Spinal Pain Management

Adverse Impacts of Chronic Pain on Health-related Quality of Life, Work Productivity, Depression and Anxiety in a Community-based Study

By Frank M. Painter|November 5, 2022|Initial Provider, Low Back Pain, Spinal Pain Management|

Adverse Impacts of Chronic Pain on Health-related Quality of Life, Work Productivity, Depression and Anxiety in a Community-based Study

SOURCE: Family Practice 2017 (Nov 16); 34 (6): 656–661

OPEN ACCESS

Kosuke Kawai, Alison Tse Kawai, Peter Wollan, Barbara P Yawn

Clinical Research Center,
Boston Children’s Hospital,
Harvard Medical School,
Boston, MA, USA.

Background: Chronic pain has major clinical and social consequences. Few studies have examined any variation in the extent of impairment on quality of life and work productivity by site and type of chronic pain.

Objective: The objective of our study is to examine adverse impacts of chronic pain on physical and psychological health and work productivity.

Methods: Our community-population study was based on a phone-interview of adults with chronic pain, residing in Olmsted County, MN. Chronic pain groups were categorized into abdominal pain, back pain, joint pain, multisite pain, neuropathic pain or no chronic pain. We used standardized instruments, including the Brief Pain Inventory, the Patients Health Questionnair-9, and Work Productivity and Activity Impairment Questionnaire.

Results: We evaluated 591 patients suffering from chronic pain and 150 participants with no chronic pain. Almost one third of patients with multisite pain (33%) and neuropathic pain (32%) reported mild/major depressive symptoms. Patients suffering from chronic pain, particularly from multisite pain and neuropathic pain, reported significant pain interferences with daily activities and impairments in physical function. Chronic pain was significantly associated with reduced performance at work but not with missed work hours. The average reported reduction in work productivity ranged from 2.4 hours (±5.6) per week for adults with joint chronic pain to 9.8 hours (±11.1) per week for adults with multisite chronic pain.

There is more like this @ our:

LOW BACK PAIN Section and the:

SPINAL PAIN MANAGEMENT Section

(more…)

0

Utilization of Chiropractic Services in Patients with Osteoarthritis and Spine Pain at a Publicly Funded Healthcare Facility in Canada: A Retrospective Study

By Frank M. Painter|March 8, 2022|Chiropractic Management, Spinal Pain Management|

Utilization of Chiropractic Services in Patients with Osteoarthritis and Spine Pain at a Publicly Funded Healthcare Facility in Canada: A Retrospective Study

The Chiro.Org Blog

SOURCE: J Back Musculoskelet Rehabil 2022 (Feb 25) [EPUB]

Amber Reichardt, Steven R Passmore, Audrey Toth, Gerald Olin

Faculty of Kinesiology and Recreation Management,
University of Manitoba,
Winnipeg, MB, Canada.

Background: Osteoarthritis (OA) is one of the most prevalent and disabling musculoskeletal diseases worldwide. There is preliminary evidence from experimental studies and consensus documents that chiropractic management may alleviate spine and/or extremity OA related pain in the short term.

Objective: This research explores the potential relationship of a pragmatic course of care, including soft tissue therapy, spinal manipulation, and other treatments commonly delivered by chiropractors, to spine and extremity pain in patients with OA.

Methods: A retrospective analysis of prospectively collected data from the chiropractic program at a publicly funded healthcare facility was conducted. The primary outcome measures for patients diagnosed with spine and/or extremity OA (n= 76) were numeric pain scores of each spinal and extremity region at baseline and discharge, and a change score was determined.

Results: Statistically significant improvements that exceed a clinically meaningful difference in pain numeric rating scale scores were demonstrated by point change reductions from baseline to discharge visits. Change scores exceeding a minimally clinically important difference of “2-points” were present in the sacroiliac (-2.91), extremity (-2.84), cervical (-2.73), thoracic (-2.61), and lumbar (-2.59) regions.

