Decreasing Intradiscal Pressure in the Cervical and Lumbar Spine through Chiropractic- by The Evidence Based Chiropractor

Traction, as a treatment, has been used for centuries in an attempt to relieve radiculopathy and pain.  Seated, standing, supine, mechanical, manual; there are a vast variety of options when performing traction on a vertebral region.

Nearly every primary care physician and orthopedist refer daily to physical therapy for some form of traction.  They refer for traction because they are attempting to decrease intradiscal pressure.  What many of them don't know is that a chiropractic technique called flexion/distraction is a far superior treatment choice.  It is our responsibility, as chiropractors, to promote and emphasize the effectiveness and safety of this treatment.  

Over 65% of chiropractors report using flexion/distraction in their practice.  Research studies have proven that flexion/distraction of the cervical and lumbar spine decreases intradiscal pressure with clinical significance.  Decreased intradiscal pressure is thought to improve tissue flow gradients, alter nociception, and allow retraction of prolapsed disc material.  We have randomized controlled trials (RCT) which have demonstrated the effectiveness of flexion/distraction for treating radiculopathy.  Additionally, the traction which many physical therapists use is void of any localizing effect!  Essentially, a little bit of the force/traction is applied everywhere; whereas with chiropractic flexion/distraction, we are able to focus at individual vertebral levels with much greater specificity.  

The Evidence Based Chiropractor's February 2014 MD Research Brief is going to focus on a piece of research supports the specificity and effectiveness of chiropractic flexion/distraction.

Intradiscal Pressure Changes During Manual Cervical Distraction: A Cadaveric Study.  Evidence Based Complementary and Alternative Medicine. Volume 2013, Article ID 954134

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Back Pain and Narcotics - The Evidence Based Chiropractor

“A recent meta-analysis revealed that narcotics provide little to no benefit in acute back pain, they have no proved efficacy in chronic back pain, and 43% of patients have concurrent substance abuse disorders, with aberrant medication-taking disorders as high as 24% of cases of chronic back pain.” - Martel et al. 2007

So why are so many medications still prescribed for acute back pain?  Well, the truth is that primary care physicians have a limited skill set to deal with musculoskeletal complaints.  Add to this the constant marketing by pharmaceutical companies and the desire to "help" the patient through the acute pain; and you start to see the formula for ill advised treatment.

Evidence based management guidelines continue to support the use of chiropractic care for these patients.  However, the impetus is on us, as chiropractors, to get out and let our local physicians know about the research.  

Martell BA, O’Connor PG, Kerns RD, et al. Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction. Ann Intern Med. 2007;146(2):116-127

-The Evidence Based Chiropractor is the fastest growing chiropractic outreach group in the profession.  The service is dedicated to increasing chiropractic utilization by showcasing research.  Marketing to medical doctors through research is efficient, cost effective, and can dramatically improve your incoming referrals.  Join us.  Lets grow chiropractic together

Do I Need an MRI? by The Evidence Based Chiropractor

Many primary care doctors order MRI's immediately for patients with spine complaints.  Did you know that research suggests the patients should be evaluated by a non-surgical spine physician first?  For many local primary care doctors, we are that choice! 

    -The Evidence Based Chiropractor is the fastest growing chiropractic outreach group in the profession.  The service, founded and run by Dr. Jeff Langmaid, is dedicated to increasing chiropractic utilization by showcasing research.  Marketing to medical doctors through research is proven, cost effective, and can dramatically improve your incoming referrals.  Join us.  Lets grow chiropractic together

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SPINE Recommending Maintenance Adjustments for Prevention?

In what may become a "landmark" study in research related to the practice of chiropractic, SPINE Journal emphatically recommends that maintenance (at a frequency of 2x month) adjustments to the lumbar spine may prevent future episodes of lumbar spine pain.   

Pain (VAS Score) and disability (Oswestry) were reduced continually with the group receiving maintenance treatment.  In conclusion they found that "we suggest that maintained SM is beneficial to patients with chronic nonspecific LBP particularly those who gain improvement after initial intensive manipulation to maintain the improved post-treatment pain and disability levels."

When powerful research such as this is produced for prescription medications, the pharm reps are banging down the door of every medical practitioner in country.  However, aside from our promotion at The Evidence Based Chiropractor, I have not seen a single chiropractic organization mount a campaign which promotes this research to the public or to other medical providers.   

Facebook, Google, Health Fairs, etc can all be good marketing for your practice.  But do not neglect perhaps the most valuable outreach and referral generator of interdisciplinary referrals.  We, as chiropractors, have an abundance of high quality research which needs to be promoted and not left dormant!  This library of research will continue to build and it will be our task to make sure that others are aware of the value of our care.  

If you do not have the time or desire to produce research briefs for other physicians in your community, then join us today. 

Join us by January 31st to receive zip code exclusivity and a FREE 30 minute implementation call!

The study- http://www.ncbi.nlm.nih.gov/pubmed/21245790

The Evidence Based Chiropractor  is the fastest growing chiropractic marketing group in the profession.  The service, founded and run by Dr. Jeff Langmaid, is dedicated to increasing chiropractic utilization by showcasing research.  Marketing to medical doctors through research is proven, cost effective, and can dramatically improve your incoming referrals. Join us.  Lets grow chiropractic together
 

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Epidural Steroid Injections Increase Risk of Vertebral Fracture- A Review by The Evidence Based Chiropractor

Research recently came to light which shows an increased risk of vertebral fracture for patients whom had received lumbar epidural steroid injections.   

The study, which appears in the Journal of Bone & Joint Surgery, randomly selected 3,000 patients who had a lumbar epidural steroid injection and compared them to 3,000 patients who did not undergo the procedure. There were no significant differences between the groups regarding patient age, gender, corticosteroid use or hyperthyroidism, according to the study abstract.

Researchers found each successive injection increased fracture risk by a factor of 1.21. This is extremely important because many patients receive multiple ESI's (therefore increasing their risk of fracture).  

This article highlights why its imperative to be reaching out to MD's in your circle of practice on a monthly basis.  Referring doctors, and the public need to know when important research is released.  If you are not already reaching out to MD's through research, please JOIN US TODAY.  It has the potential to make a HUGE difference in your practice by dramatically increasing your incoming referrals.  Position yourself as the local expert in neuromusculoskeletal care.  Join the Evidence Based Chiropractor today and save 15% off of a year membership.  

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-The Evidence Based Chiropractor is the fastest growing chiropractic marketing group in the profession.  The service, founded and run by Dr. Jeff Langmaid, is dedicated to increasing chiropractic utilization by showcasing research.  Marketing to medical doctors through research is proven, cost effective, and can dramatically improve your incoming referrals.  Join us.  Lets grow chiropractic together. 

An article on the study- 

http://www.healio.com/orthopedics/spine/news/online/%7B1C49EE96-CE0C-4A3A-83F1-D4CDFCCA17BC%7D/Steroid-injection-linked-to-increased-risk-of-vertebral-body-fractures