Practical Chiro

AETNA AGREES TO REVIEW CT CHIROPRACTIC SERVICES CLAIMS DENIED IMPROPERLY

2011-08-02T10:22:00.000-07:00

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Attorney General George Jepsen announced today that Aetna and American Specialty Health Networks, Inc. have agreed to review and reprocess chiropractic benefit claims that may have been denied improperly under Connecticut law.

The company was responding to questions raised by the Attorney General after several complaints were made by chiropractic providers on behalf of themselves and their patients. They were concerned that Aetna’s claims administration agreement with American Specialty Health Network, which took effect July 1, did not appear to include all the chiropractic services covered under Connecticut law.

Connecticut law requires health insurance plans to cover chiropractic care “to the same extent” coverage is provided for services rendered by a physician.

“Aetna’s prompt and fair response to this issue means providers will be paid for covered services and Aetna’s enrollees will continue to receive the care to which they are entitled,” Jepsen said. “Everyone benefits from this cooperation.”

Chiropractors licensed in Connecticut are permitted to provide a wide range of services, such as the use of X-ray and other diagnostic technology, the administration of foods and vitamins and preventative care. If health insurance plans cover those services when provided by physicians, they also must be covered when provided by chiropractors in Connecticut.

Aetna told Jepsen the claim system will be updated to include the procedure codes for qualifying services a chiropractor can provide in Connecticut. In addition, ASHN will review eligible claims submitted since July 1 and reprocess those denied incorrectly. No estimate was available on the number of claims affected.
Since July 1, American Specialty Health Network has provided claims administration and other services for chiropractic benefits available under Aetna’s health insurance plans with the exception of Aetna’s Traditional Choice plans in Connecticut.

Chiropractic manipulation results in little or no risk of chest injury

2011-05-13T13:13:00.001-07:00

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Dynamic chest compression occurs during spinal manipulation. While dynamic chest compression has been well studied in events such as motor vehicle collisions, chest compression forces have not been studied during chiropractic manipulation. In a study published online today in the Journal of Manipulative and Physiological Therapeutics, researchers quantified and analyzed the magnitude of chest compressions during typical as well as maximum chiropractic manipulation and have found them to be well under the threshold for injury.

"Results from this preliminary study showed that maximum chest compression during chiropractic manipulation of the thoracic spine is unlikely to result in injury," according to lead investigator Brian D. Stemper, PhD, Associate Professor, Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI. "We performed this study to get a better understanding of the force limits of chiropractic manipulation. This information may lead to safer manipulation procedures and help to decrease the possibility of adverse patient outcomes."

In the first part of the study Professor Stemper and his co-investigators worked with two practicing doctors of chiropractic, each with a minimum of 4 years of doctoral training and at least 7 years of healthcare experience. Using a crash test dummy they measured the level of chest compression induced during "normal" chiropractic manipulation and during spinal manipulations wherein the doctors of chiropractic exerted maximum effort. They performed simulated chiropractic manipulations on the test dummy at the midback level (T7 to T8 vertebrae).

In the second part of the study, an instrumented mechanical device was used to apply and measure the forces necessary to induce chest compression in the test dummy. These forces were increased until injurious levels of force were reached. The likelihood of injury was assessed and classified using the Abbreviated Injury Scale (AIS), which is a useful classification system that has been correlated to injury thresholds during biomechanical experimentation.

In the present study, manipulations incorporating typical and maximum efforts by the doctors of chiropractic resulted in maximum chest compressions corresponding to minimal risk of AIS 1 level injuries.

As with all types of patient care, Professor Stemper cautions that "individual patient characteristics including age, degeneration, and gender" should be taken into consideration during treatment such as chiropractic manipulation.

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The article is "An Experimental Study of Chest Compression During Chiropractic Manipulation of the Thoracic Spine Using an Anthropomorphic Test Device" by Brian D. Stemper, PhD, Jason J. Hallman, PhD, and Boyd M. Peterson, DC. It will appear in the Journal of Manipulative and Physiological Therapeutics, Volume 34, Issue 5 (June 2011), DOI 10.1016/j.jmpt.2011.04.001, published by Elsevier.

For Back Pain, Spinal Manipulation Holds Its Own

2011-02-16T14:25:00.000-08:00

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Source: Health Behavior News Service

If you’re suffering from chronic lower back pain, a new review of existing research finds that spinal manipulation − the kind of hands-on regimen that a chiropractor might perform on you − is as helpful as other common treatments like painkillers.

Spinal manipulation is also safe, researchers found. Ultimately, “the decision to refer for manipulation should be based upon costs, preferences of the patient and providers, and relative safety of all treatment options,” said review lead author Sidney Rubinstein, a chiropractor in private practice and a postdoctoral researcher at the VU University Medical Center in Amsterdam.

Surveys suggest that half of working Americans suffer from back pain each year. An estimated 25 percent of American adults reported that they suffered from back pain for at least a day within the last three months, according to a 2006 Centers for Disease Control and Prevention report, and lower back pain is the fifth most common reason that people go to the doctor.

Patients frequently turn to painkillers, which can cause side effects and be addictive, or to physical therapy, which is time-consuming and expensive. The new review looks at a third option − spinal manipulation.

In North America, Rubinstein said, chiropractors perform most spinal manipulation. Practitioners move their hands around a patient’s spine and joints, often producing an audible crack.

“The effectiveness of this therapy has long been controversial,” Rubinstein said. “Some proponents are slowly starting to view it as effective for chronic low-back pain. The results of this review will support that view.”
The review authors looked for randomized controlled studies, which are researchers consider as the most reliable forms of medical research. They found 26 studies − with 6,070 participants − that met their criteria for inclusion in their review, but deemed only nine studies to be of high quality.
The findings appear in the latest issue of The Cochrane Library. The journal is a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The researchers found that spinal manipulation worked about as well as the other treatments. It appears to work well in particular for certain kinds of patients, Rubinstein said, including those with restricted movement in the back, those without psychological issues, and those without symptoms below the knee related to the sciatic nerve.

Spinal manipulation “appears to be no better or worse than other existing therapies for patients with chronic low-back pain,” the review says.

There is one small caveat, however. In medical research, scientists often compare a treatment to a placebo, which is difficult when you are talking about something that's difficult to fake − like spinal manipulation.

Three of the studies reviewed the kind of spinal manipulation that produces a crack sound and tried to fool some patients into not realizing they were getting a sham treatment. However, it is unclear if they succeeded, Rubinstein said. One study appeared to show that patients could distinguish whether they were getting the real thing.
So how well do the treatments − spinal manipulation and the other examined in the review − work overall? Rubinstein said studies have shown that they help about two-thirds of patients. Sti other researchers say they have a modest impact at best.
In general, most treatments for lower-back pain “aren’t all that effective, even the ones we think that work, but some people respond better than others,” said Dr. Roger Chou, a physician and researcher with Oregon Health & Science University who has studied back pain.

“Right now the best we can say is that clinicians and patients have a number of moderately effective treatment options to consider, including exercise, manipulation, acupuncture, yoga, massage, cognitive behavioral therapy and some of the analgesic medications, and that it should be a decision between the clinician and patient,” Chou said. “In general, I think exercise is a preferred option since it has a lot of other health benefits.”

Dr. Tim Carey, director of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, said that many patients try several treatments, of which spinal manipulation is just one approach.

“We do not have a good sense of how manual therapy fits in an exercise regimen in a patient who is also taking medication, just as an example,” said Carey, who studies back pain. “While manual therapy seems to be an option for chronic low back pain, the evidence at present does not support a role as a preferred option.”

TERMS OF USE: This story is protected by copyright. When reproducing any material, including interview excerpts, attribution to the Health Behavior News Service, part of the Center for Advancing Health, is required.

Chiropractic and Neck Pain: Conservative Care of Cervical Pain, Injury

2010-07-10T07:08:00.001-07:00

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Your neck, also called the cervical spine, begins at the base of the skull and contains seven small vertebrae. Incredibly, the cervical spine supports the full weight of your head, which is on average about 12 pounds. While the cervical spine can move your head in nearly every direction, this flexibility makes the neck very susceptible to pain and injury.

The neck’s susceptibility to injury is due in part to biomechanics. Activities and events that affect cervical biomechanics include extended sitting, repetitive movement, accidents, falls and blows to the body or head, normal aging, and everyday wear and tear. Neck pain can be very bothersome, and it can have a variety of causes.

Here are some of the most typical causes of neck pain:

Injury and Accidents: A sudden forced movement of the head or neck in any direction and the resulting “rebound” in the opposite direction is known as whiplash. The sudden “whipping” motion injures the surrounding and supporting tissues of the neck and head. Muscles react by tightening and contracting, creating muscle fatigue, which can result in pain and stiffness. Severe whiplash can also be associated with injury to the intervertebral joints, discs, ligaments, muscles, and nerve roots. Car accidents are the most common cause of whiplash.

Growing Older: Degenerative disorders such as osteoarthritis, spinal stenosis, and degenerative disc disease directly affect the spine.

* Osteoarthritis, a common joint disorder, causes progressive deterioration of cartilage. The body reacts by forming bone spurs that affect joint motion.
* Spinal stenosis causes the small nerve passageways in the vertebrae to narrow, compressing and trapping nerve roots. Stenosis may cause neck, shoulder, and arm pain, as well as numbness, when these nerves are unable to function normally.
* Degenerative disc disease can cause reduction in the elasticity and height of intervertebral discs. Over time, a disc may bulge or herniate, causing tingling, numbness, and pain that runs into the arm.

Daily Life: Poor posture, obesity, and weak abdominal muscles often disrupt spinal balance, causing the neck to bend forward to compensate. Stress and emotional tension can cause muscles to tighten and contract, resulting in pain and stiffness. Postural stress can contribute to chronic neck pain with symptoms extending into the upper back and the arms.

Chiropractic Care of Neck Pain
During your visit, your doctor of chiropractic will perform exams to locate the source of your pain and will ask you questions about your current symptoms and remedies you may have already tried. For example:

* When did the pain start?
* What have you done for your neck pain?
* Does the pain radiate or travel to other parts of your body?
* Does anything reduce the pain or make it worse?

Your doctor of chiropractic will also do physical and neurological exams. In the physical exam, your doctor will observe your posture, range of motion, and physical condition, noting movement that causes pain. Your doctor will feel your spine, note its curvature and alignment, and feel for muscle spasm. A check of your shoulder area is also in order. During the neurological exam, your doctor will test your reflexes, muscle strength, other nerve changes, and pain spread.

In some instances, your chiropractor might order tests to help diagnose your condition. An x-ray can show narrowed disc space, fractures, bone spurs, or arthritis. A computerized axial tomography scan (a CT or CAT scan) or a magnetic resonance imaging test (an MRI) can show bulging discs and herniations. If nerve damage is suspected, your doctor may order a special test called electromyography (an EMG) to measure how quickly your nerves respond.

Chiropractors are conservative care doctors; their scope of practice does not include the use of drugs or surgery. If your chiropractor diagnoses a condition outside of this conservative scope, such as a neck fracture or an indication of an organic disease, he or she will refer you to the appropriate medical physician or specialist. He or she may also ask for permission to inform your family physician of the care you are receiving to ensure that your chiropractic care and medical care are properly coordinated.

Neck Adjustments
A neck adjustment (also known as a cervical manipulation) is a precise procedure applied to the joints of the neck, usually by hand. A neck adjustment works to improve the mobility of the spine and to restore range of motion; it can also increase movement of the adjoining muscles. Patients typically notice an improved ability to turn and tilt the head, and a reduction of pain, soreness, and stiffness.

Of course, your chiropractor will develop a program of care that may combine more than one type of treatment, depending on your personal needs. In addition to manipulation, the treatment plan may include mobilization, massage or rehabilitative exercises, or something else.

Research Supporting Chiropractic Care
One of the most recent reviews of scientific literature found evidence that patients with chronic neck pain enrolled in clinical trials reported significant improvement following chiropractic spinal manipulation.

As part of the literature review, published in the March/April 2007 issue of the Journal of
Manipulative and Physiological Therapeutics, the researchers reviewed nine previously published trials and found “high-quality evidence” that patients with chronic neck pain showed significant pain-level improvements following spinal manipulation. No trial group was reported as having remained unchanged, and all groups showed positive changes up to 12 weeks post-treatment.

Usual Care Often Not Consistent With Clinical Guidelines for Low Back Pain

2010-02-09T14:44:00.000-08:00

General practitioners often treat patients with low back pain in a manner that does not appear to match the care endorsed by international clinical guidelines, according to a report in the February 8 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Low back pain is estimated to be the seventh most common reason for a general practitioner visit in Australia and the fifth most common in the United States, according to background information in the article. An overwhelming body of literature on the management of low back pain—more than 1,200 published trials and systematic reviews—makes practice guidelines an efficient way for clinicians to base their care on the best evidence. A previous review concluded that guidelines in 11 countries around the world provide similar recommendations for assessment and management of low back pain.

“Given the proliferation of clinical practice guidelines outlining best practice, it is timely to consider how closely usual care aligns with guideline recommendations,” write Christopher M. Williams, M.App.Sc., of The George Institute for International Health, Camperdown, Australia, and colleagues. The authors assessed the care provided for new episodes of low back pain during 3,533 patient visits to general practitioners in Australia between 2001 and 2008. These visits were mapped to key recommendations in treatment guidelines; in addition, data were compared for two three-year periods before and after the release of Australian national guidelines in 2004.

“Our findings show that key aspects of the usual care provided to patients do not align with the care recommended in international evidence-based guidelines,” the authors write. For example, although guidelines discourage the use of imaging, more than one-quarter of patients were referred for radiology, computed tomography or similar tests.

Only 20.5 percent of patients received advice and 17.7 percent received simple pain-relieving medications, both of which are recommended as part of initial care for low back pain. Instead of the safer and equally effective acetaminophen, patients were more often prescribed non-steroidal anti-inflammatory drugs (37.4 percent) and opioids (19.6 percent).

In addition, patterns of care did not change significantly following the release of local guidelines, the authors note.

“Understanding why general practitioners do not follow key treatment recommendations of guidelines is an important prerequisite to improving this situation,” they write. Evidence suggests that the views of both patients and clinicians, and potentially miscommunication between the two, contribute to departures from guideline-based care.

“In the back pain field, there has been extensive activity in the past two decades focusing on the evaluation of new and existing therapies within clinical trials and systematic reviews,” the authors conclude. “Arguably, we need a parallel line of research that focuses on how best to encourage provision of evidence-based treatments. Educational outreach with broader societal focus may enhance guideline dissemination and reduce the burden of low back pain.”

Osteopathic Manipulative Treatment Improves Back Function in Late Pregnancy

2010-01-28T13:27:00.000-08:00

For many pregnant women, it’s inevitable. As their pregnancy progresses, tasks that involve the low back often get more difficult. It is harder to bend over, lift, sit or walk for long periods of time, and back pain increases. Treating back pain, and improving daily function relative to tasks that involve the low back is a challenge because pregnant women are limited to treatments that will not create problems for their developing baby.

“Osteopathic manipulative treatment (OMT) is a viable option for improving function related to the low back and reducing back pain in the third trimester of pregnancy because its does not appear to have any negative side effects,” said John C. Licciardone, D.O., M.S., M.B.A., the lead author of a study on OMT in the third trimester of pregnancy that was recently published in the American Journal of Obstetrics and Gynecology. Results from this study showed that osteopathic manipulative treatment slows or halts the deterioration of back-specific function in the third trimester of pregnancy.

Osteopathic manipulative treatment is a system of hands-on diagnosis and treatment that is used to reduce pain, restore range of motion and to restore normal function and balance in the body.

The Phase II randomized clinical trial of 144 subjects showed that women in the usual obstetric care+osteopathic manipulative treatment group reported less deterioration of back-specific function on the Roland-Morris Disability Scale than women in the usual obstetric care+sham ultrasound and the usual obstetric care only groups when these groups were compared using an intention-to-treat analysis. This study is the first randomized, placebo-controlled trial to explore the potential effects of osteopathic manipulative treatment during the third trimester of pregnancy.

In the study, conducted by The Osteopathic Research Center in conjunction with the Department of Obstetrics and Gynecology at the University of North Texas Health Science Center in Fort Worth, Texas, women were enrolled between the 28th and 30th week of pregnancy. After being randomized to one of the three treatment groups, the women in the usual obstetric care+osteopathic manipulative treatment and usual obstetric care+sham ultrasound groups received treatments immediately following each of their third trimester prenatal visits. Women were excluded or dropped from the study if they were determined to be at high risk by their obstetrician. The median age for women included in the study was 24 years.

Dr. Licicardone noted that outcomes were statistically significant relative to improved low back function in the OMT group. “The results also showed a trend toward pain reduction in the group that received OMT, but pain remained the same or increased in the other groups.”

Usual obstetric care was defined in this study as the conventional prenatal care received during pregnancy. Osteopathic manipulative treatment is generally considered a complementary treatment that is not included as part of routine prenatal care.

“This study is exciting because pregnant women frequently experience a negative impact on their ability to function and perform tasks related to daily living as their pregnancy progresses,” said Dr. Licciardone, the principal investigator for the project, and the executive director of The Osteopathic Research Center. “Since pregnant women are limited in the medications they can take for pain, osteopathic manipulative treatment offers a way to improve back function and decrease pain in the third trimester of pregnancy, when a majority of women experience these symptoms.”

“What is also interesting about this study is that osteopathic physicians (D.O.s) who provide obstetrical care can potentially include osteopathic manipulative treatment as part of their prenatal care for patients,” Licciardone said. “For more than 100 years, osteopathic physicians who have treated pregnant women using osteopathic manipulation have claimed that their patients have less pain, better function and improved delivery outcomes. This study may be the first step in confirming the clinical success of osteopathic physicians in this area of medicine.”

Dr. Licciardone added, “If osteopathic obstetricians view this study as the first step in developing a strong evidence base to support the use of OMT to improve back function and pain in the third trimester of pregnancy, this study could have a significant clinical impact on prenatal care, and it could have important economic implications for treating common back-related symptoms and functional disabilities in late pregnancy.”

Full text of the article is available online.

Surgeons Less Likely than Family Doctors to Prefer Back Surgery

2010-01-28T13:23:00.000-08:00

Surgeons are less likely than family physicians or patients to view surgery as the preferred treatment option for low back pain, according to a study in the January 1 issue of Spine. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, and pharmacy.

For patients with back pain, quality-of-life issues are the main factor affecting treatment preferences—which has important implications for shared decision-making between patients and their doctors, according to the new study led by Dr. S. Samuel Bederman at University of Toronto.

Family Doctors Have Highest Preferences for Surgery

The researchers presented hypothetical back pain scenarios to surgeons (orthopedic surgeons and neurosurgeons), family physicians, and patients with back and/or leg pain. The scenarios reflected key factors related to back pain: walking ability, pain duration, pain severity, neurological symptoms, factors inducing pain, and pain location. Each group rated their preference for surgery in each scenario, and the factors affecting preferences were analyzed.

Perhaps unexpectedly, surgeons had the lowest overall preferences for surgery, while family physicians had the highest preference for surgery. For orthopedic surgeons, the preference for surgery was somewhat lower than for neurosurgeons. Both the family doctors and patients had a higher preference for surgery than either group of surgeons.

The factors affecting preferences for surgery varied as well. For surgeons, the most important factor was the location of pain. In particular, they preferred surgery for patients with pain predominantly in the leg, rather than the back. Surgery provides better results in patients with problems affecting the spinal nerve roots, which tend to cause leg pain.

Revealing Differences in Reasons for Preferences

In contrast, for family physicians, the most important factor affecting preferences for surgery was neurological symptoms, followed closely by walking ability and pain severity. Family doctors may be unaware of which factors affect the chances of good outcomes from back surgery, the researchers suggest.

For patients, the most important factors were pain severity, walking ability, and pain duration. "All of these symptoms are highly related to quality of life and have little direct bearing on outcomes following surgery," Dr. Bederman and co-authors write.

When other treatments have failed, surgery can help patients with moderate to severe lower back pain. Family physicians play an important role in sending back pain patients for surgical evaluation. However, few studies looked at the factors considered by primary care doctors consider in referring patients for possible spinal surgery. The final decision is generally made through a shared process between the patient, family physician, and surgeon.

The new results suggest that, in various scenarios, surgeons have a lower preference for surgery than family physicians. In addition, the factors that surgeons feel are most important—especially the location of pain—don't match those considered most important by family doctors.