There are more articles like this @ our:

SPINAL PAIN MANAGEMENT Page

(more…)

0

Prevalence and Characteristics of Chronic Spinal Pain Patients with Different Hopes (Treatment Goals) for Ongoing Chiropractic Care

By Frank M. Painter|January 14, 2022|Chronic Low Back Pain, Chronic Neck Pain, Spinal Pain Management|

Prevalence and Characteristics of Chronic Spinal Pain Patients with Different Hopes (Treatment Goals) for Ongoing Chiropractic Care

The Chiro.Org Blog

SOURCE: J Alternative and Complementary Medicine 2019 (Oct 1); 25 (10): 1015–1025

Patricia M. Herman, ND, PhD, Sarah E. Edgington, MA, Gery W. Ryan, PhD, and Ian D. Coulter, PhD

RAND Corporation,
Santa Monica, CA.

Objectives: The treatment goals of patients successfully using ongoing provider-based care for chronic spinal pain

Design: Multinomial logistical hierarchical linear models were used to examine the characteristics of patients with

Settings/Location: Observational data from a large national sample of patients from 125 chiropractic clinics clustered in 6 U.S. regions.

Subjects: Patients with nonwork-injury-related nonspecific chronic low-back pain (CLBP) and chronic neck pain (CNP).

Interventions: All were receiving ongoing chiropractic care.

Outcome measures: Primary outcomes were patient endorsement of one of four goals for their treatment. Explanatory variables included pain characteristics, pain beliefs, goals for mobility/flexibility, demographics, and other psychological variables.

Results: Across our sample of 1614 patients (885 with CLBP and 729 with CNP) just under one-third endorsed a treatment goal of having their pain go away permanently (cure). The rest had goals of preventing their pain from coming back (22% CLBP, 16% CNP); preventing their pain from getting worse (14% CLBP, 12% CNP); or temporarily relieving their pain (31% CLBP, 41% CNP). In univariate analysis across these goals, patients differed significantly on almost all variables. In the multinomial logistic models, a goal of cure was associated with shorter pain duration and more belief in a medical cure; a goal of preventing pain from coming back was associated with lower pain levels; and those with goals of preventing their pain from getting worse or temporarily relieving pain were similar, including in having their pain longer.

There is more like this @ our:

CHRONIC NECK PAIN Page and our

SPINAL PAIN MANAGEMENT Page and our

NON-PHARMACOLOGIC THERAPY Page

(more…)

0

Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain

By Frank M. Painter|January 10, 2022|Chronic Neck Pain, Cost-Effectiveness of Chiropractic, Low Back Pain, Spinal Pain Management|

Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain

The Chiro.Org Blog

SOURCE: Frontiers in Pain Ressearch 2021 (Oct 25); 2: 765921

Carlos Gevers-Montoro, Benjamin Provencher, Martin Descarreaux, Arantxa Ortega de Mues and Mathieu Piche

Department of Anatomy,
Université du Québec à Trois-Rivières,
Trois-Rivières, QC, Canada

Spine pain is a highly prevalent condition affecting over 11% of the world’s population. It is the single leading cause of activity limitation and ranks fourth in years lost to disability globally, representing a significant personal, social, and economic burden. For the vast majority of patients with back and neck pain, a specific pathology cannot be identified as the cause for their pain, which is then labeled as non-specific. In a growing proportion of these cases, pain persists beyond 3 months and is referred to as chronic primary back or neck pain. To decrease the global burden of spine pain, current data suggest that a conservative approach may be preferable. One of the conservative management options available is spinal manipulative

The aim of this narrative review is to highlight the most relevant and up-to-date evidence on the effectiveness (as it compares to other interventions in more pragmatic settings) and efficacy (as it compares to inactive controls under highly controlled conditions) of SMT for the management of neck pain and low back pain. Additionally, a perspective on the current recommendations on SMT for spine pain and the needs for future research will be

