview with Scott Haldeman, DC, MD, PhD

The Chiro.Org Blog

SOURCE: Health Insights Today

An Interview by Daniel Redwood, DC

Scott Haldeman chaired the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Related Disorders, the most comprehensive multidisciplinary review on neck pain ever undertaken.

As with similar projects, the Task Force reviewed and evaluated all existing research on the diagnosis and treatment of neck pain. But it went further, initiating original research in insufficiently explored areas, including the now-renowned study by David Cassidy and colleagues which demonstrated that strokes are no more likely after a visit to a chiropractor than after a visit to a medical doctor. In this Health Insights Today interview, Dr. Haldeman discusses the major findings of the Neck Pain Task Force and their implications for the management of this challenging condition.

Dr. Haldeman holds the positions of Clinical Professor, Department of Neurology, University of California, Irvine; Adjunct Professor, Department of Epidemiology, School of Public Health, University of California, Los Angeles; and Adjunct Professor, Department of Research, Southern California University of Health Sciences. He is Past President of the North American Spine Society, the American Back Society, the North American Academy of Manipulative Therapy, and the Orange County Neurological Society. He served on the Executive Council of the International Society for the Study of the Lumbar Spine. (more…)

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Predictors For Success Of Spinal Manipulation For Neck Pain

By Frank M. Painter|April 19, 2011|Neck Pain, Research, Spinal Manipulation|

Predictors For Success Of Spinal Manipulation For Neck Pain

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2011 (Mar); 34 (3): 144–152

Manuel Ssavedra-Hernández, PT, Adelaida M. Castro-Sánchez, PT, PhD, César Fernández-de-las-Peñas, PT, DO, PhD, Joshua A. Cleland, PT, PhD, Ricardo Ortega-Santiago, PT, MS, Manuel Arroyo-Morales, MD, PT, PhD

Department of Nursing and Physical Therapy,
Universidad de Almería, Spain.

This newly published JMPT study attempted to identify those prognostic clinical factors that may potentially identify, a priori, patients with mechanical neck pain who are likely to experience a rapid and successful response to spinal manipulation of the cervical and thoracic spine.

Data from 81 subjects were included in the analysis, of which 50 had experienced a successful outcome (61.7%). Five variables were found to be associated with a positive response:

Initial pain intensity greater than 4.5 points
Cervical extension less than 46°
Hypomobility at T1 vertebra (more…)

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Neck Pain Experienced By Air Force Pilots

By Frank M. Painter|March 9, 2011|Air Force Pilots, Legislation, Neck Pain, News|

Neck Pain Experienced By Air Force Pilots

The Chiro.Org Blog

SOURCE: Military Medicine 2011 (Jan); 176 (1): 106–109

Netto K, Hampson G, Oppermann B, Carstairs G, Aisbett B.

School of Exercise and Nutrition Sciences,
Deakin University,
221 Burwood Highway,
Burwood, Victoria 3125, Australia

This article is of particular interest because the Department of Defense was instructed during the Clinton Administration to start providing chiropractic care through the Department of Veterans Affairs to American servicemen, and even after all these years, chiropractic care is only available at 36 VA facilities across the country. This still leaves (at least) 100 major VA medical facilities without a chiropractic physician on staff. [1]

In this study, therapists at the School of Exercise and Nutrition Sciences in Victoria, Australia designed an 18-question survey to determine type and effectiveness of various strategies used by Royal Australian Air Force (RAAF) fast jet aircrew in self-referral and management of flight-related neck pain. [2]

They provided this questionnaire to 86 eligible RAAF aircrew to determine aircrew demographics, the incidence of flight-related neck pain, and their self-referral strategies to manage these neck complaints. The results are quite dramatic: (more…)

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Cost-Effectiveness Revisited

By Frank M. Painter|June 14, 2010|Low Back Pain, Neck Pain, News|

Cost-Effectiveness Revisited

The Chiro.Org Blog

SOURCE: The Chiropractic Report

David Chapman-Smith, LL.B (Hons)

As the United States faces the prospect of major reform to its healthcare system a dramatic new expert study from leading US health economists from Mercer Health and Benefits, and Harvard University analyses chiropractic management of back and neck pain and reports:

“Almost half of US patients with persistent back pain” seek chiropractic care.
“Low-back and neck pain are extremely common conditions that consume large amounts of healthcare resources”.
“Effectiveness: chiropractic care is more effective than other modalities for treating low-back and neck pain”.
“Cost-effectiveness: when considering effectiveness and cost together, chiropractic physician care for low-back and neck pain is highly cost-effective, and represents a good value in comparison to medical physician care and to widely accepted cost-effectiveness thresholds”. (more…)

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New Report Finds Chiropractic Is More Effective for Neck and Low Back Complaints

By Frank M. Painter|April 15, 2010|Low Back Pain, Neck Pain, News|

New Report Finds Chiropractic Is More Effective for Neck and Low Back Complaints

The Chiro.Org Blog

Thanks to John Wiens, D.C. for drawing our attention to this study!

This new report, prepared for the Foundation for Chiropractic Progress by the esteemed medical authors Niteesh Choudhry, MD, PHD (Harvard Medical School) and Arnold Milstein, MD, MPH (Mercer health and Benefits), produced these conclusions from the Executive Summary:

- Chiropractic care is more effective than other modalities for treating low back and neck pain

(more…)

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