The study also highlights the importance of quality-of-life factors—especially pain severity and duration and walking ability—in affecting patients' treatment preferences. Dr. Bederman and colleagues hope their findings will help in "aligning" the opinions of patients and doctors, thus improving the shared decision-making process and promoting more accurate patient expectations of the results of surgery. "This can directly result in a significant improvement in patient satisfaction with the healthcare process and even overall health status following treatment," the researchers write.

About Spine

Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. According to the latest ISI Science Citation Impact Factor, Spine ranks highest among subspecialty orthopedic titles.

Long-term Opioid Use for Back Pain

2010-01-15T13:24:00.001-08:00

Despite limited evidence of long-term success in using opioid pain medications for chronic low back pain, opioid prescribing has increased in recent years for back pain and other non-cancer pain indications. The implications are controversial as published studies provide little evidence indicating which patients will benefit from long-term opioid treatment.

New research, published in The Journal of Pain, identifies predictors of long-term opioid use among patients with chronic back pain caused by lumbar spine conditions. Participants were recruited from 13 spine specialty centers in 11 states and totaled 2,110. Forty-two percent reported using opioids for pain from their spine condition and a third said they take opioids every day.

From their analysis of the demographic, medical and social characteristics of study participants, the researchers found that nonsurgical treatment and smoking independently predicted continued long-term opioid use and pain severity did not. The authors noted that smoking can be a marker for substance abuse disorders, which was not a characteristic evaluated in the sample due to limitations for measuring alcohol or drug use. Therefore, the researchers were unable to consider substance abuse as a predictor of long-term opioid use. However, the association with smoking could be interpreted as a surrogate predictor for substance abuse, given its strong link with smoking.

Regarding the nonsurgical predictor, the authors noted that risks associated with continued pain management with opioids in some patients may outweigh the risks of surgery. This might be a factor worth considering in surgical decision making for patients with herniated discs or stenosis, especially those with a history of substance abuse.

About the American Pain Society_Based in Glenview, Ill., the American Pain Society (APS) is a multidisciplinary community that brings together a diverse group of scientists, clinicians and other professionals to increase the knowledge of pain and transform public policy and clinical practice to reduce pain-related suffering.

APS was founded in 1978 with 510 charter members. From the outset, the group was conceived as a multidisciplinary organization. APS has enjoyed solid growth since its early days and today has approximately 3,200 members. The Board of Directors includes physicians, nurses, psychologists, basic scientists, pharmacists, policy analysts and more.

TENS Scores Zero

2010-01-02T07:37:00.000-08:00

Widely Used Device for Pain Therapy Not Recommended for Chronic Low Back Pain

A new guideline issued by the American Academy of Neurology finds that transcutaneous electric nerve stimulation (TENS), a widely used pain therapy involving a portable device, is not recommended to treat chronic low-back pain - pain that has persisted for three months or longer - because research shows it is not effective.

The guideline is published in the December 30, 2009, online issue of Neurology®, the medical journal of the American Academy of Neurology.

The guideline determined that TENS can be effective in treating diabetic nerve pain, also called diabetic neuropathy, but more and better research is needed to compare TENS to other treatments for this type of pain.

Research on TENS for chronic low-back pain has produced conflicting results. For the guideline, the authors reviewed all of the evidence for low-back pain lasting three months or longer. Acute low-back pain was not studied. The studies to date show that TENS does not help with chronic low-back pain.

All but one of the studies excluded people with known causes of low-back pain, such as a pinched nerve, severe scoliosis (curving of the spine), severe spondylolisthesis (displacement of a backbone or vertebra) or obesity. In the one study that looked at low-back pain associated with known conditions, TENS was not shown to be effective. The only specific neurologic cause of chronic low-back pain where TENS was studied was multiple sclerosis, and TENS was not shown to help.

"The strongest evidence showed that there is no benefit for people using TENS for chronic low-back pain," said guideline author Richard M. Dubinsky, MD, MPH, of Kansas University Medical Center in Kansas City and a Fellow of the American Academy of Neurology. "Doctors should use clinical judgment regarding TENS use for chronic low-back pain. People who are currently using TENS for their low-back pain should discuss these findings with their doctors."

Dubinsky stated further that good evidence showed that TENS can be effective in treating diabetic nerve pain.

With TENS, a portable, pocket-sized unit applies a mild electrical current to the nerves through electrodes. TENS has been used for pain relief in various disorders for years. Researchers do not know how TENS may provide relief for pain. One theory is that nerves can only carry one signal at a time. The TENS stimulation may confuse the brain and block the real pain signal from getting through.

Back pain -- both acute and chronic -- is the second most common neurologic ailment in the United States, according to the National Institute of Neurological Disorders and Stroke, and is the most common cause of job-related disability. About 60 percent of people with diabetes will develop neuropathy.

Manipulation Improves Late Pregnancy Back Function

2009-09-25T13:52:00.000-07:00

A study published by the American Journal of Obstetrics and Gynecology, demonstrates that osteopathic manipulative treatment slows or halts the deterioration of back-specific function in the third trimester of pregnancy.

The Phase II randomized clinical trial of 144 subjects showed that women in the usual obstetric care and osteopathic manipulative treatment group reported less deterioration of back-specific function on the Roland-Morris Disability Scale than women in the usual obstetric care and sham ultrasound and the usual obstetric care only groups when these groups were compared using an intention-to-treat analysis. This study is the first randomized, placebo-controlled trial to explore the potential effects of osteopathic manipulative treatment during the third trimester of pregnancy.

In the study, conducted by The Osteopathic Research Center in conjunction with the Department of Obstetrics and Gynecology at the University of North Texas Health Science Center in Fort Worth, Texas, women were enrolled between the 28th and 30th week of pregnancy. After being randomized to one of the three treatment groups, the women in the usual obstetric care and osteopathic manipulative treatment and usual obstetric care and sham ultrasound groups received treatments immediately following each of their third trimester prenatal visits. Women were excluded from or dropped from the study if they were determined to be at high risk by their obstetrician. The median age for women included in the study was 24 years.

Usual obstetric care was defined in this study as the conventional prenatal care received during pregnancy. Osteopathic manipulative treatment is generally considered a complementary treatment that is not included as part of routine prenatal care.
Osteopathic manipulative treatment is a system of hands-on diagnosis and treatment that is used to reduce pain, restore range of motion and to restore normal function and balance in the body.

“This study is exciting because pregnant women frequently experience a negative impact on their ability to function and perform tasks related to daily living as their pregnancy progresses,” said John Licciardone, D.O., M.S., M.B.A., the principal investigator for the project, and the executive director of The Osteopathic Research Center. “Since pregnant women are limited in the medications they can take for pain, osteopathic manipulative treatment offers a way to improve back function and decrease pain in the third trimester of pregnancy, when a majority of women experience these symptoms.”

“What is also interesting about this study is that osteopathic physicians (D.O.s) who provide obstetrical care can potentially include osteopathic manipulative treatment as part of their prenatal care for patients,” Licciardone said. “For more than 100 years, osteopathic physicians who have treated pregnant women using osteopathic manipulation have claimed that their patients have less pain, better function and improved delivery outcomes. This study may be the first step in confirming the clinical success of osteopathic physicians in this area of medicine.”

Full text of the article is available online at http://www.ajog.org/inpress.

New Guideline for Low-Back Pain Interventions, Surgery

2009-05-13T12:55:00.001-07:00

The American Pain Society (APS) has issued a new clinical practice guideline for low back pain that emphasizes the use of noninvasive treatments over interventional procedures, as well as shared decision making between provider and patient. The findings are published in the current (May 1, 2009) issue of the journal Spine.

The new APS guideline, based on an extensive review of existing research, provides clinicians with eight recommendations to help determine the best way to treat patients with low-back pain. It also expands its current and previously published guideline for initial evaluation and management of this chronic condition.

“These recommendations are based on an even more complete body of evidence than was available just a few years ago. Consequently, we believe these recommendations will give physicians more confidence when treating patients with persistent back pain,” said Roger Chou, M.D., lead author, director of the APS Clinical Practice Guideline Program, and associate professor of medicine (general internal medicine), Oregon Evidence-based Practice Center, Oregon Health & Science University.

“Unfortunately, randomized trials for a number of commonly used interventional procedures are still too limited to generate evidence-based recommendations, and our review also highlights the need for more research,” Chou added.

Low-back pain is the fifth most common reason for doctor’s visits and accounts for more than $26 billion in direct health care costs nationwide each year. While a number of interventional diagnostic tests and therapies, and surgery are available, and their use is increasing, in some cases their usefulness remains uncertain.

“We have advocated strongly in many of our recommendations for physicians to use shared decision making because of the relatively close trade-offs between potential benefits relative to harms, as well as costs and burdens of these various treatment options,” Chou explained. Shared decision making involves a patient’s full participation in medical choices after receiving comprehensive information about the impact of all options on his or her particular life situation.

To develop the guideline, a multidisciplinary APS panel, augmented by experts on interventional therapies, reviewed 3,348 abstracts and analyzed 161 relevant clinical trials. The panel found that the evidence for the use of these interventions was mixed, sparse or not available. Based on the data the panel gathered, the APS now recommends:

1. Against the use of provocative discography (injection of fluid into the disc in order to determine if it is the source of back pain) for patients with chronic nonradicular low-back pain.

2. The consideration of intensive interdisciplinary rehabilitation with a cognitive/behavioral emphasis for patients with nonradicular low-back pain who do not respond to usual, non-interdisciplinary therapies.

3. Against facet joint corticosteroid injection, prolotherapy, and intradiscal corticosteroid injections for patients with persistent nonradicular low-back pain, and insufficient evidence to guide use of other interventional therapies.

4. A discussion of risks and benefits of surgery and the use of shared decision making with reference to rehabilitation as a similarly effective option for patients with nonradicular low-back pain, common degenerative spinal changes, and persistent and disabling symptoms.

5. Insufficient evidence to guide recommendations for vertebral disc replacement.

6. A discussion of the risks and benefits of epidural steroid injections and shared decision making, including specific review of evidence of lack of long-term benefit for patients with persistent radiculopathy due to herniated lumbar disc.

7. A discussion of the risks and benefits of surgery and use of shared decision making that references moderate benefits that decrease over time for patients with persistent and disabling radiculopathy due to herniated lumbar disc or persistent and disabling leg pain.

8. Discussion of risks and benefits of spinal cord stimulation and shared decision making, including reference to the high rate of complications following stimulator placement for patients with persistent and disabling radicular pain following surgery for herniated disc and no evidence of a persistently compressed nerve root.

Chou and his colleagues also reaffirm their previous recommendation that all low-back pain patients stay active and talk honestly with their physicians about self care and other interventions. “In general, noninvasive therapies supported by evidence showing benefits should be tried before considering interventional therapies or surgery,” said Chou.

Recommendations from the first APS Clinical Practice Guideline on Low-Back Pain are intended for primary care physicians and appeared in the Oct, 2, 2007, issue of the Annals of Internal Medicine. For diagnosis, the first APS low-back pain guideline advises clinicians to minimize routine use of X-rays or other diagnostic tests except for patients known or believed to have underlying neurological or spinal disorders

About the American Pain Society

Based in Glenview, Ill., the American Pain Society (APS) is a multidisciplinary community that brings together a diverse group of scientists, clinicians and other professionals to increase the knowledge of pain and transform public policy and clinical practice to reduce pain-related suffering.APS was founded in 1978 with 510 charter members. From the outset, the group was conceived as a multidisciplinary organization. APS has enjoyed solid growth since its early days and today has approximately 3,200 members. The Board of Directors includes physicians, nurses, psychologists, basic scientists, pharmacists, policy analysts and more.

Scans for low-back pain do not improve outcomes

2009-02-07T10:35:00.001-08:00

OHSU researchers find regular MRI, CT, radiography scans unnecessary unless a significant underlying condition is first identified

Physicians should not immediately order routine scans for low-back pain unless they observe features of a serious underlying condition, researchers in the Oregon Evidence-Based Practice Center at Oregon Health & Science University report. Their findings are published in this week's edition of the The Lancet.

The regular use of radiography, MRI or CT scans in patients with low-back pain but no indication of a significant underlying condition does not improve their outcome, the researchers report.

"Our study shows that performing routine X-rays or MRIs for patients with low-back pain does not lead to improved pain, function or anxiety level, and there were even some trends toward worse outcomes," said Roger Chou, M.D., lead author; scientific director of the Oregon Evidence-Based Practice Center at OHSU; and associate professor of medical informatics and clinical epidemiology, and medicine (general internal medicine and geriatrics) in the OHSU School of Medicine.

"Clinicians may think they are helping patients by doing routine X-rays or MRIs, but these diagnostic tests increase medical costs, can result in unnecessary surgeries or other invasive procedures, and may cause patients to stop being active — probably the best thing for back health — because they are worried about common findings such as degenerated discs or arthritis, not understanding that these are very weakly associated with back pain."

To reach this conclusion, Chou and colleagues conducted a meta-analysis of randomized controlled trials that compared immediate back imaging — using one of the three scanning types above — with usual clinical care that does not involve immediate imaging. Six trials covering more than 1,800 patients were included, reporting a range of outcomes including pain and function, quality of life, mental health, overall patient-reported improvement, and patient satisfaction.

The analysis found no significant differences between immediate imaging and usual clinical care. The authors say that the results are most applicable to acute or sub-acute low-back pain of the type assessed in a primary care setting with the patient's family doctor.

The authors report that lumbar imaging for low-back pain without indications of serious underlying conditions does not improve clinical outcomes. Therefore, clinicians should refrain from routine, immediate lumbar imaging in patients with acute or subacute low-back pain and without features suggesting a serious underlying condition.

They added: "Rates of utilization of lumbar MRI are increasing, and implementation of diagnostic-imaging guidelines for low-back pain remains a challenge. However, clinicians are more likely to adhere to guideline recommendations about lumbar imaging now that these are supported by consistent evidence from higher-quality randomized controlled trials."

Patient expectations and preferences about imaging should also be addressed, because 80 percent of patients with low-back pain in one trial would undergo radiography if given the choice, despite no benefits with routine imaging, the reporters report. They indicated educational interventions for reducing the proportion of patients with low-back pain who believe that routine imaging should be done.

Other investigators who participated in this study include: Rick Deyo, M.D., M.P.H., Kaiser Permanente Professor of Evidence-Based Family Medicine, OHSU School of Medicine, Oregon Evidence-Based Practice Center; and Rochelle Fu, Ph.D., assistant professor of public health and preventive medicine, OHSU School of Medicine.

In an accompanying comment, Michael M. Kochen, Department of General Practice, University of Göttingen, Germany, and colleagues discuss how certain factors could hamper doctors changing practice to avoid immediate imaging, "such as patients' expectations about diagnostic testing, reimbursement structures providing financial incentives, or the fear of missing relevant pathology." They conclude: "Meanwhile a promising approach seems to be the way of educating patients in and outside general practitioners surgeries."

Back pain: Are we treating it right?

2008-12-16T14:35:00.000-08:00

A new study by researchers at The George Institute for International Health has found that back pain is a reoccurring problem for five million Australians.

According to lead author, Professor Chris Maher, Director of Musculoskeletal Research at The George Institute, "After an episode of back pain resolves, one in four people will experience a recurrence within one year. This explains why around 25% of the Australian population suffers from back pain at any one time."

Low back pain is the most prevalent and costly musculoskeletal condition in Australia(1), estimated to cost up to $1billion per annum with indirect costs exceeding $8billion(2). It is also the most common health condition causing older Australians to be absent from the labour force.(3)

According to Professor Maher, patients and clinicians need to shift their focus to prevention. "We tend to treat the pain when it's there, but when you recover, patients rarely take steps to prevent the problem from returning. People understand the message about lifting correctly but heavy lifting is only one of the risk factors for developing back pain. What many people do not understand is that some of the risk factors for back pain are also the risk factors for other chronic diseases like heart disease. My advice is that people should take a similar approach to back health, as they do for heart health – eating right, exercise and a healthy lifestyle is definitely good for your heart, and also your spine," he added.

"Good, previous research has shown participation in an exercise program after the original episode of low back pain is highly effective in preventing recurrence. Those in the exercise group had half the rate of recurrence of the control group. Other studies have indicated that strengthening muscles and developing fitness show some benefit in avoiding recurring back pain. Mental stress also increases the risk of back pain so including stress management in a health promotion approach would be a sensible way to reduce your chances of back pain. Just paying attention to lifting correctly is probably not enough, a holistic approach is really best."

Lug Your Luggage Safely

2008-12-11T13:24:00.001-08:00

Seasoned travelers have a saying – “Pack your bags, then take out half.” This refers to the fact that most of us bring much more than we need on our trips. Now, even more travelers are echoing that line, especially, since so many airline providers are charging passengers a fee for checking luggage. However, if you are one of those people who cannot decide which half to leave at home, the American Academy of Orthopaedic Surgeons (AAOS) has recommendations to help you carry your baggage safely.
According to the U.S. Consumer Products Safety Commission:_•In 2007, more than 50,000 people were treated in hospital emergency rooms, doctors’ offices, clinics and other medical settings for injuries related to luggage.
Packing light may prevent injuries such as:_• Strains, pulls and tears _o Any of these can occur while carrying a heavy suitcase for an extended period of time. _o Lifting and holding a bag incorrectly or lifting luggage from baggage claim carousels, overhead or under-seat compartments._• The chances of these injuries are even greater when a person has been sitting still for a long period of time (as when on a plane) or when the luggage is over-packed and especially heavy.
“Using proper lifting techniques can ensure that your trip isn’t cut short by an injury,” says William R. Marshall, MD, a spokesperson for the AAOS and orthopaedic surgeon in Fort Walton Beach, Florida. “Even a relatively minor injury, such as a muscle pull, to the back, neck or shoulders can be quite painful in the short term and end up ruining your vacation.”
The Academy offers the following strategies to prevent injuries when lifting and carrying luggage:_• Pack lightly. When possible, pack items in a few smaller bags instead of one large luggage piece. It is better – and may prevent muscle sprains and strains – to carry a lighter bag in each hand rather than one heavy bag in one hand or over one shoulder.
• As with any heavy lifting, you should bend at the knees and lift luggage with your leg muscles—not your back and waist—and avoid twisting and rotating your spine. Stand alongside your suitcase, bend at your knees, then grasp the handle and straighten up. Also, try to carry luggage as close to your body as possible.
• When placing luggage in an overhead compartment, first lift it onto the top of the seat. Then, with the hands situated on the left and right sides of the suitcase, lift it up. If your luggage has wheels, make sure the wheel-side is set in the compartment first. Once wheels are inside, put one hand atop the luggage and push it to the back of the compartment. To remove the luggage, reverse this process.
• If using a backpack, make sure it has two padded and adjustable shoulder straps. Choose one with several compartments to secure various-sized items, packing the heavier things low and towards the center. Always wear a backpack on both shoulders--slinging it over one shoulder does not allow weight to be distributed evenly, which can cause muscle strain.
• If you need to use a duffel or shoulder bag, do not carry it on one shoulder for any length of time. Be sure to switch sides often, as this may prevent soreness and discomfort to the shoulder area.
Other important tips:_• When purchasing new luggage, look for a sturdy, light pieces with wheels and a handle. Avoid purchasing luggage that is too heavy or bulky while empty.
• Do not rush when lifting or carrying a suitcase. If it is too heavy or an awkward shape, ask someone for help.
• Do not carry heavy pieces of luggage for long periods of time. If it is very heavy, and you must carry it, stop and take a break. If at all possible, check your luggage when traveling rather than carrying it on a plane, train or bus.
• Make sure to carry all rolling luggage up flights of stairs.

Preventing Back Pain

2008-12-11T13:23:00.002-08:00

One of the best things you can do to prevent and/or eliminate back pain is to exercise. Both an inactive lifestyle and being overweight contribute to back pain. Exercise benefits you in so many ways, such as lowering blood pressure, helping you maintain a healthy weight, lowering your risk for diabetes, and the list goes on!

Orthotics can help you maintain a healthy spine through the use of spinal pelvic stabilizers. Devices that you wear in your shoes, stabilizers align all three arches of your foot to provide a balanced foundation for your spine and body.

It is estimated that 80 percent of people will experience back pain at some time in their life. Since your back is a complicated structure of bones, joints, muscles, and ligaments, there are many different factors that can play a part in your back pain. It is possible to irritate joints, sprain ligaments, or strain muscles in your back -- which can all cause pain. Poor posture, obesity, and psychological stress can also lead to or worsen back pain. One thing you may not know is that along with chiropractic care, exercise can help prevent back pain.

Doctors of chiropractic (DCs) can help reduce, eliminate, and prevent back pain. Using their hands, they manually adjust the joints and tissue in your back to restore joint mobility, relieving pain and muscle tightness. Maintaining a healthy spine will help keep you healthier overall by keeping your spine free of misalignments that could interfere with your nervous system, the center for all your mental activity. DCs can also provide you with dietary, nutritional, and lifestyle counseling.