In summary, SMT may be as effective as other recommended therapies for the management of non-specific and chronic primary spine pain, including standard medical care or physical therapy. Currently, SMT is recommended in combination with exercise for neck pain as part of a multimodal approach. It may also be recommended as a frontline intervention for low back pain. Despite some remaining discrepancies, current clinical practice guidelines almost universally recommend the use of SMT for spine pain. Due to the low quality of evidence, the efficacy of SMT compared with a placebo or no treatment remains uncertain. Therefore, future research is needed to clarify the specific effects of SMT to further validate this intervention. In addition, factors that predict these effects remain to be determined to target patients who are more likely to obtain positive outcomes from SMT.

There is more like this @ our:

LOW BACK PAIN Section and the:

CHRONIC NECK PAIN Section and the:

COST-EFFECTIVENESS Section and the:

SPINAL PAIN MANAGEMENT Section

(more…)

0

Manipulative Therapy for Children Complaining of Spinal Pain

By Frank M. Painter|April 29, 2020|Spinal Pain Management|

Potential Treatment Effect Modifiers for Manipulative Therapy for Children Complaining of Spinal Pain. Secondary Analyses of a Randomised Controlled Trial

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2019 (Dec 10)

Kristina Boe Dissing, Werner Vach, Jan Hartvigsen, Niels Wedderkopp & Lise Hestbæk

Department of Sports Science and Clinical Biomechanics,
Faculty of Health Sciences,
University of Southern Denmark,
Campusvej 55, DK-5230 Odense M, Denmark.

BACKGROUND: In children, spinal pain is transitory for most, but up to 20% experience recurrent and bothersome complaints. It is generally acknowledged that interventions may be more effective for subgroups of those affected with low back pain. In this secondary analysis of data from a randomized clinical trial, we tested whether five indicators of a potential increased need for treatment might act as effect modifiers for manipulative therapy in the treatment of spinal pain in children. We hypothesized that the most severely affected children would benefit more from manipulative therapy.

METHOD: This study was a secondary analysis of data from a randomised controlled trial comparing advice, exercises and soft tissue treatment with and without the years complaining of spinal pain. A text message system (SMS) and clinical examinations were used for data collection (February 2012 to April 2014).Five pre-specified potential effect modifiers were explored:

There are more articles like this @ our:

PEDIATRICS Section

(more…)

0

Outcomes Indicators and a Risk Classification System

By Frank M. Painter|March 24, 2018|Spinal Pain Management|

Outcomes Indicators and a Risk Classification System for Spinal Manipulation Under Anesthesia: A Narrative Review and Proposal

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2018 (Mar 8); 26: 9

Dennis DiGiorgi, John L. Cerf, and Daniel S. Bowerman

Consultant Practice
Whitestone, NY, USA.

Over a period of decades chiropractors have utilized spinal manipulation under anesthesia (SMUA) to treat chronic back and neck pain. As an advanced form of manual therapy, SMUA is reserved for the patient whose condition has proven refractory to office-based manipulation and other modes of conservative care. Historically, the protocols and guidelines put forth by chiropractic MUA proponents have served as the clinical compass for directing MUA practice.

With many authors and MUA advocates having focused primarily on anticipated benefit, the published literature contains no resource dedicated to treatment precautions and contraindications. Also absent from current relevant literature is acknowledgement or guidance on the preliminary evidence that may predict poor clinical outcomes with SMUA. This review considers risk and unfavorable outcomes indicators in therapeutic decision making for spinal manipulation under anesthesia.

A new risk classification system is proposed that identifies patient safety and quality of care interests for a procedure that remains without higher-level research evidence. A scale which categorizes risk and outcome potential for SMUA is offered for the chiropractic clinician, which aims to elevate the standard of care and improve patient selection through the incorporation of specific indices from existing medical literature.

There are more articles like this @ our:

Spinal Pain Management Page

(more…)

0