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 By Frank M. Painter, D.C. in Low Back Pain on June 14th, 2010 at 5:23 pm
Source: The Chiropractic Report
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”.
Continue reading …
By Frank M. Painter, D.C. in Low Back Pain on April 15th, 2010 at 4:14 pm
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!
A 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
Continue reading …
By Frank M. Painter, D.C. in Iatrogenic Injury on April 10th, 2010 at 11:53 pm
Why Do Spinal Surgery Rates Continue To Rise?
The Chiro.Org Blog
A Chiro.Org Editorial
First, let’s review some history. In 1974, the Congressional Committee on Interstate and Foreign Commerce held hearings on unnecessary surgery. Their findings from the First Surgical Second Opinion Program found that 17.6% of recommendations for surgery were not confirmed. The House Subcommittee on Oversight and Investigations extrapolated these figures to estimate that, on a nationwide basis, there were 2.4 million unnecessary surgeries performed every year, resulting in 11,900 deaths, at an annual cost of $3.9 billion. [1]
With the total number of lower back surgeries having been estimated in 1995 to exceed 250,000 in the U.S., at a hospital cost of $11,000 per patient. [2] This would mean that the total number of unnecessary back surgeries each year in the U.S. could be 44,000, costing as much as $484 million. [3]
So, the first risk of spinal surgery is that it may not be necessary.
A most-recent review suggests that:
Back Surgery Fails 74% of the Time
Continue reading …
By Frank M. Painter, D.C. in Low Back Pain on April 1st, 2010 at 6:54 pm
Two New Low Back Pain Studies Favor Chiropractic Care
The Chiro.Org Blog
Thanks to Health Insights Today for drawing our attention to these studies!
A major randomized controlled trial on chronic low back pain was just published in the Clinical Rehabilitation Journal, involving 210 patients (140 women and 70 men) with chronic, non-specific low back pain. These individuals were randomized into 3 groups: spinal manipulation, personalized physiotherapy, or back school. [1]
Chiropractic adjusting (Spinal Manipulation) was associated with much higher functional improvements and long-term pain relief than the other 2 groups after release from care and again at the 12-month follow-up.
Continue reading …
By Frank M. Painter, D.C. in Guidelines on February 11th, 2010 at 1:58 pm
Thanks to ChiroACCESS for access to this article!
A February 2010 study of 3,533 general practice low back pain patients found that many providers are not following their own evidence based guidelines. [1] Guidelines do provide the overall best evidence but are not meant to be a cookbook approach to care. There is also a need for flexibility so the physician can deviate from guidelines when the specific needs and desires of the patient dictate. In addition, the clinical judgment of the physician may override the guidelines when in a particular patient’s case they are inappropriate.
There is, however, reason for concern when risky and or expensive unneeded procedures are used. The medical guideline for acute low back pain call for advice and analgesics, but 80% of the 3,533 patients in this study were not given advise and 82% were not given analgesics. More harmful medications that are not recommended in the guidelines were prescribed, with 37% getting anti-inflammatory drugs and ~20% opiods.
Continue reading …
By Frank M. Painter, D.C. in Education on January 7th, 2010 at 4:19 pm
More Bad News For Medical Patients
The Chiro.Org Blog
Medical Training For Musculoskeletal Conditions is Inadequate
From Harvard Medical School in the U.S. to medical schools in Europe, medical education related to musculoskeletal conditions is inadequate. A 2009 survey tested physician’s knowledge related to simple low back pain management [1]. The average survey score of family practitioners was 69.7 and the average score of orthopedists was far less at 44.3. Orthopedists were less likely to make the proper radiological referral and appropriate pharmacological prescription based upon the literature.
Continue reading …
By Frank M. Painter, D.C. in Diagnosis on October 21st, 2009 at 11:41 am
Symptomatology: The Lumbar and Sacral Areas
The Chiro.Org Blog
We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.
This is Chapter 12 from RC’s best-selling book:
“Symptomatology and Differential Diagnosis”
These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.
Chapter 12: THE LUMBAR AND SACRAL AREAS
Low Back Pain
Low back pain has been the second most frequent health complaint in the United States for many years, second only to headaches. More lost working hours are attributed to this affliction than any other factor, and the vast majority of these complaints find their cause in biomechanical failures. These failures are often complex, accumulative, and subtly hidden by the body’s marvelous adaptive mechanisms –a diagnostic challenge when pain is solely referred.
BASIC INVESTIGATIVE APPROACH
Because of its prevalence, backache requires a meticulous consideration of all possibilities, a comprehensive case history, and a systematic examination associated with necessary laboratory data and x-ray findings. In addition, emotional factors must be considered. In eliciting the case history, the manner of onset, location and nature of pain and spasm, aggravating and relieving factors, and a thorough systems review are almost mandatory if professional justice to the patient is to be achieved.
The Lumbar Nociceptive Receptor System. The lumbar ligaments and fascia are richly innervated by nociceptive receptors. When the lumbar spine is in a relaxed neutral position, its nociceptive receptor system is relatively inactive. However, any mechanical force that will stress or deform receptors, with or without overt damage, or any irritating chemical of sufficient concentration will depolarize unmyelinated fibers and enhance afferent activity. Thus, the pain experienced after either intrinsic or extrinsic trauma can be the result of mechanical factors, chemical factors, or both.
Mechanical Pain. Normal mechanical force applied to normal tissue does not produce pain. However, abnormal mechanical deformation occurs whenever:
(1) abnormal stress is applied to normal tissues (eg, postural pain),
(2) abnormal stress is applied to abnormal tissues, or
(3) normal stress is applied to abnormal tissues (eg, soft-tissue shortening).
Continue reading …
By Frank M. Painter, D.C. in Diagnosis on October 11th, 2009 at 2:33 pm
Lower Back Trauma
The Chiro.Org Blog
We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.
This is Chapter 12 from RC’s best-selling book:
“Chiropractic Posttraumatic Rehabilitation”
These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.
CHAPTER 12: LOWER BACK TRAUMA
Although it is easier to teach anatomy by dividing the body into arbitrary parts, a misinterpretation can be created. For instance, we find clinically that the lumbar spine, sacrum, ilia, pubic bones, and hips work as a functional unit. Any disorder of one part immediately affects the function of the others.
BACKGROUND
A wide assortment of muscle, tendon, ligament, bone, nerve, and vascular injuries in this area is witnessed during posttrauma care. As with other areas of the body, the first step in the examination process is knowing the mechanism of injury if possible. Evaluation can be rapid and accurate with this knowledge.
Low-back disability rapidly demotivates productivity and athletic participation. The mechanism of injury is usually intrinsic rather than extrinsic. The cause can often be through overbending, a heavy steady lift, or a sudden release —all which primarily involve the muscles. IVD disorders are more often, but not exclusively, attributed to extrinsic blows and intrinsic wrenches. An accurate and complete history is invariably necessary to offer the best management and counsel.
INITIAL ASSESSMENT
A player injured on the field or a worker injured in the shop should never be moved until emergency assessment is completed. Once severe injury has been eliminated, transfer to a back board can be made and further evaluation conducted at an aid station.
Neurologic Levels
Continue reading …
Low Back Pain and Chiropractic
The Chiro.Org Blog
As you may know, until the late 90s, all chiropractic research was funded by our schools, or by research organizations like the FCER and the ICPA.
Even since then, the Federal Government has funneled homeopathic doses of cash towards chiropractic research. For this reason, much of early the funded research focused on low back pain.
Continue reading …
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