Take More Breaks to Avoid Back Injury at Work

2008-12-11T13:23:00.001-08:00

Take More Breaks to Avoid Back Injury at Work, Study Says
Workers who lift for a living need to take longer or more frequent breaks than they now do to avoid back injury, according to a new study at Ohio State University.
The study also suggests that people who are new on the job need to take breaks even more often than experienced workers, and that the risk of injury is higher at the end of a work shift.
People who participated in the study lifted boxes onto conveyor belts for eight hours, while researchers measured the amount of oxygen that was reaching the muscles in their lower back.
The oxygen level indicated how hard the muscles were working, and whether they were becoming fatigued, explained William Marras, professor of industrial welding and systems engineering at Ohio State. His research and others' has shown that muscle fatigue is linked to back injury.
The study, which appeared in a recent issue of the journal Clinical Biomechanics, is the first to examine what happens to muscle oxygenation over a full workday.
Despite the fact that the study participants were performing the same job at the same pace all day, their back muscles needed more oxygen as the day went on. Taking a half-hour lunch break helped their muscles recover from the morning's exertion, but once they started working again, their oxygen needs rose steeply and kept climbing throughout the afternoon.
"That was alarming to us, because it means that their muscles were becoming fatigued much faster during the afternoon, and we know that fatigue increases the risk of back injury," Marras said.
Two 15-minute breaks, one mid-morning and the other mid-afternoon, helped muscles recover a little, but not as much as the half-hour lunch.
"This tells us two things," Marras said. "First, rest is good -- a half-hour break does a good job of helping muscles recover. But it also tells us that people are especially at risk for back injury at the end of the day, and the only way to counteract that effect is with more breaks as the day goes on."

Expanded Musculoskeletal Care During Pregnancy

2008-12-11T13:22:00.000-08:00

Women Need Expanded Musculoskeletal Care During Pregnancy, Study Finds

Despite the high prevalence of musculoskeletal pain during pregnancy, few women in underserved populations receive treatment for their low back pain. Moreover, researchers found that pain in a previous pregnancy may predict a high risk for musculoskeletal complaints in future pregnancies. 85 percent of women who experienced pain in a previous pregnancy reported pain during their current pregnancy.
According to Clayton Skaggs, DC, the study’s chief author, 85 percent of women surveyed reported that they had not received treatment for their musculoskeletal pain, and of the small percentage who perceived that their back complaints were addressed, less than 10 percent were satisfied with the symptom relief they obtained.
“Based on the findings of this study, doctors of chiropractic and other health care professionals need to expand the musculoskeletal care available during pregnancy, especially in underserved populations,” Dr. Skaggs said. “As a proactive step, health professionals should consider including back pain screening as part of early obstetrical care to help identify musculoskeletal risk factors and allow for early education and/or treatment.”
The study findings suggest that pregnant women with back pain are predisposed to sleep disturbances. In the survey, close to 80 percent of women reporting sleep disturbances had back pain, whereas only 8 percent of women without pain reported problems sleeping. More alarming was the significant relationship between reports of musculoskeletal pain and the use of pain medication.

38% adults: complementary and alternative medicine

2008-12-11T13:20:00.000-08:00

Government survey shows 38 percent of adults and 12 percent of children use complementary and alternative medicine

Approximately 38 percent of adults in the United States aged 18 years and over and nearly 12 percent of U.S. children aged 17 years and under use some form of complementary and alternative medicine (CAM), according to a new nationwide government survey.* This survey marks the first time questions were included on children's use of CAM, which is a group of diverse medical and health care systems, practices, and products such as herbal supplements, meditation, chiropractic, and acupuncture that are not generally considered to be part of conventional medicine.

The survey, conducted as part of the 2007 National Health Interview Survey (NHIS), an annual study in which tens of thousands of Americans are interviewed about their health- and illness-related experiences, was developed by the National Center for Complementary and Alternative Medicine (NCCAM), a part of the National Institutes of Health (NIH) and the National Center for Health Statistics (NCHS), a part of the Centers for Disease Control and Prevention (CDC). The survey included questions on 36 types of CAM therapies commonly used in the United States—10 types of provider-based therapies, such as acupuncture and chiropractic, and 26 other therapies that do not require a provider, such as herbal supplements and meditation.

"The 2007 NHIS provides the most current, comprehensive, and reliable source of information on Americans' use of CAM," said Josephine P. Briggs, M.D., director of NCCAM. "These statistics confirm that CAM practices are a frequently used component of Americans' health care regimens, and reinforce the need for rigorous research to study the safety and effectiveness of these therapies. The data also point out the need for patients and health care providers to openly discuss CAM use to ensure safe and coordinated care."

The 2007 survey results, released in a National Health Statistics Report by NCHS, are based on data from more than 23,300 interviews with American adults and more than 9,400 interviews with adults on behalf a child in their household. The 2007 survey is the second conducted by NCCAM and NCHS—the first was done as part of the 2002 NHIS.**

CAM Use Among Adults

Comparison of the data from the 2002 and 2007 surveys suggests that overall use of CAM among adults has remained relatively steady—36 percent in 2002 and 38 percent in 2007. However, there has been substantial variation in the use of some specific CAM therapies, such as deep breathing, meditation, massage therapy, and yoga, which all showed significant increases.

The most commonly used CAM therapies among U.S. adults were

Nonvitamin, nonmineral, natural products (17.7 percent) Most common: fish oil/omega 3/DHA, glucosamine, echinacea, flaxseed oil or pills, and ginseng***
Deep breathing exercises (12.7 percent)
Meditation (9.4 percent)
Chiropractic or osteopathic manipulation (8.6 percent)
Massage (8.3 percent)
Yoga (6.1 percent).
Adults used CAM most often to treat pain including back pain or problems, neck pain or problems, joint pain or stiffness/other joint condition, arthritis, and other musculoskeletal conditions. Adult use of CAM therapies for head or chest colds showed a marked decrease from 2002 to 2007 (9.5 percent in 2002 to 2.0 percent in 2007).

Consistent with results from the 2002 data, in 2007 CAM use among adults was greater among:.

Women (42.8 percent, compared to men 33.5 percent)
Those aged 30-69 (30-39 years: 39.6 percent, 40-49 years: 40.1 percent, 50-59 years: 44.1 percent, 60-69 years: 41.0 percent)
Those with higher levels of education (Masters, doctorate or professional: 55.4 percent)
Those who were not poor (poor: 28.9 percent, near poor: 30.9 percent, not poor: 43.3 percent)
Those living in the West (44.6 percent)
Those who have quit smoking (48.1 percent)
CAM Use Among Children

Overall, CAM use among children is nearly 12 percent, or about 1 in 9 children. Children are five times more likely to use CAM if a parent or other relative uses CAM. Other characteristics of adult and child CAM users are similar—factors such as socioeconomic status, geographic region, the number of health conditions, the number of doctor visits in the last 12 months, and delaying or not receiving conventional care because of cost are all associated with CAM use.

Among children who used CAM in the past 12 months, CAM therapies were used most often for back or neck pain, head or chest colds, anxiety or stress, other musculoskeletal problems, and Attention Deficit/Hyperactivity Disorder (ADD/ADHD).

The most commonly used CAM therapies among children were

Nonvitamin, nonmineral, natural products (3.9 percent) Most common: echinacea, fish oil/omega 3/DHA, combination herb pill, flaxseed oil or pills, and prebiotics or probiotics
Chiropractic or osteopathic manipulation (2.8 percent)
Deep breathing exercises (2.2 percent)
Yoga (2.1 percent).
"The survey results provide information on trends and a rich set of data for investigating who in America is using CAM, the practices they use, and why," said Richard L. Nahin, Ph.D., MPH, acting director of NCCAM's Division of Extramural Research and co-author of the National Health Statistics Report. "Future analyses of these data may help explain some of the observed variation in the use of individual CAM therapies and provide greater insights into CAM use patterns among Americans."

Low back pain recovery slow

2008-07-08T13:34:00.000-07:00

Low back pain recovery slow; and worse for those on compensation

Contrary to current guidelines and common belief, new research published in The British Medical Journal has shown that recovery from low back pain is much slower than previously thought and even slower again for those with a compensable injury.

Australian researchers at The George Institute for International Health proved that prognosis from acute (or recent) lower back pain is not as favourable as claimed in clinical practice guidelines and challenges the common belief that 90% of patients recover within four to six weeks, with our without treatment.

"These are extremely important results because they confirm that low back pain is a significant health problem and that there is substantial room for improvement in its management," said Professor Maher. "We found that recovery from low back pain was typically much slower than previously reported - nearly one third of patients did not recover from the original episode within a year."

Professor Chris Maher, The George Institute, Australia and colleagues studied 973 patients with acute low back pain for one year. Each was managed by their preferred clinician; a doctor, physiotherapist or chiropractor, who followed treatment guidelines established by Australia's National Health and Medical Research Council (NHMRC).

These new findings show that even with treatment, after two months only 50% had fully recovered from the original episode of pain. At one year about 40% reported that their back was still causing them pain.

"These results challenge the accepted view that recovery is rapid following an episode of acute low back pain. For many people back pain becomes a long-term problem that severely impacts their life. This is despite receiving what we think is the best possible care. We clearly need to rethink our approach," Professor Maher added.

The strongest predictor of delayed recovery was if the episode of low back pain was compensable: compensation halved the chances of recovery.

"The results also highlight that we should review our compensation system because people within this system do much worse than those outside of it."

In 2005 the additional health care expenditure due to spine problems was estimated to be US$86 billion or 9% of USA health expenditure .

New Low Back Pain Guideline

2008-05-08T13:57:00.000-07:00

For low-back pain patients and their doctors, the American Pain Society, www.ampainsoc.org, said today it is expanding its evidence-based, clinical practice guideline on diagnosis and treatment of chronic low back pain to include recommendations on surgery and other interventional treatments. The expanded guideline was previewed today in a symposium at the APS Annual Scientific Meeting.

The second part of the APS guideline is based on a multidisciplinary panel’s review and analysis of volumes of evidence related to diagnosis and treatment of low-back pain with a number of interventional procedures and surgeries, according to Roger Chou, MD, director of the American Pain Society’s Clinical Practice Guideline Program and associate professor of internal medicine, Oregon Health & Science University.

Chou noted that in addition to the multidisciplinary panel that formulated the guideline for evaluation and management of low back pain in primary care settings, additional experts with expertise on interventional therapies and surgeries for low back pain were recruited to review the evidence and formulate the expanded recommendations.

"Prior to finalizing the guideline, APS conducts extensive peer review, and has sent the guideline to more than 20 experts in surgery, interventional pain medicine, primary care, and other disciplines for comments and feedback," Chou said.

Low-back pain is the fifth most common reason for doctor’s office visits and one in four adults report having it last a least a day. Annually, low-back pain is estimated to account for more than $26 billion in direct health care costs in the U.S.

“The evidence is much better than even five or 10 years ago and both the primary care and interventional recommendations will help physicians be more confident when evaluating possible therapies for low back pain,” said Chou. “As always, physicians and patients should discuss possible options proven by the evidence and choose the ones that make sense for their situation," he added.

During the symposium, Chou and two panel co-chairs, Richard Rosenquist, MD, assistant professor of anesthesiology, University of Iowa, and John Loeser, MD, professor, Department of Neurological Surgery, University of Washington, reported that for many interventional procedures the evidence from randomized controlled trials is mixed, sparse, not available or showed no benefits. Accordingly, the expanded, evidence-based APS guideline will report:

* Invasive diagnostics, such as provocative discography, facet joint block and sacroliliac joint block tests, have not been proven to be accurate for diagnosing various spinal conditions, and their ability to effectively guide therapeutic choices and improve ultimate patient outcomes is uncertain.

* Epidural stenois injections are an option for short-term pain relief for persistent radiculopathy (radiating low back pain caused by a herniated disc). Other interventional therapies, such as local injections, prolotherapy, botulinum toxin (botox) injection, facet joint injection, sacroliliac joint injection, radiofrequency denervation and intradiscal electrothermal therapy are not supported by convincing, consistent evidence of benefits from randomized trials.

* Surgery to treat radiculopathy and spinal stenosis is effective, though the benefits diminish over time.

* Effectiveness of surgery for non-radicular low back pain is less certain, with some studies showing no benefits compared to intensive interdisciplinary rehabilitation. In addition, a significant proportion of patients experience suboptimal outcomes including persistent pain or functional deficits following surgery.

The expert panel reaffirms its previous recommendation that all low-back pain patients stay active and talk honestly with their physicians about self care and other interventions. “In general, non-invasive therapies supported by evidence showing benefits should be tried before considering interventional therapies or surgery,” said Chou.

Recommendations from the first APS Clinical Practice Guideline on Low Back Pain were intended for primary care physicians and appeared in the Oct, 2, 2007 issue of the Annals of Internal Medicine. For diagnosis, the first APS low-back pain guideline advises clinicians to minimize routine use of x-rays or other diagnostic tests except for patients known or believed to have underlying neurological or spinal disorders.

In addressing treatment options, it recommended that medications used should be appropriate for the severity of baseline pain and functional impairment, and clinicians should weigh carefully potential benefits and risks of any drug and explain them. Also for various non-pharmacological treatments supported by the evidence, from spinal manipulation to massage therapy, the first guideline panel recommended they be considered for patients who do not improve with self-care options and prefer not to take pain medications.

About the American Pain Society
Based in Glenview, Ill., the American Pain Society (APS) is a multidisciplinary community that brings together a diverse group of scientists, clinicians and other professionals to increase the knowledge of pain and transform public policy and clinical practice to reduce pain-related suffering.

Neck pain study sheds light on best care

2008-02-15T13:35:00.001-08:00

A seven-year, international study published today finds that some alternative therapies such as acupuncture, neck manipulation and massage are better choices for managing most common neck pain than many current practices. Also included in the short-list of best options for relief are exercises, education, neck mobilization, low level laser therapy and pain relievers.

Therapies such as neck collars and ultrasound are not recommended. The study found that corticosteroid injections and surgery should only be considered if there is associated pain, weakness or numbness in the arm, fracture or serious disease.

The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders 236 page review of the current research on neck pain is published in the journal Spine. The multi-national and inter-disciplinary study team included Canadian, American, South American, Australasian and European researchers. The Task Force was created to help neck pain sufferers and health professionals use the best research evidence to prevent, diagnose and manage neck pain.

"Neck pain is not a trivial condition for many people," says Task Force president Dr. Scott Haldeman, clinical professor, department of neurology at the University of California, Irvine; and adjunct professor, department of epidemiology University of California Los Angeles. "It can be associated with headaches, arm and upper back pain and depression. Whether it arises from sports injuries, car collisions, workplace issues or stress, it can be incapacitating. Understanding the best way to diagnose and manage this problem is of high importance for those who are suffering and for those who manage and pay for its care."

The study found that neck pain is a widespread experience that is a persistent and recurrent condition for the majority of sufferers. It is disabling for approximately two out of every 20 people who experience neck pain and affects their ability to carry on with daily activities says the Task Force.

A key recommendation of the Task Force is that neck pain, including whiplash-related pain, be classified and treated in a common system of 4 grades:

Grade 1: neck pain with little or no interference with daily activities
Grade 2: neck pain that limits daily activities
Grade 3: neck pain accompanied by radiculopathy ("pinched nerve" -- pain weakness and/or numbness in the arm)
Grade 4: neck pain with serious pathology, such as tumor, fracture, infection, or systemic disease.

"The majority of neck pain falls into Grades 1 or 2," says Task Force member, Dr. Linda Carroll, Associate Professor, School of Public Health at the University of Alberta, and Associated Scientist, Alberta Centre for Injury Control and Research (ACICR). "Many sufferers manage to carry on with their daily activities. Others find their pain interferes with their ability to carry out daily chores, participate in favorite activities or be effective at work. For these people, the evidence shows there are a relatively small number of therapies that provide some relief for a while, but there is no one best option for everyone."

In addition to its comprehensive review of the existing body of research on neck pain, the Task Force also initiated a new study into the association between chiropractic care of the neck and stroke. This innovative piece of research found that patients who visit a chiropractor are no more likely to experience a stroke than are patients who visit their family physician. The study concludes that this type of stroke commonly begins with neck pain and/or headache which causes the patient to seek care from their chiropractor or family physician before the stroke fully develops.

"This type of stroke is extremely rare and has been known to occur spontaneously or after ordinary neck movements such as looking up at the sky or shoulder-checking when backing up a car," noted the study's lead author, Dr. David Cassidy, professor of epidemiology at the University of Toronto and senior scientist at the University Health Network at Toronto Western Hospital.

For the minority of neck pain sufferers who experience Grade 3 neck pain -- that is neck pain accompanied by pain, weakness and/or numbness in the arm, also referred to as a "pinched nerve", corticosteroid injections may provide temporary relief says the study. Surgery is a last resort according to the findings and should only be considered if accompanying arm pain is persistent or if the person is experiencing Grade 4 pain due to serious injury or systemic disease.

Top findings for neck pain suffers:

Stay as active as you can, exercise and reduce mental stress.
Don't expect to find a single "cause" for your neck pain.
Be cautious of treatments that make "big" claims for relief of neck pain.
Trying a variety of therapies or combinations of therapies may be needed to find relief -- see the therapies for which the Task Force found evidence of benefits.
Once you have experienced neck pain, it may come back or remain persistent.
Lengthy treatment is not associated with greater improvements; you should see improvement after 2-4 weeks, if the treatment is the right one for you.
There is relatively little research on what does or does not prevent neck pain; ergonomics, cervical pillows, postural improvements etc. may or may not help.
"This is an important body of research that will help to improve the quality of patient care by incorporating the best evidence into practice and patient education," says Dr. Carroll. "Neck pain can be a stubborn problem -- we hope this comprehensive analysis of the evidence will help both sufferers and health care providers better manage this widespread complaint."

Acupuncture for lower back pain?

2007-09-26T04:35:00.000-07:00

Acupuncture treatment may be more effective than conventional therapy in treating lower back pain

Six months of acupuncture treatment appears to be more effective than conventional therapy in treating low back pain, according to a study in the Sept. 24 issue of Archives of Internal Medicine, one of the JAMA/Archives journals, although the study suggests that both sham acupuncture and traditional Chinese verum acupuncture appear to be effective in treating low back pain.

“Low back pain is a common, impairing and disabling condition, often long-term, with an estimated lifetime prevalence of 70 percent to 85 percent,” the authors write as background information in the article. “It is the second most common pain for which physician treatment is sought and a major reason for absenteeism and disability.” Acupuncture is increasingly used as an alternative therapy, but its value as a treatment for low back pain is still controversial.

Michael Haake, Ph.D., M.D., of the University of Regensburg, Bad Abbach, Germany, and colleagues conducted a randomized clinical trial involving 1,162 patients (average age 50) who had experienced chronic low back pain for an average of eight years. Patients underwent ten 30-minute sessions (approximately two sessions per week) of verum acupuncture (387 patients), sham acupuncture (387 patients) or conventional therapy (388 patients). Verum acupunture consisted of needling fixed points and additional points to a depth of 5 millimeters to 40 millimeters based on traditional Chinese medicine, while sham acupuncture consisted of inserting needles superficially (1 millimeter to 3 millimeters) into the lower back avoiding all known verum points or meridians. Conventional therapy consisted of a combination of medication, physical therapy and exercise. Five additional sessions were offered to those who had a partial response to treatment (10 percent to 50 percent pain reduction).

“A total of 13,475 treatment sessions were conducted (verum acupuncture, 4,821; sham acupuncture, 4,590; conventional therapy, 4,064),” the authors write. Patients receiving the additional five sessions were 232 (59.9 percent) in the verum group, 209 (54.3 percent) in the sham group and 192 (52.5 percent) in the conventional group.

Response rate was defined as a 33 percent improvement in pain or a 12 percent improvement in functional ability. “At six months, response rate was 47.6 percent in the verum acupuncture group, 44.2 percent in the sham acupuncture group and 27.4 percent in the conventional therapy group,” the authors note. “Differences among groups were as follows: verum vs. sham, 3.4 percent; verum vs. conventional therapy, 20.2 percent; and sham vs. conventional therapy, 16.8 percent.”

“The superiority of both forms of acupuncture suggests a common underlying mechanism that may act on pain generation, transmission of pain signals or processing of pain signals by the central nervous system and that is stronger than the action mechanism of conventional therapy,” the authors conclude. “Acupuncture gives physicians a promising and effective treatment option for chronic low back pain, with few adverse effects or contraindications. The improvements in all primary and secondary outcome measures were significant and lasted long after completion of treatment.”

Increased Rx Adverse Events

2007-09-26T04:07:00.000-07:00

FDA Report on Increased Rx Adverse Events Points Americans to ''Drug-Less'' Approach to Patient Care

Following the publication of a report based upon U.S. Food and Drug Administration data that says serious adverse drug side effects -- and deaths stemming from them -- more than doubled from 1998-2005 (Archives of Internal Medicine; 9/10/07), The Foundation for Chiropractic Progress points to the value of “drug-less” care delivered by the nation’s chiropractors. The Foundation (www.f4cp.org) is a non-profit organization dedicated to increasing the awareness of the benefits of chiropractic care.

“One of the goals of the practice of chiropractic is to offer patients a non-drug oriented approach to addressing many health problems, and to assist patients in avoiding the use of over-the-counter and prescription drugs whenever possible -- to the greatest extent possible,” says Gerard W. Clum, D.C. president of Life Chiropractic College West, Hayward, Calif., and spokesperson for the Foundation. “This holistic approach to care benefits the patient and avoids the clear risks associated with taking unnecessary medications.”

According to the FDA report, from 1998 through 2005, reported serious adverse drug events increased 2.6-fold from 34,966 to 89,842, and fatal adverse drug events increased 2.7-fold from 5,519 to 15,107. Reported serious events increased 4 times faster than the total number of outpatient prescriptions during the period. Data for the report came from The U.S. Food and Drug Administration Adverse Event Reporting System, in operation since 1998.

The announcement by the Foundation is consistent with The Identity Consultation of the World Federation of Chiropractic (WFC), according to Clum. The WFC holds as a central tenet that chiropractors are the spinal health care experts in the health care system, and should work “without use of drugs and surgery, enabling patients to avoid these where possible.”

Dr. Clum points to a previously reported study which documents significant decrease in blood pressure following upper cervical chiropractic care using the NUCCA analysis and adjusting protocols. Results published in the March 2007 online issue of the Journal of Human Hypertension validate that this decrease is equivalent to taking two blood pressure drugs simultaneously,” says Dr. Clum. “Americans have valid, well established options of a drugless nature, the core of a chiropractor’s approach to wellness.”

Visit www.foundation4cp.com to access an online free health seekers calendar or call 916.359.0327.

About F4CP

The Foundation for Chiropractic Progress is a 501c6 corporation that represents a cross section of the chiropractic and vendor communities with the goal of increasing the public’s awareness of the benefits of chiropractic. www.f4cp.org.

Chiropractor Adds ZYTO Biotechnology

2007-09-26T03:54:00.000-07:00

Chiropractic Physician Dr. Tamara Santa Ana has added ZYTO (tm) bioechnology to the healthcare services offered to clients at her chiropractic and wellness clinic, ProActive Health Solutions & Chiropractic.

ProActive Health Solutions & Chiropractic is a chiropractic and clinical nutrition facility offering detoxification, individualized clinical nutrition programs, as well as ZYTO Balance (tm) and ZYTO LSA Pro (tm).

ProActive Health Solutions & Chiropractic is located at 150 Walker Street on Summit Square in Lexington. Additional information and appointments can be obtained by calling 540-463-2462.

ZYTO Corp. is a bio-technology company specializing in bio-information and bio-communication. Using principles of biology, quantum physics, and the science of information the technology can facilitate meaningful communication between computers and living things.

“The use of ZYTO technology has advanced my ability to work with individual patients to an extent that is absolutely awe inspiring. I can use the ZYTO LSA Pro to very quickly determine which areas of concern we need to look at, and which nutrition needs should be considered. Many times I have discovered areas of developing concern that the patient was not even yet aware of,” explained Santa Ana.

By combining quantum physics, biology, and information theory ZYTO technology provides an interface between living things and computers allowing them to talk to each other, according to company founder and C.E.O. Dr. Vaughn R. Cook, OMD.

“My practice has grown wildly since employing the technology of ZYTO. I have had numerous patients come from out of state to be tested. It is even more exciting that they can now purchase a hand cradle and I can continue to test them remotely from their home. I found it absolutely amazing that word of this incredible tool has traveled so quickly. I will soon be testing a patient long-distance when they travel to Peru,” said Santa Ana.

The process is simple to administer with just one brief office visit. Patients simply place their hand on a sensor that is connected to a computer. In just a few minutes the results can be seen on a computer screen, and an assessment and recommendation can be made, according to Santa Ana.

ZYTO Corp. has a web site at http://www.ZYTO.com

Alpha-Stim SCS stress control

2007-09-25T10:25:00.000-07:00

Relieving patient's pain and suffering naturally has always been a goal for Dr. Michael McIrvin.

This is why Dr. McIrvin, Chiropractic Physician and clinic director of The Pain Relief Center in McPherson, now utilizes the Alpha-Stim 100 micro-current electrical stimulator (MET). The Alpha-Stim 100 works for those suffering from acute, chronic or post-operative pain, and is FDA-approved for reducing pain. The Alpha-Stim 100 works with the body on a large variety of ailments, including many difficult-to-treat problems. The Alpha-Stim produces residual and cumulative results, far superior to previous (TENS) devices. Turn a TENS off and the pain returns. Although broadly classified as a TENS, the Alpha-Stim 100 is significantly superior because MET works with tiny currents, closer to the type and amount of electricity that naturally occurs in the body. By comparison, the electric current used by typical TENS devices is thousands of times greater than natural body current. Although a slight tingling sensation is sometimes felt under the electrodes, it is not necessary to feel this in order to achieve results. Many people feel nothing at all with the Alpha-Stim 100 except positive results. It is applied through easy to use probes or self-adhesive electrodes.

“The Alpha-Stim 100 treats anxiety, depression and insomnia with micro-current using a method called cranial electrotherapy stimulation (CES). The treatment is very simple.” Dr. McIrvin said. The current is applied by easy-to- use clip electrodes that attach on the ear lobes. It is used just 20 to 40 minutes every day, every other day. Or on an as needed basis, it can help induce a pleasant, relaxed feeling of well being.

The Alpha-Stim is well-tolerated and very safe in contrast to drugs used in the treatment of mood disorders, many of which have been proven to have undesirable side effects and can be addictive. Unlike drugs, the Alpha-Stim 100 leaves the mind alert. Anxiety reduction is usually experienced during treatment. Depression and insomnia control is generally experienced after one to two weeks of daily treatment. CES can also help treat the underlying mood disorders associated with pain. It may be used as an adjunct to medication and/or psychotherapy. After treatment, there are usually no physical limitations imposed so that the majority of people can resume normal activities immediately. Maintenance of a relaxed, yet alert, state is generally achieved with treatments three times per week. As a result, the Alpha-Stim 100 is suitable for clinical or home use.

“Since the Alpha-Stim 100 is FDA approved for treatment of pain, insomnia, anxiety and depression, we are assured it is a safe and effective treatment for these conditions” said Dr. McIrvin. “I have used the Alpha-Stim to treat acute and chronic back and neck pain, post operative and cancer pain, carpal tunnel, headaches, fibromyalgia and sinus pain. For patients with severe or chronic pain, the Alpha-Stim can be prescribed for purchase or rental for home use. We teach patients how to utilize the Alpha-Stim for home use right here in the clinic. It has been a great therapy to use in addition to the chiropractic care I provide.”

Dr. McIrvin indicated that many patients will feel immediate relief of their pain after just one treatment. “Even for patients that are too painful to undergo traditional chiropractic care, we can give them almost immediate pain relief of 50-80%. Most patients are amazed at how well the device works. Many of my patients with fibromyalgia are counting the hours until their next treatment. They feel so much better, they can hardly wait!”

Research-based practice of chiropractic medicine

2007-09-25T10:21:00.000-07:00

What: SpineCare Inc.

Who: Dr. Anthony Houssain

What it does: Functions as a spine rehabilitation clinic. The practice's approach varies from a traditional chiropractic clinic with its "research-based practice of chiropractic medicine," Houssain said. The practice has clinics in Huntsville and Madison.

Employees: 15 - four doctors, six rehabilitation assistants, five office staff

Company history: Founded in January 2002 and "defied conventional wisdom. We focused on quietly building a research-based practice of chiropractic medicine ... to market effectively to an untapped resource: medical doctors." Houssain identified family physicians and spine surgeons as "two opportunities for rapid business growth. Our model has evolved into 'quarterbacking' " spine cases for teams such as the Huntsville Havoc and Tennessee Valley Vipers, Alabama A&M University and Bob Jones High School football. While SpineCare doctors explore new areas to develop ideas, "Our foundation remains unchanged - providing evidence-based, non-surgical spine management to the medical community and their patients."

Honors: Finalist for Entrepreneur of the Year at the Huntsville/Madison County Chamber of Commerce's Small Business Awards program.

Secret of success: Equal attention to "sciences of chiropractic medicine and business. Both are required to identify an unmet need, realize the solution and, most importantly, communicate to our market."

Biggest mistake: "Systems in place that helped us in one clinic didn't work with two clinics." Fortunately, the doctors learned about controlling growth of the practice.

http://www.visitspinecare.com

Chiropractor Celebrates Profession's 112th Birthday

2007-09-21T04:39:00.001-07:00

On September 18, 1895 the first chiropractic profession was born. That’s when Daniel David Palmer gave the first chiropractic “adjustment” to a Davenport, Iowa man named Harvey Lillard whose hearing was restored as a result. Since that time, millions of Americans have used chiropractic as a natural remedy for a variety of chronic health problems.

To celebrate chiropractic’s discovery, Dr. Tim Langley of Langley Chiropractic Office in Marietta, Georgia has announced “Health Freedom Week”, “The Membership Practice” and the “112 Special”. Health Freedom Week allows individuals not already under chiropractic care to receive three visits, including exam, consultation and first three adjustments for a one-time fee of $65. The Membership Practice is designed for those individuals who wish to incorporate chiropractic care into an overall wellness strategy, provides unlimited care at a fixed fee, ensures privacy rights and offers an alternative to costly insurance-based programs. The “112 Special” offers 10 office visits for only $112 for those individuals starting care during the remainder of September.

Langley Chiropractic is a wellness practice located in Marietta, Georgia. Dr. Tim Langley is a graduate of Life University and is available for public speaking opportunities, health fairs, and corporate wellness consultations.

Chiropractor Takes Practice to New Heights

2007-09-21T04:35:00.000-07:00

Dr. Jon Sherman, a solo family practitioner who divides his time between offices in Panama City and Panama City Beach, has increased his patient retention rate by 50 percent and increased the clinic's annual revenue rate by one-third since engaging the ACOM Chiropractic Consulting Group in early 2007 to audit his practice and make recommendations for improving efficiency and profitability._ _Unlike many doctors who seek out consultants to fix practice ailments, Dr. Sherman's Panama City Chiropractic was doing well, seeing 135-160 patients per week in the two offices and generating an annual revenue stream in excess of $450,000. Although the only professional at the clinics, he was supported by a three-person office staff and four contract massage therapists. But the Life University graduate sensed that his practice had stalled at that level and that although prosperous, it would require changes in order to continue its growth.
"I was using homegrown processes that I knew were inefficient since like most chiropractors, I was well trained in health sciences but not so well in business," he said. "I looked at quite a few coaches and ultimately attended a seminar conducted by the ACOM Healthcare Business Consulting Group. I was blown away…."

The consulting group focuses on the business side of chiropractic, stressing case management and accuracy of chiropractic billing, coding and documentation. Dr. Sherman retained the group for a two-day visit to the practice, during which a consultant studied the organization and flow of office activities and reviewed the paperwork and forms used throughout the typical day.
At the end of the visit, the consultant laid out his analysis of existing problems and proposed alternative procedures, along with detailed guidance for more precise coding so as to collect fully for all services provided. ACOM continues to provide coaching remotely since the on-site engagement.
Among the achievements Dr. Sherman cites:
• Reduced patient waiting time

• Diversion of staff from routine office work to revenue-producing activities

• Shorter, higher quality patient visits

• More patients per day

• Higher rate of conversion to wellness programs

• Better overall patient retention rate

• Dramatic revenue increase

"The practice was successful but I was working hard and not getting to where I wanted to be," Dr. Sherman said, "ACOM found the holes and plugged them and now we're moving forward again. It proves that you don't have to be struggling in order to benefit from their consulting services."

About ACOM's Chiropractic Consulting Group
The ACOM Chiropractic Consulting Group, a professional services unit of ACOM Solutions, Inc., offers a suite of consulting programs for educating, equipping and empowering healthcare providers for success. Group consultants diagnose practice problems and provide options for improving chiropractic office operations and addressing the critical coding and document issues that are unique to the profession. The Consulting Group's two-fold mission is to enable doctors to make more money ethically by collecting fully for all services performed while protecting themselves against audits, payback demands and possible legal actions. For information on ACOM's Chiropractic Consulting Services, phone 866-286-5315, ext. 503; or visit http://www.acomconsulting.com

American Black Chiropractic Association

2007-09-07T11:05:00.001-07:00

Dr. Juneau K. Robbins of Minneapolis has been named Chiropractor of the Year by the American Black Chiropractic Association. The honor was announced at the organization's 2007 Annual National Convention held in Little Rock, Arkansas. The American Black Chiropractic Association (ABCA) was established in 1982 by Dr. Bobby Westbrooks to unify minorities, primarily African Americans, in the practice of chiropractic.

In a career spanning just over a decade, Dr. Robbins has become a recognized leader amongst African Americans in the chiropractic field. The ABCA's Chiropractor of the Year award was established to recognize and honor a member in good standing who performed at a level above the rest during the previous year.

"It's a thrill to be respected at a high level by your peers," said Robbins. "This came as a surprise, and I am honored and thankful to be recognized by the American Black Chiropractic Association for my work in the profession."

Originally from Toronto, Canada, Robbins received his Doctor of Chiropractic degree and his Honors Bachelor of Science in Human Biology degree from Northwestern Health Sciences University in Bloomington. He also studied at the University of Windsor, Ontario before relocating to the Twin Cities to complete his professional education.

Since establishing his first clinic in 1997, Robbins has provided employment and mentorship for five young doctors who have moved on to establish their own successful chiropractic practices, creating associated jobs and minority commerce in the community.

"Dr. J," as he is called by his patients, is known by the community for his warmth and compassion. Having downsized from owning three clinics and full-time practice, he currently sees patients three and a half days a week in his North Minneapolis clinic, Cultural Chiropractic North. Soft tissue injuries, nutritional consultations and wellness/lifestyle coaching make up the majority of his private practice.

Robbins is also the co-author of 121 Tips on Raising a Child of Color, a parenting book co-authored with his father, Larry Mansfield Robbins, a city council member and retired educator from Chatham-Kent, Ontario. It is the first book of its kind written by a father-son combination of color.

Dr. Robbins is heading an effort to create a website called www.blacknutrition.com, a health and wellness site designed to educate the African American community on drug-free health and wellness options, along with providing nutritional recommendations targeted for communities of color. The site will be launched in fall 2007.

Chiropractic May Help Attention Deficit

2007-09-05T14:26:00.000-07:00

A pilot study, published in the Journal of Vertebral Subluxation Research (www.jvsr.com), suggests that chiropractic care may help adults suffering from concentration problems and attention deficit (ADD/ADHD).

The study was performed by Yannick Pauli, DC, director of the "Centre Wellness NeuroFit" in Lausanne, Switzerland. Dr. Pauli is a chiropractor specializing in wellness neurology.

"In this pilot study, we used objective outcome measures to evaluate attention in nine adult patients before and after two months of wellness chiropractic care. All patients experienced significant improvement in concentration and 88% normalized parts of the test," explained Dr. Pauli. "Although the results are preliminary and more research is needed, the outcome of the study suggests that patients suffering from attention deficit benefited from chiropractic care."

Research has shown that the ability to concentrate is affected in a number of disorders such as Attention-Deficit/Hyperactivity Disorder (ADHD), traumatic brain injuries, dementia, Alzheimer's disease and Parkinson's disease.

In the United States, between 1-6 percent of adults and 3-10 percent of children suffer from ADHD. Problems with attention go far beyond the ability to concentrate. Epidemiological studies have shown that individuals suffering from ADHD suffer greater risks associated with daily living such as higher rates of car accidents, increased risk of substance abuse, greater risk of failing school, increased likelihood of divorce and even greater difficulty managing money.

According to Pauli, concentration problems affect all parts of our life and even possibly our ability to heal. Although most people think of attention as the ability to focus on the external world only, new health paradigms indicate that we can direct our attention inward as well. The clinical experience of Pauli and his colleagues suggests that our ability to heal is highly dependent upon the ability of our brain to pay attention to what is going in the body.

"Studies done with people suffering from post-traumatic stress disorder (PTSD) suggest that those patients suffer when parts of their brain become deactivated, such as the prefrontal cortex, while others become hyperfunctioning," Pauli noted." Our hypothesis is that this leads to an inability for the brain to pay attention to the body's internal processes, resulting in decreased body awareness and decreased ability to access healing resources. Our study is part of a first attempt to document whether chiropractic care could be helpful to improve attention, and therefore all areas of life that are dependent upon this crucial cognitive function."

Usually, attention deficit is a clinical diagnosis. But to avoid potential subjectivity, Pauli used an objective measure of attention, called a continuous performance test. "It is a computer-based evaluation that objectively measures various parameters of attention" he explained. "This system is also used by some neurologists and psychiatrists to find the exact dosage of medication they are going to prescribe for attention deficit sufferers. Our preliminary results suggest that attention can be improved naturally with chiropractic."

The connection between attention, a process occurring in the brain, and chiropractic, which is generally associated with spinal health, is not readily obvious to most people. Yet, the research emphasizes the direct link between the spine and brain activity.

"As a chiropractor specializing in wellness neurology, I understand that the spine is as much about neurology as it is about biomechanics" Pauli states.

The articulations and the muscles of the spine are rich in mechanoreceptors, which are sensors that send information to the nerve system. "Each time we work with the spine, we activate neurological circuits in the direction of the brain and bring the nerve system into balance," the researcher says.

Pauli also notes that chiropractors affect, in particular, a small part at the back of the brain called the cerebellum. Studies have shown that this structure is involved in attention. "Higher parts of the brain are also dependent upon the proper balance and function in the cerebellum," he elaborated. "If the cerebellum does not function at par, the rest of the brain becomes somewhat clumsy and by activating the spinal receptors and balancing the cerebellum, we help the brain function better."

According to Matthew McCoy, DC, editor of the Journal of Vertebral Subluxation Research, "this preliminary study is exciting. It is part of an increasing amount of research suggesting that chiropractic care may be an effective natural choice for people suffering from ADD/ADHD. It offers the possibility of a new option for millions of children and adults that are seeking to manage their conditions naturally."

The Journal of Vertebral Subluxation Research is a peer-reviewed scientific journal devoted to subluxation-centered chiropractic research and is affiliated with the World Chiropractic Alliance, an international organization representing doctors of chiropractic and promoting the traditional, drug-free and wellness-oriented form of chiropractic.

Lotions Now Available to Chiropractic Patients

2007-08-31T09:21:00.000-07:00

Vaso Active Pharmaceuticals, Inc. ("Vaso Active") (VAPH.ob) (http://www.vasoactive.us), distributor of uniquely formulated branded topical over-the-counter ("OTC") lotions for temporary relief from minor arthritis, muscle and joint pain, as well as treatment for athlete's foot, and Chiropractors Buying Group, Inc. (“CBG”) (http://www.cbgsave.com) announce a marketing agreement to make Vaso Active’s Osteon® and A/R Extreme® OTC topical lotions available through CBG’s network of chiropractors.

According to Stephen Cataldo, Director of Marketing for Vaso Active, “Vaso Active will not have to incur the slotting fees and marketing support costs normally associated with distribution through chain supermarkets. Distribution directly through chiropractic offices is a more cost effective and logical mix to our distribution strategy. The agreement with CBG is just one step in our plan to increase distribution directly through the professional community, including podiatrists, chiropractors, massage therapists, and others. Vaso Active has been aggressively seeking strategic alliances and promoting its products to the professional community through product sampling and other sales initiatives.”

Stephen Cataldo added “CBG, a well-known and respected Chiropractor Group Purchasing Organization targets product distribution directly to chiropractic offices and through H&H Wholesale Services, Inc. to more than 5,000 independent pharmacies. Vaso Active is very exited to be working with CBG. This arrangement is a great opportunity for Vaso Active to efficiently introduce its products and increase product awareness to expanded distribution channels, bringing its products within reach of more customers that are in need of pain relief. I have personally tried most of our competitor’s topical products that are being used in the industry and I believe that our products, with their unique delivery system, should find broad consumer acceptance as we continue to look for ways to expand. Our mission, here at Vaso Active, has always been to enhance the quality of life.”

As part of their services, CBG will be introducing these OTC products to professional chiropractic associations at industry trade events in Colorado, Florida, Minnesota, North Carolina, Georgia, Illinois, Missouri, New Mexico, and New York. CBG also plans to make Osteon®, A/R Extreme® and Termin8® Athlete’s Foot Lotion available through its website (http://www.cbgsave.com).

David Kapla/Director of Sales and Marketing of CBG indicated, “CBG will distribute and restock samples, product coupons and informative pamphlets about wellness to nearly 200 chiropractic offices as part of its Patient Wellness Referral Program. Targeted states include Connecticut, Indiana, Kentucky, Michigan, New Jersey, New York, Ohio, and Pennsylvania. CBG is proud to have Vaso Active partnered with us to make a significant difference in the lives of CBG members patients by offering this high quality natural product line! Vaso Active topical lotions embrace a natural lifestyle and will be a significant addition to chiropractic care.”

About Vaso Active

Based in Danvers, Massachusetts, Vaso Active is an early stage company focused on commercializing, marketing and selling OTC pharmaceutical products, including Osteon®, A/R Extreme® and Termin8®, that incorporate the proprietary PENtoCORE® technology.

Proprietory PENtoCORE Technology Provides High Performance Results.

The PENtoCORE technology is a topical formulation that we believe allows for the formulation of OTC products with certain "use advantages" over similar products marketed by our competitors. "Use advantages" include characteristics such as less odor, less greasy feel and less residue with a more pleasant texture. Vaso Active licenses the PENtoCORE technology from its parent company, BioChemics, Inc. ("Biochemics") (http://www.biochemics.com).

Three free chiropractic adjustments

2007-08-22T12:35:00.000-07:00

Chiropractor Declares "Health Freedom Week": Accepts All Cases Regardless of Physical Condition or Financial Ability to Pay

Dr. Tim Langley, a chiropractor in Cobb County, Georgia has declared “Health Freedom Week” from August 20-25 as part of ongoing efforts to introduce the public to the lifestyle of health without drugs and fear. During Health Freedom Week chiropractic exams, consultations and three chiropractic adjustments will be offered at no cost to the public.

Health Freedom Week is open to any individual (not currently under active chiropractic care) regardless of their physical condition or financial ability to pay. Health Freedom Week is the kickoff of a new campaign to reach families all over the northern Metro Atlanta area and to inform them of the true nature and value of chiropractic care. At a time when the lifespan of Americans is rated 41st in the world despite outspending the rest of the world on healthcare, it’s time someone let the public know that there is an alternative to our drug-based system of sick care.

While the Health Freedom Week promotion will last only one week, the program will be offered on an ongoing basis at a cost of $47 for the initial exam, consultation and first three visits. This is a way of taking the risk out of trying chiropractic care for either a specific health problem or for long-term wellness care. If after trying the program for one week and participating in a one-hour “Natural Health and Healing” workshop you don’t feel that the chiropractic approach is right for you, there is no further obligation for continued care or payment. This really puts the burden on the doctor to demonstrate the value of chiropractic care as well as his/her competence as a doctor of chiropractic.

Dr. Tim Langley is a chiropractor, economist and business consultant. He lives and practices in Marietta, Georgia, a suburb of Atlanta. Dr. Langley writes on issues that relate to health, business, personal development, economic development and politics.
Langley Chiropractic Office: www.langleychiropractic.com

Chiropractic and Autism

2007-08-18T06:49:00.000-07:00

EVERY month, Susan Crisp takes her eight-year-old son, Daniel, for a 15-minute chiropractic treatment.

Daniel has autism and Susan and her husband, Gary, firmly believe that this complementary therapy has been key to the recent improvements they've seen in his development. "His communication has improved tremendously," says Susan. ..

Television presenter, Quentin Willson, has reported similar success from the treatment for his son, Max.

Indeed, it was after seeing Quentin talking about his son on TV two years ago that Susan first got the idea to try chiropractic for Daniel.

"It was a coincidence that I saw it. I had the TV on and it really caught my eye because there were so many similarities between what he was talking about with his son and Daniel," she remembers…

"We thought, `If nothing happens, that's the worst that can happen'.

"At the time, Daniel was walking on his tip-toes and his feet were pointing inwards when he walked - which can be symptoms of autism. I was worried about it and we thought that the chiropractic might be able to help with his posture."

Susan took Daniel to see chiropractor Doug Clark at Dynamic Chiropractic in Sale. Chiropractic is a complementary therapy used to treat problems with joints, bones and muscles and the effects these have on the nervous system.

This is done by a chiropractor, using their hands to make often gentle, specific adjustments to joints, concentrating particularly on the spine, to improve the nervous system and release the body's natural healing ability.

Doug explains: "Daniel demonstrated quite striking spinal stiffness both in the left side of his lower back and his upper neck.

"From a chiropractic point of view, spinal movement problems, typically at the top of the neck, may contribute to distorted nerve function in the central nervous system.
Brain effects

"Typically, the left side of the upper neck communicates with the right side of the frontal brain and with the parts of the brain cortex that is involved with speech and language and co-ordination of movement.

"Whilst I treated Daniel's spine for mechanical problems, which we could be certain would benefit his health, we didn't know at this stage how his communication skills, speech and language might respond to treatment."

Initially, Daniel's treatment was once a week for the first month. This reduced to once a fortnight and now Daniel sees Doug once a month.

"Some parts of the treatment look uncomfortable, but it doesn't hurt Daniel at all," says mum, Susan.

"He loves it. Usually when Daniel comes in from school, that's it, he's in and it's really hard to get him to go anywhere, but when I say we are going to see Doug he wants to go.
"Every time Doug has a little chat to ask how Daniel has been getting on. Then Daniel sits in the chair - we call it the Thunderbird chair, and Doug doesn't have to tell him anything now, he knows what to do.

No bother
"Doug manipulates Daniel's neck. This part looks uncomfortable but Daniel smiles and mimics the clicking sound his neck makes when he has it done.

"After this Daniel lies flat on his tummy and Doug manipulates his spine in different ways. He finishes the treatment by massaging the back of his neck.

"Daniel loves this but when I've tried to do it at home he won't let me do it, only Doug - they've built up a really lovely relationship.

"But it's not just a matter of Daniel enjoying it. Within four to six weeks we noticed a huge improvement in his condition.

"We took him in June and by August people who don't see him regularly commented that his speech had come on tremendously. He started to initiate sentences - it was a real surprise, to us."

Daniel continues to make excellent progress and is now speaking and engaging with people on a regular basis.

As well as his chiropractic treatment he receives educational help through a specialist school, which includes seeing a speech therapist twice a week…

To see complete article:
http://www.manchestereveningnews.co.uk/lifestyle/health_and_beauty/health_and_beauty_feature/s/1013/1013378_alternative_cures_for_autism.html

ACOM's RAPID EMR

2007-08-18T05:44:00.001-07:00

The board of directors of the Florida Chiropractic Association (FCA) has elevated the status of ACOM's RAPID EMR clinical documentation and reporting solution to that of a "Recommended" solution within the FCA Membership Benefit Program. RAPID EMR is the only http://www.acomemr.com/rapid-emr.html chiropractic documentation and reporting solution to be included in the FCA Membership Benefit Program at this time and one of only eight products overall to be so designated by the association.
RAPID EMR has been a "Recognized" product in the FCA program since early 2006, and it has earned a high degree of acceptance among association members. The FCA is the largest state chiropractic association in the country, with more than 4,000 members.

RAPID EMR is an extensively featured solution that supports chiropractors in the diagnosis and documentation of problems and treatments, building electronic patient files in a sophisticated, intelligent database. Custom reports, typically a drawn-out process involving extensive analysis of notes, dictation and transcription, can be accomplished in minutes with the press of a few computer keys, with reports assembled and generated automatically directly from the electronic patient file.

Missed Appointments

2007-08-18T05:42:00.001-07:00

Dr. Michael Lagana, Director of BackSmart Wellness Center in New Jersey, has first-hand experience of no-show damage caused to a busy chiropractic office. "Missed appointments are the first signs of eroding patient loyalty and potential patient relationship management problems. Billing Precision's integrated automated solution protects billing revenue in a disciplined fashion and at significantly lower cost," says Dr. Lagana.

"When patients miss appointments, they interrupt the flow of care, impede clinic productivity, and reduce billing and revenue. Appointment reminders or confirmation calls for upcoming appointments and follow up calls (recalls) on recent no-shows reduce numbers of no-shows more effectively than any other strategy," says Dr. Lagana.

Protect Your Child’s Back at Back-to-School Time

2007-08-15T04:54:00.000-07:00

California Chiropractic Association Alerts Parents to Injuries Caused by Backpacks

With the beginning of the school year just around the corner, the California Chiropractic Association today issued its “Backpack Safety Checklist” to help parents of school-aged children know what to look for and how to avoid back injuries as they select backpacks for the coming year.

“Childhood injuries from backpacks can be avoided by following a few simple, preventive measures,” said Dr. William Updyke, DC, president of CCA. “If parents take the time to choose the right pack and teach their children how to wear it correctly, it will go a long way toward preventing the injuries in the first place.”

A study of 3,498 California students in 2004 found back pain to be highly prevalent, severe and chronic. The study also found a link between backpack weight and back pain.

A loaded backpack should not exceed 15 percent of the child’s weight. However, as many as 55 percent of today’s students carry loads in excess of the recommended limit. The backpack problem is made worse by the fact that so many of today’s children are obese. Not only are they obese, they are also out of shape, making it hard for them to support any extra weight on their backs.

Often the harm caused by backpacks can occur without obvious symptoms.

“Young people may be experiencing only mild symptoms now, but it is likely a precursor to problems like chronic back pain and spine degeneration later in life,” Dr. Updyke said. “Doctors of chiropractic are sounding the alarm about kids’ backpacks because of our expertise in dealing with this type of injury. Parents must be aware of the potential long-term harm caused by backpacks, and help their children take preventive steps now.”

The California Chiropractic Association recommends the following checklist to help prevent backpack injuries.

BACKPACK SAFETY CHECKLIST

When choosing a backpack, look for:
Padded shoulder straps
Padded back
Lumbar support
A waist belt
Multiple compartments
Correct size

How to pack:
Loaded backpacks should weigh no more than 15 percent of the child's body weight
Distribute the weight properly; load heavier items closest to the back

How to wear:
Wear both shoulder straps
Tighten straps until snug, but not tight
Use the stabilizing waist strap
Take the backpack off when standing for a long time
A Guide to Maximum Backpack Weight for Children

Child's weight
Recommended backpack weight when loaded

50 lbs. 7.5 lbs.
80 lbs. 12 lbs.
100 lbs. 15 lbs.
130 lbs. 19.5 lbs.

Rolf Structural Integration Therapy

2007-08-10T13:57:00.000-07:00

Back pain can be… well, a real pain in the back. Just ask the two to three million people who are chronically disabled by it. As disturbing as it sounds, however, such misery doesn’t have to be something these individuals accept as a daily part of their lives. Long-term relief and hope exist in the form of a ten-session series of body joint and segment re-organization techniques called Rolf Structural Integration. To learn more about this short-term, all-natural approach to back pain, visit the program online at http://www.corestructuraltherapy.com.

The American Chiropractic Association estimates that in any given timeframe, 31 million Americans suffer from low-back pain. The National Pain Foundation statistics further indicate that between “50 to 80 percent of people will be disabled by back pain at some point during their lives.” In a quest to obtain relief from their misery, it is estimated that Americans spend at least $50 billion each year on back pain.

Given that the vast majority of back pain sufferers first seek out traditional-medicine avenues for relief from their problem, this expense figure is not all that surprising. The nation’s consistently rising healthcare costs spell a simultaneous increase in prescription and hospital coverage. Even chiropractic medicine has gone main stream in recent years, resulting in skyrocketing costs for such treatment.

Although the company recommends that all its clientele to get checked out by a medical professional, Core Structural Therapy also encourages them to consider the alternatives before resorting to dangerous painkillers and/or risky surgeries. The company’s Rolf Structural Integration series (coined by its early followers Rolfing) is one such alternative. The most advanced system taught at this time, it integrates the classical treatment formats designed by Dr. Ida P. Rolf over a half-century ago to eradicate even the most persistent back pain.

Roseann Bongiovanni, a Core Structural Therapy client, is a firm believer in the program: “When I complained about lower back pain, other therapists rubbed my muscles harder and/or longer, but never tried to identify the source of the pain. Joe’s [Ackerman, Structural Integration program developer] techniques made my back feel stronger, more flexible and with much less pain.”

For more information on how to get rid of chronic back pain, contact CoreStructuralTherapy.com’s founder, Joseph Ackerman, at (781) 425-5057. To learn how the Rolf Structural Integration ten-session program can relieve back problems, visit the company online at http://www.corestructuraltherapy.com.

Grow Your Practice With Massage Therapists

2007-08-08T14:47:00.000-07:00

by Dr. Ryan Marshall

Dr. Ryan Marshall is a Tulsa chiropractor and a member of the American Chiropractic Association.

One group of professionals you may consider adding to you network are licensed massage therapist or LMT’s. It is a good idea to know a few massage therapists because you will have patients ask you who you recommend from time to time. Your patient will be very thankful if you refer them to a good LMT, especially if they were going to resort to a blind attempt of finding someone credible by using the phone book. If your philosophy is sound, you should not be intimidated by massage therapists and understand that what you do is very different. You should also be able to explain these differences. Unfortunately sometimes the general public may not know the difference between massage therapist and chiropractors. That’s fine; this can be another opportunity to educate your patients.

Your first necessity is to come into contact with a reputable massage therapist. Introduce yourself to as many as possible throughout your town or area of practice. Many will offer you a tour of their facility and sometimes even a free massage. Take them up on the free massage if offered. This will give you a chance to see how good they are at what they do and give you more time to work on your new network relationship by visiting with them. When you are visiting with these LMT’s you are interviewing them at the same time. They are probably interviewing you also. Ask yourself questions like, “is this someone I would trust with my patient”, “could I see myself becoming a client of this person?” They need to have a respectable facility, reasonable fees and a philosophy that is somewhat close to your own. The last thing you want to do is refer a patient to a bad business that does not share your same philosophy. This could jeopardize your relationship with your patient.

I recommend you have about 4 to 5 massage therapist that you have built a rapport with. They need to be spread out in your area of practice for two reasons. First your patients do not want to drive all over town to get to your recommended LMT. Second this gives you a spread out area to receive your referrals from. Once you have your 4 to 5 LMT’s you can trust and refer to, you also have 4 to 5 LMT’s referring to your business. As always it is a good idea to keep in contact with each of them periodically to maintain your network.

When you refer a patient to a LMT, call them and let them know you sent that patient over to their business. Do no be afraid to put light pressure on them to refer you a patient or two when the timing is right.

Occasionally LMT’s will want to barter with you. You may want to do the same. It is your decision. This may be the chance you are looking for to build your network relationship even stronger.

A great way that I have found to start the referral process with LMT’s and build my practice at the same time is to offer a monthly special. For example, in the month of July refer a friend or family member to our office and receive a free 30 minute massage from a licensed massage therapist. Post signs in your office, have your receptionist tell patients and tell them yourself. This inspires patients to refer people to your office and at the same time allows you to start the referral process with your network of LMT’s. Run the special only once every few months. This puts a since of urgency to your patients to receive their free massage. The only down side is you pay for the 30 minute massage. This is a small price to pay to add a new patient to your growing practice, and some massage therapist will give you discounts for your paid referrals. Again, it’s a win, win, win situation for everyone involved.

Dr. Ryan Marshall is a Tulsa chiropractor and a member of the American Chiropractic Association.

Code and document work properly!

2007-08-06T05:34:00.000-07:00

"When doctors do not code their services properly they can be impacted in two ways," Hoag said. "If they don't bill fully for everything they do, they collect less than they should, impairing the success of their practice. If they unintentionally overbill, they risk audits and payback demands that can run into thousands of dollars. In this analysis, we identify for the doctors if they fall into either group and recommend what to do about it. ACOM's Consulting Group is focused on helping Chiropractors make more money ethically and empower them to fight back if charges are challenged."

Noting that up to 50 percent of all chiropractors victimize themselves and their practices by failure to code and document their work properly, the ACOM Chiropractic Consulting Group today announced a three-phase Chiropractic coding and documentation analysis service designed to assure fair payment for services and to avoid problems with billing compliance.

The new service is conducted entirely over the phone in three sessions that take place within an approximate two-week time period, according to Senior Consultant Bharon Hoag. It involves no disruption of practice activities and routine
The service emulates the SOAP format, Hoag said. In the first call, practice basics are reviewed, with the doctor providing his view of practice status and goals and furnishing the analyst with samples of notes and documentation. In the second phone session, the doctor and the analyst review and discuss the analyst's findings, also gathering any further information needed to complete the analysis. Between the second and third sessions, the analyst develops a professional assessment of the data and information developed in the first two calls. In the final call, the analyst reviews the assessment and addresses questions stemming from the assessment and other practice issues, establishing a foundation for a remedial plan.

"This process is straightforward, but it is not easy for the doctor to do independently," Hoag said. "Typically, the doctor is too close to the methodologies that are familiar to him or her. It is the combination of the doctor's intimate knowledge of the practice and the educated objectivity of the analyst that makes this program so effective."

About ACOM's Chiropractic Consulting Group:
The ACOM Chiropractic Consulting Group provides a suite of consulting services for educating, equipping and empowering healthcare providers for success. Now in its 24th year of business, ACOM Solutions, Inc. has multiple divisions in markets across the globe. The Healthcare Business Division develops and markets chiropractic software for clinical documentation/reporting and practice management. ACOM headquarters are in Long Beach, California; with regional offices located in several major U.S. cities. For information on ACOM's Chiropractic Consulting Services, phone 866-286-5315, ext. 305; or visit http://www.acomconsulting.com

Dr. Amanda Warren

2007-08-06T05:32:00.000-07:00

Dr. Amanda Warren, CACCP, recently completed 180 hours of classroom instruction and received her board certification status from the International Chiropractic Pediatric Association and the Academy of Chiropractic Family Practice. The CACCP (Certification from the Academy Council on Chiropractic Pediatrics) certification is a standalone certification as well as a prerequisite for Diplomate status.

Both graduates of Parker College of Chiropractic in Dallas, Texas, Dr. Amanda Warren and her husband, Dr. Dennis Warren, own and operate Generations Chiropractic Wellness Center, which is located in the Evelyn Hills Shopping Center on College Avenue.

To fulfill the certification requirements, Dr. Amanda Warren traveled frequently to Dallas for a series of 12-hour seminars on specialized topics ranging from Perinatal Care and Neuroimmunology to Chiropractic Pediatrics for the Challenged Child and Diagnostic Imaging and Instrumentation. In addition, she successfully completed a comprehensive essay examination that covered specifics from 15 separate instruction modules.

Drs. Warren are trained and certified in the Webster Technique, a "safe means to restore proper pelvic balance and function for pregnant mothers" according to ICPA. Registered with the ICPA Webster Practice-Based Research Network, Dr. Amanda Warren currently is an active participant in a worldwide research study to document the safety and efficacy of the Webster Technique through a collaborative effort among doctors, patients and ICPA.

"Earning the pediatric certification was lots of hard work, but Denny and I both are committed to continuing education that will help us address the needs of families here in Northwest Arkansas," remarked Dr. Amanda Warren. "This and the arrival of our new digital X-ray machine for the office," she continued, "are major milestones for Generations Chiropractic Wellness Center." As for future plans, she intends on pushing forward to complete the 180 additional hours of clinical competency and clinical application courses necessary for Diplomate status.

New in Town and Needs a Chiropractor?

2007-08-06T05:31:00.001-07:00

Dr. Will Tickel, (what a great name for a chiropractor!) Wilmington's Chiropractor, announced today that he is now offering the New Mover’s Treatment Package™ to anyone recently moving to the Wilmington area. Dr. Tickel stated, "Moving to a new city is stressful, and I'm trying to make it easy for new residents to discover the soothing benefits of chiropractic care at my office."

For anyone transferring from another chiropractor’s office, there is no cost for your first visit if you bring in your medical records and x-rays. If you are transferring from another chiropractor’s office and you don’t have your records or x-rays, the cost for your first visit is only $20. Also, if you have never been to a chiropractor before, your first visit is only $20 at Dr. Tickel’s Wilmington office. This is a $243 value.

In any event, your first visit will include the following services:
1) A private health consultation with Dr. Tickel
2) A comprehensive exam
3) Any necessary x-rays
4) A three-page report of your exam findings
5) Your first gentle treatment

Sandy Wainscott, who moved to Wilmington 2 months ago commented, "Choosing a new doctor for my family was stressful because I didn't know anyone here. Dr. Tickel made it painless and fun, and we love him."

If you have recently moved to the Wilmington area, please call Tammy or Mia today at (910) 791-0055 to schedule your first appointment. Still not sure about coming in? If so, please go to: www.TickelChiropractic.com
for more information.

Dr. Lynne Kavulich

2007-08-06T05:29:00.001-07:00

Today, many scientists believe the secrets of regeneration and healing lie not within costly medical drugs or expensive medical treatments, but in the body’s own Quantum Energy Biofield (QEB). QEB is a magnetic energy field encompassing our bodies that synchronizes and controls all of your body’s systems.

Quantum Reflex Analysis™ (QRA) uses the QEB as a pattern to define and eliminate stressors that have deactivated the body’s own potent internal healing systems for rejuvenation, endurance, vitality and longevity.

Anti-aging physician specialist and best selling author Dr. Lynne Kavulich, D.C is actively employing these techniques at her American Wellness Care practice located in Hopewell Junction, New York. QRA™ provides a simple, safe and efficient analysis of even the worst cases and is especially helpful for more complicated cases where a weakened or disordered physiology has caused the body to be resistant to traditional medical procedures.

As a compassionate Doctor of Chiropractic, Dr. Lynne Kavulich has been helping her patients achieve optimal health. Focusing on state-of-the-art nutrition, disease prevention, and anti-aging technologies, Dr. Kavulich, through her website at www.feel-great-at-any-age.com, now helps thousands to look and feel five to ten years younger. You can learn more about Dr. Lynne Kavulich by visiting www.american-wellness-care.com.

American Wellness Care is a multi-disciplinary center providing chiropractic and holistic care techniques with over 25 years of serving New York Hudson Valley residents. To find out more about the latest breakthroughs in pain management, therapeutic laser therapy and anti-aging medicine contact American Wellness Care.

Pain in the neck could be bad for blood pressure

2007-08-02T13:48:00.000-07:00

How a pain in the neck could be bad for your blood pressure

A chance discovery in the lab has helped University of Leeds scientists to show how the treatment for a stiff neck could do wonders for your blood pressure.

Chiropractors have long known that tackling pain and stiffness by “cracking” the neck through manipulation can also lower blood pressure – but the reasons were never clear.

Now a team led by Professor Jim Deuchars has examined pathways between the neck and the brain to show how the neck muscles could play a crucial role in controlling blood pressure, heart rate and breathing.

Their study, published in the Journal of Neuroscience, provides the first evidence for a role for these connections in influencing brain regions which control body functions that we don't need to think about, such as breathing and blood pressure.

The area of the brain where the signals from the neck terminate were first identified by “Godfather of Neuroscience” Ramon Y Cajal, more than 100 years ago, though its function was not understood. What happened after these signals arrived remained a largely-overlooked area of research until new techniques allowed the Leeds team to take the work forward.

Their work began by chance, as Prof Deuchars explained: “Cells in the area that receive neck signals jumped out at us when we labelled sections with particular markers. We wanted to know how these cells were organised and the other brain regions to which they were connected.”

The team, which includes researchers from Japan and Hungary, found a link between these cells and the nucleus tractus solitarius, an area of the brain that is pivotal in control of autonomic functions - body functions under unconscious control. They propose that nervous signals from the neck could play a key role in ensuring that adequate blood supply is maintained to the brain as we change posture, such as from lying down to standing up. Where such signalling fails, we can suffer problems with balance and blood pressure.

The findings offer a clear rationale for manipulative treatments: “Reports from chiropractic journals say that manipulating the neck region helps to reduce blood pressure in some people,” Prof Deuchars explained. “By identifying the pathways we can see why these treatments might work and it could also explain why some people suffering whiplash injuries may experience a change in their blood pressure.”

“The work also contributes to understanding postural hypotension – fainting which can be caused by standing up too fast. The neck muscles could be a part of the system which normally prevents this from happening by sending signals to the brain upon neck movement that posture has changed.”

More research is now needed to see which sensory nerve fibres and precisely which cells are involved in the process. Amongst other things, the team would now like to know what other brain regions the neck muscle termination site connects to. They believe that there are many malfunctions associated with whiplash injuries to the neck that could be better understood by unravelling these connections. They hope that this knowledge could be used to design more effective treatments for such injuries.

Top athletes use regular chiropractic care

2007-07-30T04:32:00.000-07:00

What do Barry Bonds, Tiger Woods, Andy Roddick, and Lance Armstrong have in common? They are incredibly accomplished athletes that have used chiropractic care as a key ingredient to their success.

The fact is that more professional athletes use chiropractic than ever before. Even more revealing is the increased use of regular chiropractic care for entire professional teams. In fact, Chiropractic Economics reported that over 95% of teams in the NFL use chiropractors as a regular part of player care.

Some professional athletes pay personal chiropractors to give treatment before, during, or after a game. Barry Bonds, one of the best all time baseball players, has a personal chiropractor who travels to games. Bonds has incorporated chiropractic into his lifestyle. He reportedly said, "I think it should be mandatory to see a chiropractor and massage therapist."

Dr. Rose Soanes, D.C. is an experienced sports chiropractor and owner of Berrien Family Chiropractic in Niles, MI. Dr. Soanes has worked with hundreds of athletes in various sports. She said, "Professional athletes get three main benefits with chiropractic care. They are to prevent injury, manage injury, and to enhance physical performance."

Dr. Soanes said, "Perhaps the most exciting thing about chiropractic is the performance enhancing abilities it provides athletes." A study in 1991 in the Journal of Chiropractic Research and Clinical Investigation revealed that chiropractic care can increase athletic performance by as much as 16.7%! Another study in the Journal of Vertebral Subluxation Research in 1997 revealed that chiropractic care increases an athletes capillary count. This means increased blood flow and more oxygen to the body.

Dr. Soanes strongly recommends both professional and amateur athletes look into chiropractic and how it can help them perform to their potential. Many chiropractors, like Dr. Soanes offer a free consultation to athletes interested in learning more about chiropractic.

Dr Alicia Burke

2007-07-29T15:32:00.001-07:00

Combining a multi-specialty approach to holistic healthcare, with the latest generation of equipment. Dr Alicia Burke, Chiropractor for 8 years in Los Angeles, has just created a new health renewal center named Absolute Health of Los Angeles in the heart of Beverly Hills. This new clinic is providing several services : Chiropractor, Hyperbaric Oxygen Therapy, Colon Hydrotherapy, Light Rejuvenation, Massage Therapy, Acupuncture.

Absolute Health of Los Angeles offers State of the Art Health, healing and beautifying services for individuals seeking and intimate facility with a variety of treatments. Each practitioner provides their signature treatments tailored to your needs. The practitioner’s having years of experience and have practiced in Europe, Asia, United Kingdom, and throughout the United States. “We are providing services for the entire body. Many Americans wait until the body fails structurally and mechanically. Many wait until the body cries out in distress before seeking some sort of intervention. I have decided to build a place where people in all phases of health are educated about their personal health status, empowered to make changes and motivated to adopt lifestyle that promotes long term wellness free of multiple prescription drugs that so many people over the age of 50 are required to take due to poor health decisions over the previous years.” says Dr Alicia Burke.

Dr. Alicia Burke is a leading Los Angeles Chiropractic practitioner. With a bachelor’s degree in Physical Education and Health in hand, Dr. Burke taught at an inner-city school and later became the Athletic director for a East Los Angeles school district. She graduated Cum Laude with a Doctorate degree from Life Chiropractic College West, a leading chiropractic college in San Francisco. She was awarded Excellence in Clinic for Outstanding Patient Care throughout clinic internship, and was named Chiropractic Student of the Year 1997. Dr. Burke maintains a license to practice Chiropractic in California. She has also completed the National Boards Parts I, II, III, IV and Physiotherapy examinations accepted throughout the United States.

Reduce Back Pain During Pregnancy

2007-07-23T11:49:00.000-07:00

Pregnancy greatly increases a woman's vulnerability to back problems during and after birth. Did you know that at least half of pregnant women experience back pain during pregnancy? Some studies suggest that these numbers are even higher.

Many women simply accept back pain as an unavoidable trade off in the creation of new life. However, Dr. Mitchell Shea, D.C., of Shea Chiropractic says that pregnant women do not have to take back pain "lying down." Dr. Shea is an experienced chiropractor in Cookeville, TN who aims at increasing women's awareness of the relationship between back pain and pregnancy. He said, "Women who are more educated are more likely to seek care and reduce back pain."

Studies have proven that chiropractic care greatly reduces the amount of pain and discomfort throughout pregnancy, childbirth, and postpartum. A study in the Journal of Manipulative and Physiological Therapeutics in 1991 revealed that 84% of patients who received spinal manipulative therapy (chiropractic care) reported a decrease in back pain while pregnant. Another study reported in the book "Chiropractic Pediatrician" showed that regular chiropractic adjustments reduced average labor times by an average of 33%.

Dr. Shea said, "Women who have regular chiropractic treatment and are properly instructed about ways to reduce pain have a much easier, smoother child bearing experience. Also, women who have significant back pain during pregnancy are more likely to experience a longer period of pain in subsequent pregnancies. That's why I really stress a preemptive approach, meaning get educated before your body begins to make its maternal changes."

Dr. Shea strongly suggests contact with a local chiropractor who can give valuable guidance and care. Some other things that can be done to reduce strain on the back are sleeping on your side, maintaining good posture, eating and exercising properly, using a pregnancy pillow or support belt, and many more.

Dr. Shea's website is at www.drshea.ws

Scoliosis Treatment Alternative to Scoliosis Surgery

2007-07-23T11:46:00.000-07:00

A new scoliosis treatment, available at Victor Advanced Chiropractic, is changing the future of scoliosis. Studies prove that this new scoliosis treatment shows dramatic results comparatively to the "barbaric" method of surgery. Research includes very specific x-rays to determine if the scoliosis is correctible. Amazingly, 75% are correctible.

Until now patients have only had three options for the reduction and correction of scoliosis: to do nothing, bracing, and surgery. Doing nothing only makes matters worse, but bracing and scoliosis surgery are no better. Bracing outcomes are very poor and expensive, stabilizing the scoliosis at its current position, not correcting it. Studies have shown that patients felt that bracing handicapped their life and left a psychological scar.

Surgery includes implanting a Harrington rod for the correction of the disease. However, after many complications, including rusting and corrosion, bending, or breaking completely, proved that this method is ineffective. Some sufferers undergo surgery again to remove the rod. Every year thousands of post-surgery patients are legally defined as permanently disabled for the rest of their lives, and follow up x-rays in some cases reveal that their scoliosis returned to pre-operative levels.

"The new Mix, Fix, and Set routine is cutting edge", Dr. Robert Luckey said. He and Dr. Bill Ferris run Victor Advanced Chiropractic (www.victorac.com). The mix uses specific rehab for the soft tissues, the fix includes the spine adjusting and the set is to hold the position with further rehab. Exercise rehabilitation therapy is mandatory to reverse scoliosis, including vibratory stimulation. Envision a life free from the pain of scoliosis. A life free from physically and emotionally scarring treatments. Scoliosis affects 4.5% of the general population; almost 500 cases diagnosed each day, taking an average of 15 years reduction from each patient's life span.

Case studies show results seemed to reduce scoliosis curvatures in 19 subjects by an average of 17 degrees. This reduction took place within a 4 to 6-week period. The technique does not require any bracing or surgery. Furthermore, the new treatment costs less than bracing or surgery. The average corrective surgery costs $60-$120,000,00 while this new treatment averages $4-$6,000.00. Dr. Luckey and Dr. Ferris took intensive training at the CLEAR Institute to become certified and now practice the treatments at Victor Advanced Chiropractic in upstate New York. Chiropractors trained by CLEAR Institute are committed to achieving structural changes to the spine that will allow the body to de-rotate and correct itself. Victor Advanced Chiropractic (www.victorac.com) is the only certified place to find this new treatment in New York State, and in a two hundred and fifty mile radius.

The CLEAR Institute was founded in 2000, its intent is to providing advanced professional training to chiropractors and chiropractic students on all aspects of practice; diagnostic, treatment protocols, and management. CLEAR (Chiropractic Leadership, Education, Advancement, and Research) has a goal to guide chiropractors every step of the journey as they become true "spinal experts". Scoliosis is their most challenging spinal condition of all.

Dr. Ferris and Dr. Luckey urge pediatricians, mothers, and current scoliosis patients everywhere to research more information regarding this disease and the incredible benefits of this new treatment. Both doctors invite questions or concerns at their practice, Victor Advanced Chiropractic.

Lynch Chiropractic Adds Spinal Decompression

2007-07-13T08:09:00.001-07:00

Lynch Chiropractic, of Salem, New Hampshire has added spinal decompression to its services.

Spinal decompression is a non-surgical treatment for the lumbar or cervical spine. It can also be used in the treatment of leg, neck or arm pain that works by reducing loading of the spine. Spinal decompression has evolved into a breakthrough treatment for herniated and degenerative spinal disc disease, one of the major causes of back pain. This non-surgical treatment for herniated and degenerative spinal disc disease heals the injured spinal segment by minimizing intradiscal strain. Chronic low back pain disability is the most expensive benign condition that is medically treated in industrial countries. It is also the number one cause of disability in persons under age 45.

Spinal decompression alleviates pain by increasing the capacity between the discs. This allows the disks to return to a normal position. It’s one of the one most effective treatments for severe cases of degeneration herniation, arthritis, stenosis and pressure on the spine. Spinal Decompression is a catalyst for healing because the therapy stimulates the cartildge to renew which it cannot do on its own because. The actually stimulates nutrient rich blood filling the disc space and evoking the healing response.

“Patients think that spinal decompression must hurt to work when the opposite is true. For spinal decompression to work, it must be virtually painless,” explains Dr. Lynch. “I see the patient for 20 to 30 minutes. Patients may need approximately 20 visits over a 6 to 8 week program to completely heal. Many are pain free in 6 to 8 visits, but the body is still healing. I have had patients complete the program while still working. This allows patients to be treated without the traditional down time of surgery and rehabilitation”

Spinal Decompression is ideal for people suffering from bulging or herniated discs, chronic back or neck pain, sciatica, disc degeneration who are looking for a non-surgical approach to regain their health back.

Chiropractic Marketing

2007-07-13T07:22:00.000-07:00

According to survey results conducted by the American Chiropractic Association (ACA), the percentage of chiropractors using computers in 1981 was just 8.1%. 13 years later that number jumped a whopping 73.8% with 81.9% of chiropractors reporting they use computers. According to one chiropractic marketing expert, we're on the verge of witnessing yet another massive shift in the behavior of chiropractors.

"Just like the use of computers skyrocketed with chiropractors and radically changed the way doctors ran and managed their offices, I believe we're seeing the beginning of the same magnitude of change with the way doctors are doing their chiropractic marketing," says Todd Brown, CEO and Founder of More Chiro Patients, Inc.

"Between the tremendous cost savings, ability to use video and audio, and the automation, I predict we're going to see more and more chiropractors move to the Internet for almost all of their chiropractic practice marketing."

Brown, a chiropractic marketing expert and the creator of the Chiropractic Dashboard - a comprehensive multi-media chiropractic marketing and practice-building system that uses technology to automate everything for doctors - refers to doctors who aren't yet using the Internet to grow their practice as "behind in the times as a doctor who isn't yet using a computer in his or her office".

"With over 1,000,000 million searches taking place every month on the Internet for keywords like 'chiropractor', 'chiropractic office', and 'chiropractic care', the doctors who are using the automated chiropractic marketing options the web now provides are going to be the ones experiencing the greatest practice growth", states Brown. "And, it's the whole reason we went ahead and created the Chiropractic Dashboard for doctors -- because it's the quickest way for chiropractors to tap into those online chiropractic marketing technologies." For more information go to: www.TheChiropracticDashboard.com.

Bio-technology Improves Patient Services

2007-07-09T08:30:00.001-07:00

Chiropractor Adds Bio-technology to Improve Patient Services

Dr. Bruce R. Lowry, D.C. has added ZYTO bio-technology to the healthcare services offered to clients at his chiropractic and wellness clinic._

The chiropractic and wellness clinic is located at 420 West Main St. in American Fork. Lowry provides chiropractic, acupuncture, energy work, bio-identical HRT, nutrition, patient education services and has recently added ZYTO technology to his practice, which enables him to get patients on the road to better health faster and often for lower cost.

“We are excited about the addition of ZYTO technology to the services we offer,” said Lowry. “Using the ZYTO technology we are now able to perform a health scan of the body and obtain the information we need so we can make the best recommendation to improve health. It is quick, easy to administer, and very effective.”_

The process is simple to administer with just one brief office visit. Patients simply place their hand on a sensor that is connected to a computer. In just a few minutes the results can be seen on a computer screen, and an assessment can be made, according to Lowry.__

ZYTO Corp. has a web site at http://www.ZYTO.com _

Chiropractic Care for Whiplash Injuries

2007-07-06T13:27:00.001-07:00

Multiple Studies Confirm Positive Outcomes of Chiropractic Care for Whiplash Injuries

The Foundation for Chiropractic Progress (www.f4cp.org), a not-for-profit organization, points to four published research studies which validate that chiropractic care provides significant, ongoing relief for whiplash. Whiplash is defined as an injury to the cervical spine caused by an abrupt jerking motion of the head, backward or forward, often occurring from rear on-set automobile accidents and amusement rides or the result of falls, accidents and sporting activities.

“Nearly one out of 15 adult Americans suffers from the annoying and sometimes debilitating long-term effects of whiplash injury, usually in the form of neck stiffness and pain,” states Arthur C. Croft, D.C., M.Sc., M.P.H., F.A.C.O. director of the Spine Research Institute, San Diego, CA and a member of the Foundation. “While chiropractic care in the acute stage can often stave off this unpleasant outcome, two of the studies have shown that even in the chronic stage, chiropractic intervention can provide up to 90 percent relief for these sufferers.”

Dr. Croft cites research reported in Injury (27(9), 643-645) where authors Gargan and Bannister state, “93 percent of the 28 patients studied retrospectively were found to have a statistically significant improvement following chiropractic care. Chiropractic care in this study consisted of spinal manipulation, PNF (Stretching) and cryotherapy.”

In a follow-up study published in Journal of Orthopaedic Medicine, 21(1), authors Khan, Cook, Gargan, & Bannister conclude, “Whiplash injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment.”

Additionally, Croft points to two studies reported in the Journal of Manipulative Physiology and Therapy, 28(1), 3-11 in which authors Giles and Muller state, “For chronic spinal pain in general, when compared to acupuncture and traditional medical approaches, chiropractic has generally be shown to be more effective.”

Since most whiplash injuries occur from unexpected accidents, doctors at the Foundation advise motorists and passengers to always practice safe driving habits, regardless of how far they are traveling from home.

“Whether you are driving locally to a convenience store or embarking on a long road trip, careful driving and using the proper restraints and seatbelts can help to prevent whiplash resulting from automobile accidents,” says Gerard W. Clum, D.C. president of Life Chiropractic College West, Hayward, California, and spokesperson for the Foundation.

“Proper safety and head gear can also assist in preventing whiplash in sporting and other activities. Chiropractic care is a well established and effective intervention providing considerable relief.”

For more information on the benefits of chiropractic care visit www.f4cp.com and access the Foundation’s free Health Seekers calendar or call 916.359.0327.

Ten Best Ways to Avoid Going to the Chiropractor

2007-07-05T04:27:00.001-07:00

By Dr. Andrew Mark Rodgers
Chiropractic Expert Witness

1. Stretch your Hamstrings- Lay on your back thirty times a day in three sets of ten repetitions. Start before getting out of bed, leg straight, circles with your foot.

2. Use a moist heating and on your back two pillows under your knees for twenty minutes, three times a day. Those lumbar muscles fatigue then tear resulting in spasm, that tear misaligns the sacroiliac joint the most common cause of low back pain actually mimicking a disc herniation. 80% of low back pain is not caused from a herniated disc, but from a S.I joint misalignment and lumbar muscle tearing, so nurture with heat and rest those lumbars and they will support you.

3. Check out the McKenzie protocol for stretching and strengthening especially prone hyperextension, but tips one and two never let anything interfere with these first two.

4. Cardiovascular and proper breathing techniques. Reclined bicycle and fast to regular speed walks at least three times a week. Of course, swimming is the gold standard for non-weight bearing C.V. exercise and toning. Muscles need oxygen to fire.

5. Lean towards a vegetarian whole grain daily food plan.

6. Positive Mental Attitude- Reinforcement every five minutes. Talk to yourself. Everything is O.K. I can do this, I will do it, I am doing it.

7. Avoid Flexion-Bending forward and sitting. If sitting is vital boost up on a wedge tilting you forward, thereby restoring the natural lumbar lordosis.

8. A healthy neck, upper/mid back and low back are a daily life style of standing, (check out- Alexander Technique), sitting and sleeping correctly. Defy one of these starting in the morning, it all falls apart collectively.

9. Be a proactive, compliant self-caring manager of your own health- and life, of course. Be enthusiastic, pain and poverty are horrific and preventable.

10. Periodical spinal check-ups to any professional practicing manipulative medical procedures. Presently, your chiropractor is the specialist for this and the most versed and experienced. In your insurance company, managed care directories under specialists, this will check for spinal and pelvic misalignment from prior falls or accidents, emotional stress or chemical stress. These misalignments (subluxations) are like dental cavities. These spinal and pelvic misalignments (called subluxation by medicare.com) can be hidden for a long time, then cause acute or chronic symptoms. Have them corrected preventatively at your monthly chiropractic check-up.

For more information on Dr. Andrew Mark Rodgers visit

www.fortleechiropractic.com

Dr. Kenneth Golden

2007-07-05T04:24:00.001-07:00

Dr. Kenneth Golden is a licensed and board certified chiropractic physician with extensive experience in medical acupuncture with an emphasis on pain management techniques.

Formally associated with Zimmer Chiropractic, Dr. Golden’s new practice leverages a variety of noninvasive pain management techniques featuring a unique form of acupuncture designed to rapidly relax tightened muscles.

Trained in both chiropractic medicine and acupuncture, Dr. Golden blends these two very different treatments into a comprehensive healing strategy for his patients.

“There is nothing more frustrating than having your enjoyment of life limited by pain!” said Dr. Golden. “At Symmergy, we help patients reduce pain levels, identify how the pain started and design a plan on how to prevent it in the future.”

A Wisconsin native, Dr. Golden graduated from the University of Wisconsin-Parkside in Kenosha with a degree in Psychology. In addition to a degree in human biology, Dr Golden went on to attain his doctorate degree graduating as Valedictorian of his class from the National University of Health Sciences (NUHS).

In his spare time Dr. Golden is an active part of his community and enjoys playing music at his church, Holy Spirit. He also performs with a couple of different local bands around town as well.

Dr. Golden is very physically active and has a strict routine of resistance and cardiovascular exercise 6 days a week. Dr Golden tries to practice what he preaches which keeps him at peak performance for his patients. This also enables him to help patients design their own healthy lifestyle routines.

For more information on Dr. Golden and Symmergy visit www.symmergy.com.

Chiropractor to Address Future Medical Students

2007-07-05T04:20:00.000-07:00

Dr. Tim Langley, a family chiropractor in Marietta, Georgia, has been invited to address future medical students attending the National Youth Leadership Forum on Medicine at Emory University in Atlanta. This is the sixth consecutive year that Dr. Langley has been invited to address the Forum.

“It is always a pleasure and privilege to address these future doctors on both career opportunities as a Doctor of Chiropractic and the benefits of chiropractic care to individuals and the community at large. They are among the top of their peer group and are interested in all of the healing arts. It’s exciting to share the chiropractic story to an open audience of future practitioners of all stripes".

Other fields represented at this years National Youth Leadership Forum on Medicine included neurology, cardiology, podiatry, orthopedics, obstetrics, optometry and bariatric medicine.

Dr. Langley practices on Shallowford Road in east Cobb County and is an alumnus of Life University in Marietta, Georgia. He considers himself a family wellness chiropractor with customers ranging from newborn babies and student athletes to working parents and senior citizens. Dr. Langley is available to speak to groups about chiropractic care and living a simpler, drug-free lifestyle. You can learn more about Dr. Langley and chiropractic at his web site at www.langleychiropractic.com.

Hypertension treated successfully w/ chiropractic

2007-06-21T05:26:00.000-07:00

Thelma had been a patient of mine during the past 10 years. She would come in a couple of times a month for a tune-up, or "maintenance..."

Thelma developed high blood pressure and had a heart attack. A few weeks ago, her blood pressure was on the rise and she asked me to adjust her to help lower her blood pressure as it has done so in the past. We check her blood pressure before and after the adjustment and noticed a significant drop. Thelma is not alone. Many people suffering from hypertension have been treated successfully with chiropractic.

According to a study published in the March issue of Journal of Human Hypertension, chiropractic adjustments to the upper neck can significantly lower blood pressure in patients with Stage-1 hypertension.

Dr. George Bakris, principal investigator of this study, supplied patients from his clinic at the Rush University Hypertension Center in Chicago for the research.

He said the chiropractic technique studied "has the effect of not one but two blood pressure medications given in combination. And it seemed to be adverse-event free. We saw no side effects and no problems."

In describing why chiropractic was effective, Bakris discussed a "subpopulation of hypertensive patients that have neurogenic hypertension." In this case, it is thought that misalignment of the atlas vertebrae (the top vertebrae in the neck) results in changes in the vertebra artery and "are associated with the relative ischemia of the brainstem circulation and increased blood pressure."

...Thelma and I continue to work together. She is in her 80s now, and I appreciate her and the time we have together in friendship and health.

This is the opinion of Michelle Greenspan, a doctor of chiropractic and a certified chiropractic extremity practitioner. She can be reached at www.greenspanchiro.com.

To see full article:
http://www.citizen-times.com/apps/pbcs.dll/article?AID=2007706190308

Dr. Joseph Hudak

2007-06-21T05:20:00.000-07:00

Dr. Joseph Hudak would like patients to think of chiropractic care as one spoke in the wheel of general wellness, not just a quick fix when they break down in a health crisis.

"I view myself as a chiropractor and as a health coach who should be part of your wellness too," he said. "Body parts and organs need to be maintained. We get our teeth cleaned. We get our eyes checked. I think everyone should be checked (by a chiropractor), from womb to tomb.

"Chiropractic is an art, a philosophy and a science."

The doctor... sees more female patients.

"Women value their health more," he said.

His patients generally are 35 to 55, although he sees young children, often with sports injuries.

"Injuries on a developing spine are probably more hazardous" than those to mature bones, he said.

Hudak's book, "The Journey to Wellness, A Practical Guide to Health Through Diet, Rest, Exercise, Alignment and Mental Attitude," was recently released...

Hudak emphasizes stress reduction, breathing exercises, attention to diet and sleep as steps on the path to wellness...

Interest in chiropractic came at an early age. Hudak was born with a dislocated hip and wore leg braces as a child. As a teenager, his condition was helped by a chiropractor. It was then he decided to study to become one.

Hudak receives chiropractic care at least once a week from Dr. Matthew Singer, who joined the office team three years ago.

Singer received his doctor of chiropractic degree from Logan Chiropractic College in St. Louis after completing his undergraduate studies at the University of Delaware. He also completed a two-year program in chiropractic neurology at Chicago's National Chiropractic College. Born in New Jersey, he lives in North Brunswick with his wife, Kelly.

Hudak attended Our Lady of Peace Grammar School in Fords and Bishop George Ahr High School in Edison. He attended Middlesex County College and then New York Chiropractic College. He completed a residency program at the Levittown Health Center in Long Island and practiced with Park Avenue Chiropractic in New York City before opening his wellness center in Edison in 1996.

Hudak and his schoolteacher wife, Christina, are expecting their first child in August.

Not surprisingly, the doctor said he plans to give his newborn a full chiropractic evaluation shortly after the birth.

More information is available at www.hudakchiro.com.

To see full article:
http://www.thnt.com/apps/pbcs.dll/article?Date=20070619&Category=LIFE07&ArtNo=706190429&SectionCat=&Template=printart

Chiropractic Care Improves Fitness, Restores Balance

2007-06-20T14:11:00.001-07:00

Never Too Old to Go for Gold: Chiropractic Care Improves Fitness, Restores Balance to Three Figure Skaters in Their Late 30’s

2007 U.S. Adult Singles and Pairs Champions apply chiropractic care to their ice skating regimens

Young or old, amateur or professional, figure skating at any level is a sport that causes discomfort and consistently strains muscles in the back, neck, legs and arms. For “30-something” skaters Ninotchka Aschow, Choeleen Loundagin and William Abel – all from Santa Rosa, California -- chiropractic care has not only been an important and necessary staple in their training and preparation but has also helped each one to realize a dream of winning a gold medal..

Along with competing at around the same age bracket, the three skaters have something else in common: they all work with chiropractor Dr. Christina Dumbadse, who not only offers the skaters physical relief from their injuries, but also takes a holistic approach to patient management, introducing ways to improve the skaters’ wellness, nutrition and mental acuity. Dr. Dumbadse is a member of The Foundation for Chiropractic Progress (www.f4cp.org), a not-for-profit organization providing education about the benefits of chiropractic care.

“I am thoroughly impressed with Dr. Dumbadse’s approach, especially her attention to the latest research, best approaches for athletes and her pro-active approach to care,” says Loundagin, a 39-year-old singles skater throughout her entire career who did not actively compete for almost 22 years.

As a skating coach, she was constantly around the rink watching and interacting with the skaters, and assisting with their training. When the opportunity to participate in a pairs competition was presented to her, Loundagin embarked on an intense training schedule with skating partner, William Abel.

“Going from singles to pairs was a tricky transition, however seeing a chiropractor two to three times a week allowed me to develop the additional muscle and upper body strength for lifting, as well as keeping my alignment consistent,” explains Loundagin, who along with Abel won gold in the first championships pair’s competition at the U.S. Adult Championships. “I think it is important to take care of your body and appreciate what it is doing for you. Chiropractic care definitely helped me become stronger in areas that I was lacking.”

In the beginning, Abel would only visit with his chiropractor for adjustment purposes. Soon his office visits increased when he learned that chiropractic care was just as useful for preventative care.

“Skating is an unbalanced sport – you are jumping and landing on the same side of your body over and over,” says Abel. “Pairs skaters are always lifting with one arm and continuous favoring one side of the body. Over time, you begin to feel various pain sensations that can put your body into an uncomfortable state. For me, chiropractic care is the only thing that can turn around this type of situation. I would not go to a medical doctor for something like this.”

Ninotchka Aschow also understands the health and wellness benefits that come with chiropractic care. At age 37, she captured her second championship, the Gold Ladies Title at the 2007 U.S. Singles Championship.

“I have been seeing a chiropractor for the last 15 years and am confident that if I fall awkwardly and feel some discomfort during my performance, my chiropractor will fix my alignment and get me back on the ice later that day,” says Aschow. “I feel more vibrant and alive at age 37 than I did at age 27, and I can say that is a direct result of chiropractic care.”

Chiropractic is Helping Patients Feel Younger

2007-06-19T07:24:00.001-07:00

As the baby boomer generation approaches retirement age, they have begun experiencing many of the ailments typically associated with aging. Common complaints are stiffness and aches and pains of various sorts.

According to Dr. Rode, it doesn’t have to be this way. “I get many patients who come to me in pain and one of their most frequent complaints is that their pain makes them feel old. They just naturally assume that as they age, they are going to automatically start having these problems.” Pain that is associated with aging can actually be attributed to misalignments in their spine. A common misconception is that soreness and aches in the muscle are only a muscular problem and that stretching will make it go away. What happens is nerves from the spine are pinched and that decreases or interrupts the nerve flow to the muscles causing the aches and pains.

Dr. Rode recommends chiropractic care to reduce and eliminate the pressure on the nerves thus getting rid of the aches and pains. He explains, “Often patients will have more energy, more stamina and are able to do things that they had mistakenly believed they couldn’t do any more. They tell me they feel several years younger now that they are pain free and can enjoy life more fully.”

Chiropractic Helps Lower Your Golf Score

2007-06-19T07:22:00.000-07:00

Dr. Raymond Sue of University Chiropractic is helping golf lovers to stay on the green longer. "All too often I see golfers end up taking pain killers or having to reduce playing the game they love so much, all because of back pain from golf. Recently chiropractic treatment has really caught on with both amateurs and pro’s as an excellent way to alleviate those on-the-green pains," said Dr. Sue.

The problems occur from all those repetitive golf swings. It puts a significant strain on the lower back and other areas of the body. Since chiropractic is the science of the spine, they are in a good position to help golfers understand the correct way to take care of their bodies while still enjoying lots of golf.

Many of the nation’s head golf instructors now regularly seek chiropractic care to keep themselves healthy while going through the daily physical grind of golf instruction. Top professional golfers, like Tiger Woods, seek chiropractic care on a regular basis.

How well does chiropractic work in aiding golfers? A recent study reported that up to 85 percent of injuries on the PGA Tour and Senior Tour relate to the spine. Between 70 to 75 percent of these golfers receive chiropractic care regularly. There are approximately 25 to 30 million amateur golfers in America. Dr. Sue said, "It's my goal to educate part-time golfers who are passionate about their game, that chiropractic can keep them playing longer, more often, and into their retirement years while playing without pain. And chiropractic is also terrific for preventing injuries.”

Some chiropractors, like Dr. Raymond Sue, D.C., offer Free Golf Screenings to those with a sincere desire to explore how chiropractic might help them in improving their golf game and in staying healthy. For more information on how chiropractic can help improve your golf game, please consult your local chiropractor.

Chiropractors: Court Victory vs. 'Quackbuster'

2007-06-15T04:36:00.000-07:00

In a strongly worded opinion, the Appeals Court for the State of Pennsylvania ruled against Stephen Barrett, a long-time critic of chiropractic and alternative health care. In an action that chiropractors see as a major setback for their nemesis, the judge refused to overturn a 2005 decision against Barrett.

The earlier lawsuit was won by chiropractor Tedd Koren, DC, whose company markets chiropractic educational pamphlets that Barrett had harshly criticized.

In his newsletter, Dr. Koren referred to the self-proclaimed "Quackbuster" as a "Quackpot" and commented that Barrett was "de-licensed," and "in trouble." Barrett sued Koren for defamation and lost the case.

Barrett, who represents himself as an expert on health care quackery, has appeared as a medical expert in numerous court cases and claims the FDA, FTC and other governmental agencies have consulted him on health care issues. He is noted for his outspoken opposition to and criticism of non-medical health care approaches, most of which he labels "quackery." His targets have included chiropractic, homeopathy, naturopathy, and even two-time Nobel Prize winner Linus Pauling.
Heading the legal team for the original Koren case and appeal was Carlos Negrete, who serves as legal counsel for the World Chiropractic Alliance (WCA).

"This is a great victory for the chiropractic profession," Koren stated after the Pennsylvania Appellate Court decision was announced. "Once again, chiropractors across the country have been vindicated and exposed the specious and evil attacks by someone who has no knowledge or expertise in our field."

Negrete specializes in representing alternative health care providers who are targeted by advocates of the medical and pharmaceutical industries. His previous court victories have positioned him as the premier "health freedom" attorney in the US.
During heated and often dramatic courtroom proceedings, Negrete pointed out many of the questionable statements Barrett includes on his websites attacking chiropractic, as well as facts about Barrett's own credentials that shocked even his supporters. Under Negrete's intense cross-examination, Barrett admitted that he had not been a licensed physician for more than a decade and had failed the neurological exam, preventing him from being certified as a specialist. Negrete demonstrated that, despite his claims, Barrett had no real expertise in any medical field.

Barrett also admitted, under questioning, that he misrepresented himself as a licensed physician in a previous court case.
"These revelations cast serious doubts about Barrett's credibility and integrity and were major factors in the judge's decision," Negrete stated.

Calling the case a "landmark decision" for chiropractors and alternative care providers, Negrete noted that "Barrett has made a career out of attacking core chiropractic values, specifically subluxation, with no scientific basis for his contentions. This case clearly shows that his opinions about chiropractic or other health care options are irrelevant."

WCA President Terry A. Rondberg, DC, agreed with Negrete. "This is a turning point not only for Barrett, but for all unscientific and uninformed opponents who seek to impose the medical monopoly on the public. People around the world deserve freedom of choice in health care and need valid, unbiased and truthful information on all options available to them. Thanks in great part to the WCA legal counsel, Carlos Negrete, they now have a better chance of getting both."

The World Chiropractic Alliance — an international organization representing doctors of chiropractic — promotes traditional, drug-free and non-invasive chiropractic to correct vertebral subluxations. The WCA is an NGO (Non-Governmental Organization) associated with the United Nations Department of Public Information and publishes the peer-reviewed chiropractic research journal, Journal of Vertebral Subluxation Research. For more information, contact the WCA at 800-347-1011 or http://www.worldchiropracticalliance.org.

CAM = Cost Savings, High Patient Satisfaction

2007-06-08T05:14:00.000-07:00

Patients visiting chiropractors and other holistically-oriented physicians who serve as primary care providers (PCPs) have lower utilization costs and higher patient satisfaction levels than patients treated by conventional medical doctors, according to a study published in the May issue of the "Journal of Manipulative and Physiological Therapeutics" that tracked data from a unique Independent Physicians Association (IPA) where chiropractors serve as first- contact, primary care physicians.

"The escalation of medical expenditures remains an urgent problem in the United States and it's becoming quite clear that cost containment strategies by conventional medical providers are failing to achieve even mediocre results," said study coauthor James Winterstein, DC. "This study confirms that integration of allopathic, chiropractic and other complementary and alternative medicine (CAM) providers can positively impact patient quality of care while limiting overall costs. This approach to patient care has great potential to improve the U.S. healthcare system."

Led by Richard Sarnat, MD, researchers directly compared cost and clinical utilization data from an integrative CAM Independent Physicians Association (IPA) with conventional medical IPA data from members enrolled in a traditional health maintenance organization (HMO). The recent report analyzes data from 2003 to 2005 and is a follow up to the original report published in 2004, which compared data from 1999 to 2002.

"Our most recent analysis supports earlier findings that patients visiting CAM-orientated primary care physicians (PCP) -- primarily chiropractors -- experienced fewer hospitalizations, underwent fewer surgeries and used considerably fewer pharmaceuticals than HMO patients who received traditional medical care," Dr. Winterstein said. "Moreover, doctors of chiropractic succeeded in diagnosing and treating patients at a level nearly equal to medical doctors."

Researchers found that over the course of the seven-year study, patients visiting chiropractors and other CAM-oriented PCPs had 60 percent fewer hospitalizations, 62 percent fewer outpatient surgical cases, and 85 percent lower pharmaceutical costs when compared with total network HMO utilization rates and costs. The chiropractors and other CAM doctors treated and managed cases ranging from upper respiratory tract infections and allergies to headaches, orthopedic and other medical conditions.

In 2005, the chiropractic PCPs managed 60 percent of their enrolled patients without requiring a referral to a conventional medical specialist. These data mirror the 2001 findings, which also demonstrated that 60 percent of the patient population within the integrative IPA was solely managed by their chiropractic PCPs.

"The most current data from our ongoing study suggests that doctors of chiropractic are well-suited to provide patients with valuable primary care services," Dr. Winterstein notes. "We have demonstrated that it is possible to deliver CAM-oriented primary care in a highly regulated environment without compromising either quality or safety."

Patients reported on the quality of care they received through the use of annual patient satisfaction surveys. On average, data from patients enrolled between 2003 and 2005 demonstrated a high degree of satisfaction (96 percent, 94 percent, and 91 percent, respectively). These findings were similar to data from 1999 through 2002 (100 percent, 89 percent, 91 percent, and 90 percent, respectively). The integrative CAM patients consistently rated their experiences more positively than did members enrolled within the HMO's conventional medical IPAs.

The "Journal of Manipulative and Physiological Therapeutics," the premier biomedical publication in the chiropractic profession and the official scientific journal of the American Chiropractic Association, provides the latest information on current research developments, as well as clinically oriented research and practical information for use in clinical settings.

Frederick Family Chiropractic

2007-06-04T05:49:00.000-07:00

...Donna Frederick opened Frederick Family Chiropractic on June 1, 2006. She believes she is the only female chiropractor in Delaware County. Frederick is a Muncie native who graduated from Southside High School, Ball State University and Palmer College of Chiropractic in Davenport, Iowa...

Were you a non-traditional student? "I had been out of school for nine years and was going on 30. But non-traditional students are very common at chiropractic schools. People decide later in life to go..."

You decided to open your own practice? "The dream is to open your own practice. It doesn't happen a lot. Most of the students in my class did associateships with another doctor for a year or two. You want to build a patient base, but most sign a non-compete clause so you can't take patients with you. Few people in my class planned to start their own practice right away. It's usually a money issue..."

Have you reached your goal with your practice? "I'm not there yet. We're seeing about 80 people a week. My goal is 300."

Is that number typical? "There's a low percentage of chiropractors who see 300 or more a week..."

Do you have a most memorable moment? "I went to India on a clinic abroad trip. I had a 'miracle case,' a 24-year-old who could barely walk, barely speak, his eyes diverged to opposite corners of his sockets. They brought him in for low back pain. I adjusted him three times. The second day he was saying the word 'doctor.' By the third day he was speaking in complete sentences, walking without assistance and his eyes had coordinated."

What affected him? "I think he had a nerve compression in his neck and information from his brain was not getting to where it needed to get. I just happened to be the person who saw him. It's not that I think I'm so great, but I can do this."

What's the difference between chiropractors and MDs? "To get an MD, I would have to go to school two more years. The difference is we don't do minor surgeries or prescribe medication. I can do a physical, order tests and MRIs and blood work. But my treatment consists of adjustments and therapies."

What's the most common problem you treat? "Headaches and low back pain."

What's the most common treatment? "I have stretches that I have them do or I do an adjustment and then recommend exercises. I do manual techniques. I use my hands. I move the bone so it helps relieve the pressure on the nerve. You do a very small adjustment."

To see rest of article and picture:
http://www.thestarpress.com/apps/pbcs.dll/article?AID=/20070603/BUSINESS/706030327/1046

Dehydration Cause of Headache and Back Pain?

2007-06-04T05:45:00.000-07:00

Doctor of Chiropractic Claims Dehydration is Primary Cause of Chronic Headache and Back Pain

After 12 years of clinical practice both in New York and Texas, Dr. Daniel Bettiol is hanging up his white coat forever to promote the healing benefits of proper body hydration.

Dr. Daniel Bettiol is leaving the profession of Chiropractic to pursue his clinically-tested belief that the primary causative factor in Headaches, Neck & Low Back pain is Dehydration of the tissues and the inability to eliminate accumulated Metabolic wastes from the body.

While treating over 3,500 patients and delivering over 120,000 chiropractic adjustments, Dr. Bettiol observed that over 90% of his patients were inadequately hydrated. "My most consistent finding was that 100% of my chronic Headache and Low Back patients were severely dehydrated. Many of these patients acknowledged an absolute disdain for drinking water," says Dr. Bettiol. "For those patients who adopted my daily water regimen, an immediate decrease in pain symptomology was observed. That result was too consistent to be a coincidence."

Dr. Bettiol is determined to continue the work of Fereydoon Batmanghelidj, M.D., who wrote the blockbuster 1992 best-seller, Your Body’s many cries for Water. Dr. Batmanghelidj died in 2005, but his signature slogan "You are not Sick, you are Thirsty---Don’t treat thirst with Medications" lives on. "Dr. Batmanghelidj warned the public back in the 1980s that America’s thirst for Soda, Coffee, and Sugar-filled drinks would create a huge population of unhealthy and obese people," says Dr. Bettiol. "To say his prediction was accurate would be a gross understatement."

Bettiol begins his new journey with the firm opinion that ALL water is not optimum for health. His extensive research has shown that Tap, Bottled, Charcoal-filtered, Distilled and Reverse Osmosis Water is NOT the ideal Water for long-term health and healing. "America has ignored the miraculous healing being experienced by the Koreans and Japanese with Ionized Alkaline Water," says Bettiol. "Where Bill Gates vision was a computer in every home, my lifetime mission is to get an Alkaline Water Ionizer in every home throughout the world. That would not only eliminate obesity, chronic pain and the need for useless Medication, Surgery & Radiation...it would singlehandedly cut our annual $1.5 Trillion health care costs by 90%."
"I would rather people spend more time with their families, their hobbies and the work they love, than sit in a doctor’s office for four hours waiting for a Doctor visit they really DON’T NEED."

Laptops = Backache (7)

2007-06-01T12:13:00.000-07:00

Booming sales of laptops have led to a surge in the number of computer users with back and muscle problems, experts have warned.

Girls as young as 12 are being diagnosed with nerve damage caused by slouching over screens, a group of leading chiropractors said.

Millions of others are at risk of "irretrievable damage" to their spines, necks and shoulders because of poor posture when using laptops, it was claimed.

Back specialists say as many as four in five patients have chronic nerve damage caused by working on portable PCs.

The problem is being driven by falling prices and the increasing availability of wireless technology, which makes portable computers more attractive.

Laptop sales in PC World went up by more than 25 per cent last year.

In addition, laptops used at work are not subject to the same health and safety regulations as desktop computers.

This makes it more likely they will be used incorrectly.

A common problem is perching a laptop on the legs so users stare down at the screen and put strain on their necks, spines and legs.

London-based chiropractor Michael Durntall was among those calling for more research into the issue.

He said he had seen dozens of Xrays showing signs of degeneration in the joints of regular laptop users.

Mr Durntall added: "Mothers bring in their 12-year-old daughters suffering back pain and when they arrive I can see their slumped posture straight away.

"I also see many people in their twenties and thirties with a dowager's hump - a rounding at the base of the neck - after only a few years of looking down at a small screen while sitting slumped on a chair for long periods."

Rishi Loatey, a chiropractor from Wembley, North-West London, said he often treated back and neck pain caused by using a laptop on the move, such as on a train...

Compete Article

IDD Therapy Offers Non-Surgical Back Pain Relief

2007-06-01T04:29:00.000-07:00

There is an innovative treatment option at the Advanced Physical Medicine Center locally in Fairview, N.J.

"There are only a handful of these machines in Bergen County," explains Dr. Michael Arber, a chiropractor at the center, who administers non-invasive Intervertebral Disc Decompression (IDD) therapy. "The best part about the equipment is that it's not just temporary relief. It actually reduces the size of disc injuries and helps the surrounding soft tissue return to normal function."

Thanks to IDD Therapy, a non-surgical treatment, approximately 85 percent of people can relieve back pain symptoms without drugs or surgery. This revolutionary technology is ideal for herniated or bulging discs, degenerative disc disease, spinal stenosis, sciatica and acute or chronic back pain.

IDD therapy is deployed via the Accu-SPINA System, and works to reshape the spine using computer technology to apply traction to spots causing lower back pain. The traction provides a negative pressure that allows fluid, blood and nutrients into the affected discs that cause pain. In other words, as each challenge is introduced to the body, it supports muscles and ligament tissue to retone itself, re-educating the neuromuscular system and relieving pain. The typical treatment is 18 to 24 treatments over eight weeks, and each session lasts 30 minutes.

"It's not painful. Once on the machine, a lower harness pulls at a specific angle and tension to alleviate the area of stress," says Dr. Arber. "While IDD therapy is not currently reimbursable by insurance carriers, the cost of getting lower-back surgery is far greater. And IDD therapy is non- invasive."

Dr. Arber says a lumbar MRI and an exam is all that is needed to determine if IDD therapy is right for a patient.

The Advanced Physical Medicine Center specializes in chiropractic care, physical therapy, paint management and massage therapy. Located in Fairview, N.J., the facility has numerous certified professionals including chiropractors Michael Arber, BS, DC, DAAPM, and David Berk, BS, DC, MS, CCSP.

iPods, Blackberries a Literal ‘Pain in the Neck,’

2007-06-01T04:16:00.000-07:00

With the increasing popularity of cell phones, Blackberries, I-Pods and handheld games, Americans are spending a lot of time peering down at their laps. While the gadgets are a source of entertainment and help keep people connected to friends and coworkers, handheld devices are also a source of muscle pain and injury, according to the American Chiropractic Association.

“I have seen a dramatic increase in the number of people complaining of pain as a result of their handheld devices,” said Dr. Keith Overland, a chiropractor from Norwalk, Conn. Dr. Overland says most of his patients don’t realize how much looking down at a gadget can worsen neck, back and shoulder problems.

“We actually ask patients to hold the device in their hands and then take a look at the way they’re holding their body,” Dr. Overland noted. “We can see almost immediately the cause of their pain – poor posture and overused muscles.”

To help lessen muscle soreness caused by popular handheld devices, Dr. Overland and the American Chiropractic Association suggest the following:
Practice good posture when using any handheld device. Sit in a chair that provides solid back support and keep feet comfortably on the floor.
Spend 10 minutes or less with your head tilted down looking at the device, and when possible hold the gadget at eye level.
When at home or in the office, connect the device to your keyboard or computer.
Take frequent breaks and alternate activities that use different muscle groups.
Watch for warning signs of overuse such as headaches, fatigue or muscle pain.

Spinal Manipulation Beneficial for Neck Pain

2007-06-01T04:15:00.000-07:00

A new literature review finds evidence that patients with chronic neck pain enrolled in clinical trials reported significant improvement following chiropractic spinal manipulation, according to a March/April 2007 report in the Journal of Manipulative and Physiological Therapeutics (JMPT).

According to Howard Vernon, DC, PhD, the review’s chief author, “The results of the literature review confirm the common clinical experience of doctors of chiropractic: neck manipulation is beneficial for patients with certain forms of chronic neck pain.”

As part of the literature review, Dr. Vernon and his colleagues reviewed nine previously published trials and found “high-quality evidence” that patients with chronic neck pain showed significant pain-level improvements following spinal manipulation. No trial group was reported to remain unchanged, and all groups showed positive changes up to 12 weeks post treatment. No trial reported any serious adverse effects.

This literature review did not include studies involving patients with acute neck pain, neck and arm pain, neck pain due to whiplash, or those with headaches. In this review, chronic neck pain was defined as being a minimum of 8 weeks duration.

Researchers also found that mobilization therapy was beneficial in improving patients’ pain levels, with many achieving full recovery after six to seven weeks of treatment; however, the current evidence did not support a similar level of benefit from massage therapy.

Neck pain is a very common complaint – approximately 15 percent of women and 10 percent of men are estimated to have chronic neck pain at any one time. According to a report issued by the National Board of Chiropractic Examiners, 18 percent of chiropractic patients list neck pain as their chief complaint.

Spinal manipulation, commonly referred to as a chiropractic adjustment, is the main therapeutic procedure performed by doctors of chiropractic. The purpose of manipulation is to restore joint mobility by manually applying a controlled force into joints that have become hypomobile.

Chiropractors practice a hands-on, drug-free approach to health care that includes patient examination, diagnosis and treatment. Chiropractic is widely recognized as one of the safest non-invasive therapies available for the treatment of back pain, neck pain, headaches and other neuromusculoskeletal complaints. In addition, a significant amount of evidence shows that the use of chiropractic care for certain conditions can be more effective and less costly than traditional medical care.

The Journal of Manipulative and Physiological Therapeutics, the premier biomedical publication in the chiropractic profession and the official scientific journal of the American Chiropractic Association, provides the latest information on current research developments, as well as clinically oriented research and practical information for use in clinical settings.

House Passes Bill for Expansion of Chiro in VA

2007-06-01T04:14:00.001-07:00

America’s veterans are one step closer to gaining expanded access to chiropractic services after the U.S. House of Representatives passed legislation on May 23 that includes a provision to expedite expansion of the chiropractic benefit through the Department of Veterans Affairs (VA) health care system. The bill was approved 421:1.

The American Chiropractic Association (ACA) and the Association of Chiropractic Colleges (ACC) lobbied successfully for passage of the bill, HR 1470, which requires the VA to have a chiropractor on staff at no fewer than 75 major VA medical centers before the end of 2009 and for all major VA medical centers to have a chiropractor on staff before the end of 2011.

“I am proud that ACA and ACC spearheaded the advocacy efforts in support of HR 1470,” said ACA President Dr. Richard Brassard. “The health and well-being of our nation’s veterans is one of America's most important obligations. This legislation builds and expands on ACA’s previous work with Congress and will greatly improve the availability of chiropractic care to veterans young and old.”

Congressman Bob Filner (D-Calif.), a strong supporter of extending chiropractic care benefits to military retirees as well as active-duty personnel, worked closely with the ACA in securing support for the legislation. As Chairman of the House Veterans Affairs Committee, Rep. Filner’s leadership was essential to securing House passage of the bill.

According to remarks contained in the March 12, 2007, Congressional Record, Rep. Filner said that when writing the legislation he worked closely with “chiropractic patients, particularly our veterans, who know the benefits of chiropractic care and bear witness to the positive outcomes and preventative health benefits of chiropractic.”

“I also was pleased to work with the American Chiropractic Association (ACA), the nation’s largest chiropractic organization and the national voice of doctors of chiropractic and their patients,” Rep. Filner said.

Through previous congressional action, chiropractic care is now available at 30 VA facilities across the country; however, in the more than 120 facilities without a chiropractor on staff, the chiropractic care benefit that Congress authorized for America’s veterans remains virtually non-existent. Detroit, Denver, and Chicago are a few examples of major metropolitan areas without a doctor of chiropractic available at the local VA facility.

ACA leaders believe that integrating chiropractic treatment into the VA health care system would not only be cost-effective, it would also speed the recovery of many of the veterans returning from current operations in Iraq and Afghanistan. A 2006 report from the Veterans Health Administration indicates that nearly 42 percent of veterans returning from the Middle East and Southwest Asia who have sought VA health care were treated for symptoms associated with musculoskeletal ailments – the top malady of those tracked for the report.

HR 1470 is now headed to the Senate for consideration.

Integrative Medicine IPA Reduces Clinical Utilization

2007-05-26T06:39:00.000-07:00

New Landmark Study Confirms Integrative Medicine IPA Reduces Clinical Utilization and Costs for Large Midwest Managed Care Plan

Results of a follow-up study released today from the Journal of Manipulative and Physiological Therapeutics (May 2007;00:1-7) reinforce and amplify the effectiveness of an integrative IPA management model vs. conventional strategies to decrease clinical utilization and costs over an extended period of time and in a safe and highly regulated large Chicago HMO environment. The unique feature of the care model was that doctors of chiropractic (DCs) represented two-thirds of the primary care providers involved.

In the report, "Clinical utilization and cost outcomes from an integrative medicine independent physician association: an additional 3-year update," authors Richard L. Sarnat, MD, James Winterstein, DC and Jerrilyn A. Cambron, DC, PhD analyze utilization data from the IPA and include first-time comparisons in data points among primary care physicians (PCPs) whose training backgrounds were in chiropractic, osteopathic and allopathic medicine.

Author Dr. James Winterstein says, "Health care delivery in the United States has become 'business centered' rather than 'patient centered. The AMI model, through the integration of allopathic, osteopathic, chiropractic and various forms of alternative and complementary medicine, has demonstrated the potential to revolutionize health care delivery by refocusing on the needs of the patient. This model eliminates the turf battles and in doing so, greatly diminishes costs while helping the patient optimize health with fewer high tech procedures and less hospitalization. These should be the intentions of all who function in health care delivery."

According to Mike Flynn, DC, board member and spokesperson for the Foundation for Chiropractic Progress (www.F4CP.org), "This continuing study clearly establishes the ability of the doctor of chiropractic to function effectively and efficiently as primary care gatekeepers in a managed care setting. Decreased utilization was uniformly achieved by all providers."

Results of the study demonstrate clinical and cost utilization decreases based on 70,274 member-months over a seven-year period. Differences in utilization include: 60.2 percent in-hospital admissions, 59.0 percent hospital days, 62.0 percent outpatient surgeries and procedures and 85 percent in pharmaceutical costs when compared with conventional medicine IPA performance for the same HMO product in the same geography and time frame. The IPA's current PCP 21-member physician panel includes a mix of 14 DCs, and seven MDs and DOs.

Dr. Flynn notes that the current study updates the authors' initial report (JMPT, 2004) and covers a larger population than originally reported. Methodology included demographic analysis and patient satisfaction surveys to determine clinical utilization and costs. Comparisons to the original publication's comparative blinded data, using non-random matched comparison groups, were also assessed for differences in age and disease profiles to compare outcomes.

HMO members are recruited to the IPA during an open enrollment period offered to the total plan population. Members obtain information about the IPA from the HMO's standard primary care and specialist physician directories or their companies' human resources personnel. No marketing incentives were used by the HMO to attract potential patient enrollees to the IPA study during any of the years of operation.

"This study gives credence to the perspective that the power to achieve reduced utilization results from the underlying philosophy of patient management and is not the result of differences in PCP education or licensure," says Dr. Flynn. "As our nation faces the acute challenges of rapid escalation of health care costs, and with conventional strategies for clinical improvement and cost containment failing to achieve targeted goals, all stakeholders can look to this study for evidence of an integrative model's ability to deliver tangible results."

Visit www.foundation4cp.com to access the calendar or call 916.359.0327.

About F4CP

The Foundation for Chiropractic Progress is a 501c6 corporation that represents a cross section of the chiropractic and vendor communities with the goal of increasing the public's awareness of the benefits of chiropractic. www.foundation4cp.org.

Safe treatment for chronic back pain

2007-05-25T14:38:00.000-07:00

New Treatment Offers Relief from Chronic Back Pain

Study Suggests Safe Treatment for a Variety of Conditions

Chronic back pain is a condition that affects a significant part of the population, with patients falling into three major groups; those with herniated discs, spinal stenosis (a nerve affecting narrowing of the spinal cord), and complications from failed back surgery. Radiofrequency thermolesioning is a widespread treatment for chronic back pain, but because of its neurodestructive nature, it is often considered an unsuitable treatment.

Building on earlier work, a new study led by Dr. David Abejón investigates the use of an alternative treatment known as pulsed radiofrequency (PRF) in treating chronic back pain. It finds that the treatment yields significant improvements for herniated disc patients and notable improvements for those with spinal stenosis. Since PRF does not involve drugs, it may be repeated multiple times. This study appears in the journal Pain Practice.

While the preexisting conditions that accompany chronic back pain, such as neurological lesions or neuropathic pain, make conventional radiofrequency a controversial treatment, Abejón notes “the use of PRF could reduce or potentially even eliminate these risks,” providing safe, effective pain relief for patients with a variety of lower back pain conditions.

Aggressive treatment for whiplash?

2007-05-25T13:29:00.001-07:00

Aggressive treatment for whiplash does not promote faster recovery

Whiplash, the most common traffic injury, leads to neck pain, headache and other symptoms, resulting in a significant burden of disability and health care utilization. Although there are few effective treatments for whiplash, a growing body of evidence suggests that the type and intensity of treatment received shortly after the injury have a long-lasting influence on the prognosis. A new study published in the June 2007 issue of Arthritis Care & Research (http://www.interscience.wiley.com/journal/arthritiscare) examined whether the association between early types of care and recovery time shown in an earlier study was reproducible with whiplash compensated under tort insurance.

A previous study led by Pierre Côté, of the University of Toronto in Toronto, Canada, found that patients compensated under no-fault insurance had a longer recovery if they visited general practitioners numerous times and/or consulted chiropractors or specialists than if they just visited general practitioners once or twice. In the current study, the authors examined patterns of care for 1,693 patients with whiplash injuries who were compensated under tort insurance.

The results showed that increasing the intensity of care to more than 2 visits to a general practitioner, 6 visits to a chiropractor, or adding chiropractic care to general practitioner care was associated with slower recovery. "The results agree with our previous analysis in a cohort of patients compensated under a no-fault insurance scheme and support the hypothesis that the prognosis of whiplash injuries is influenced by the type and intensity of care received within the first month after injury," the authors state.

They note that effective care, if medically needed, improves the prognosis of patients and that practice guidelines recommend treatment shortly after the injury. However, it may be that doctors responding to pressure from patients use treatments, schedule follow-up visits and refer patients to specialists when not medically needed. "This in turn may lead to adverse outcomes and even prolong recovery by legitimizing patients’ fears and creating unnecessary anxiety," according to the authors. It is also possible that early aggressive treatment delays recovery by encouraging the use of passive coping strategies. "Reliance on frequent clinical care, a form of passive coping strategy, may have a negative effect on recovery by reinforcing the patients’ belief that whiplash injuries often lead to disability," the authors state. They cite another study that showed that whiplash patients who used coping strategies such as wishing for pain medication or believing that they couldn’t do anything to lessen the pain had a slower recover than those who did not use such strategies.

Unlike the previous study, the current one did not show a slower recovery for patients who consulted a general practitioner and a specialist. This suggests that the insurance system (tort versus no-fault) can affect the association between certain patterns of care and recovery because it may influence how patients perceive their medical needs, the pressure they put on clinicians to be referred, and how insurers require them to legitimize their injury. The authors conclude that further trials "are essential to understand the influence of health care provision in preventing or facilitating disability."